Posts Tagged “Steroid Injections”

Localizing the Lesion

By | May 22, 2015

I have been meaning to do a blog on the value of physiologic testing for some time now and Tuesday the perfect patient walked into the Burbank office of Schlesinger Pain Centers. Marcy Peters (not her real name) is an 85-year-old woman whom I have been treating for radicular back pain and neck pain for […]

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In Search of the Best Pain Clinic in Los Angeles: Inversion Not Excision

By | November 30, 2012

The best pain clinic in LA would always be concerned with future problems, not just the complaint which brings the patient in today. In addition the best pain clinic in Los Angeles would always look for the best solution to a problem, not the easiest. Perhaps the best way to illustrate is point is with […]

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In Search of the Best Pain Clinic in Los Angeles: Clinical Presentation

By | November 7, 2012

I remember being told over and over again in medical school, that the history was the most important part of the diagnostic process and that if you didn’t have a list of reasonable diagnostic possibilities in mind by the time you were starting the physical exam and before ordering any lab tests, you were in […]

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Not Your Average Chronic Pain Patient: Bobby June Knowles

By | April 23, 2012

I would like to continue our “Not Your Average Chronic Pain Patient” series of articles on extraordinary patients and their exploits with a look at a woman with garden variety back pain (that is her back pain gets worse when she works too much in her garden). Bobby June Knowles (her real name) is just […]

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In Search of the Best Pain Clinic in LA: Steering Clear of Pill Mills, An Introduction

By | February 24, 2012

In our continuing search for the best pain clinic in LA we come to the fallacy of the one-dimensional pain clinic, in this case the “pill mill”. As we spoke of in our last blog, the last 30 years have seen the steady development of more sophisticated and comprehensive pain clinics. Unfortunately the recent economic […]

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Understanding Epidurals: Lumbar Transforaminal Injections

By | February 22, 2012

  As we have said before transforaminal lumbar epidural steroid injections (TF LESIs) appear to be more powerful in cases involving single level unilateral disc disease or foraminal stenosis. In cases where the compression is more diffuse transforaminal injections, because of their more limited spread will be less effective, although treatment with interlaminar lumbar epidural […]

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Interlaminar versus Transforaminal Injections

By | February 21, 2012

  There is a raging controversy in pain management circles about which injection is better, interlaminar lumbar epidural steroid injections (IL LESIs) or transforaminal lumbar epidural steroid injections (TF LESIs). Like most issues in chronic pain, the situation is not quite so simple. Each injection has its advantages and disadvantages and the choice of technique […]

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Efficacy of Epidural Steroid Injections in Axial Back Pain

By | February 20, 2012

Patients with axial back pain, in general respond less well to epidural steroid injections than do chronic pain patients with primarily radicular symptoms. Like patients with radicular back pain, many patients, those whose primary site of inflammation is intracanalicular, will feel better after an epidural injection of steroids. But for the 50% or more of […]

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Overall Efficacy of Epidural Steroid Injections

By | February 18, 2012

There are many who tout the value of lumbar epidural steroid injections in the treatment of low back pain and many who decry it. Large studies of LESIs have yielded contradictory results, largely because many of these studies mix chronic pain patients with different diagnoses, receiving different types of injections and often using different endpoints […]

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In Search of the Best Pain Clinic in LA: Acute Radicular Back Pain, Natural History

By | January 29, 2012

How the best pain clinic in Los Angeles treats acute radicular back pain can be most instructive.  As with so many other conditions treatment is based on a detailed knowledge of the natural history of the disease. We know that about 50% of all cases of acute lumbar radiculopathy will resolve with conservative treatment and […]

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