Opinion ID: 4517908
Heading Depth: 4
Heading Rank: 1

Heading: Javery Pain Institute

Text: The first series of records comes from the Javery Pain Institute, where Emard received treatment for low-back and neck pain from August 2012 to July 2013. Emard was initially seen for a pain-management consultation by Aaron Greene, a Physician Assistant. Greene’s notes describe a magnetic-resonance-imaging (MRI) exam showing two small herniations of Emard’s spine. But Emard’s spinal range of motion was described as normal at the time of his first visit. Emard, who returned to the Javery Pain Institute nine times over the following year, was seen for a range of follow-up treatments. He received a cervical medial-branch block and a lumbar steroid injection, both of which he described as “very effective” in treating his pain. Emard was also treated with cervical radiofrequency ablation, an intervention that he described as a somewhat-effective pain treatment. In another visit, Dr. Christopher Russo, a physician at the Institute, met with Emard for pain-medication review. Dr. Russo also routinely saw Emard to review his treatment plan and perform physical exams. Emard initially told Dr. Russo that his back pain was the same since his first visit to the Institute. Toward the end of his appointments with Dr. Russo, however, Emard reported that his pain was becoming more controlled. Dr. Russo’s physical exams of Emard also consistently No. 19-1591 Emard v. Comm’r of Soc. Sec. Page 3 showed a normal spinal range of motion. Indeed, with the exception of several positive painassessment tests and reports by Emard of tenderness in the spinal area, Dr. Russo’s physical exams were normal. Emard’s mood was likewise described as normal during each visit.