Hand, Arm, Chest & Shoulder Pain Management Our Philosophy Pain is a complex problem that requires treatment and management by a pain medicine specialist. Millions of people suffer from headaches and nerve pain at great personal cost. If you find that you cannot safely control your pain with over-the-counter medications, or have failed to find relief from other treatments or practitioners, you should consider consulting with our pain management physicians. For most patients, interventional pain management procedures can treat or reduce pain, allowing the patients to regain function, and thereby improving their quality of life. Hand, Arm, Chest & Shoulder Pain Conditions & Treatment Options CAUSE OF JOINT PAIN INTRA-ARTICULAR STEROID INJECTIONS HYALURONIC ACID INJECTIONS PLATELET RICH PLASMA INJECTIONS Joint pain is common, and it can be caused by osteoarthritis of aging, trauma, or inflammatory conditions like Rheumatoid arthritis. If you have tried hot and cold packs, physical therapy, and medications but find yourself still struggling with pain, it may be time to consider the next level of therapy with an image-guided joint injection. Peripheral Neuropathy Neuropathy is the medical term for nerve damage. A generalized type of neuropathy, known as polyneuropathy, is the most common type of peripheral neuropathy. Signs and symptoms of peripheral neuropathy include loss of sensation and/or burning pain in the hands or feet. Treatments for peripheral neuropathy are available and include several elements: diet and exercise, control of blood glucose levels for diabetics, prevention of injury, and control of painful symptoms. LEARN MORE ABOUT NEUROPATHY Intercostal Neuralgia/Chest wall pain Pain can come from the rib cage be coming from several sources. When pain arises from the nerves in the chest, it typically comes from the intercostal nerves. The intercostal nerves arise from the spinal cord and lie under the rib, along with the vein and artery. These nerves innervate the muscles of the rib cage and the skin and chest cavity. The intercostals nerves can be injured in from surgery or trauma, viral infections such as shingles, or idiopathic (no identifiable cause). Procedure The appropriate location in the rib cage is located under fluoroscopy (real time x-ray) in the procedural suite. An IV is usually placed and a light anesthetic (twilight) may be administered if needed beforehand. After sterile prep of the area, a small needle (25g) is advanced carefully to the inferior border of the rib under fluoroscopic guidance. The needle is then walked off the rib to lie immediately below the rib. The vein, artery, and nerve lie underneath the inferior portion of the rib. A small amount of contast material is then injected and the structures should be outlined. A small amount of local anesthetic and steroid is then injected into the space to block the nerve. This injection is both potentially diagnostic and therapeutic, in that if the pain resolves with the local anesthetic then we know the correct nerve was blocked. The steroid component may provide longer term relief. If the underlying condition does not improve over time with the assistance of this injection, then the pain may return. If the pain recurs, there are other procedures that can be considered for longer term relief such as a pulsed radiofrequency ablation of the nerve root or spinal cord stimulation or dorsal root ganglion stimulation to control the pain. The procedure is not relatively painful. There is a small risk of pneumothorax (puncture of the lung) with this procedure and systemic absorption of the local anesthetic, which is real and must be taken into consideration when deciding whether or not to proceed with the injection. SHOULDER & ARM RESOURCES SHOULDER & ARM RESOURCES SHOULDER & ARM RESOURCES WRIST & HAND RESOURCES WRIST & ARM RESOURCES TYPES OF PAIN Let's live pain free. Is Pain Management Right for You? Depending on many factors, such as the type of pain and your general health, there are numerous options for treating your pain. Some patients are surprised to learn that a treatment that previously failed to provide relief may be effective when combined with a multi-treatment approach. Our specialists treat complex pain issues. There are many different physical and neurological disorders that contribute to pain, and we treat all types of pain including: LEARN MORE ABOUT PAIN MANAGEMENT Practice Policies We are pleased you chose The Spine and Pain Institute of New York for the diagnosis, treatment and management of your pain. To acquaint you with our office policies, we provide the following information. PRIOR TO PROCEDURE FORMS *If your insurance requires a referral for a visit to a specialist, you must obtain this referral from your Primary Care Physician prior to your visit. INITIAL CONSULTATIONS Please bring the following relevant information to your consultation. Photo ID Insurance Information Referral* Diagnostic Studies & Reports (MRI/X-Rays) List of Medications INSURANCE & BILLING We accept most insurance programs and their subsidiaries. If we do not participate in your insurance plan, please contact Billing to find out if other arrangements are possible. Text us via Klara using the messaging option to the bottom right of this page! Just detail your concern or question, and a member of the team will reply via return text message or phone call. Insurance co-payments are due at the time of arrival. We accept cash, checks and credit cards. APPOINTMENTS If you are a new patient, please arrive 15 minutes prior to your appointment to allow time to register. If you are running late or need to reschedule, please contact us as soon as possible to make us aware. Unfortunately, if you are more than 30 minutes late for your appointment time, we will have to reschedule. PROCEDURES If you are scheduled for a procedure or plan on having one in the future, please read the attached important instructions to follow prior to a procedure.You will be called prior to your procedure and notified about the following information as well. MEDICATIONS & REFILL REQUESTS Please discuss your medication needs, including refill requests, with your provider at the time of your appointment. Medications should be taken only as prescribed. Please do not request early refills of your medications. Patients are responsible for lost or stolen medications and prescriptions once they leave the office. AFTER HOURS EMERGENCIES Our regular phone lines are transferred to an answering service after normal business hours. Please proceed to the nearest emergency room for after-hours emergencies. MANHATTAN 860 Fifth Ave New York, NY 10065 212.724.7246 NEW JERSEY 1 Bay Ave. 2nd Fl. Suite 1 Montclair, NJ 07042 718.667.3577 STATEN ISLAND 1360 Hylan Blvd. Staten Island, NY 10305 718.667.3577 STATEN ISLAND 1534 Victory Blvd. Staten Island, NY 10314 718.667.3577 BROOKLYN 1513 Voorhies Ave. Brooklyn, NY 11235 718.427.2110 DOWNTOWN BROOKLYN 188 Montague St. 3rd Fl. Brooklyn, NY 11201 718.667.3577 BRONX 2932 Wilkinson Ave. Bronx, NY 10461 718.667.3577 LONG ISLAND 1 Hollow Ln. #102 New Hyde Park, NY 11042 516.587.5500 Copyright © 2021 Spine & Pain Institute Of New York | Site By Industry Media