2002 Orange Road #201
Culpeper, VA 22701
Tel: 540-423-6239
Thank you for considering us in the care of your patients. It is our job to exceed all expectations and to provide excellent care to those who seek our help. We also strive to provide outstanding customer service to our referring providers. If you ever feel we are not delivering on our promise to do so, please do let us know so we can immediately address and remedy the situation.
Also, if possible, please take the time to learn a bit more about us and read a brief background on what we can offer that may help your patients by clicking here.
We consider the optimal pain treatment to consist of a multidisciplinary team approach. Please read about our philosophy and goals for our patients by clicking here.
Brief Background
Due to the relatively recent birth of the specialty of Interventional Pain Medicine, many referring providers are not fully aware of the services we offer. In a nutshell, we manage all types of pain regardless of etiology and using a variety of methods. These methods include, although are not limited to
Epidural Steroid Injections
Anesthetic Peripheral Nerve Blocks
Joint Injections
Sympathetic Nerve Blocks
Trigger Point Injections
Spinal and Peripheral Nerve Stimulation
Kyphoplasty
Medication management
Ultrasound and X-ray guided injections
Radiofrequency lesioning of nerves innervating arthritic and painful joints
Physical and Occupational Therapy
Nearly all procedures are performed on an outpatient basis, saving substantial time and money for patients.
Pain symptoms are often complex and frequently multifactorial in nature. Diagnosing the exact cause of pain is difficult and typically requires a strong fund of anatomic knowledge, conducting a thorough history and physical examination, and reviewing imaging studies and the effects of diagnosing procedures. Based on our experience, we feel that all of these must be used together as individually, they are far less useful in helping to determine a correct diagnosis. For instance, imaging studies have a low accuracy for identifying sources of pain (e.g., MRIs of the lumbar spine have positive findings in the majority of asymptomatic individuals and negative findings in many patients suffering from low back pain) and physical exam findings can be equivocal. Nonetheless, correctly identifying the pain generator and recognizing and teasing out the varying factors contributing to the patient's symptoms are pivotal in developing the appropriate treatment plan. Without this, treatment may not be optimal. For example, a foot drop with associated pain symptoms may be caused by an entrapped nerve at the knee or at the nerve root level (radiculopathy). Without correctly diagnosing the location of the problem, treatments such as injections or surgery may be directed towards the wrong site. In addition, because pain receptors are ubiquitous throughout the body, pain can stem from almost any part of the body including soft tissues, joints, or from the nerves themselves. Each requires a different workup and a different approach to treatment. Top this off with the expanding problem of prescription drug abuse and you have a picture that can become very cloudy and complicated. Notwithstanding, it is our job to help you correctly identify the correct patient with the correct diagnosis for the correct treatment.
Please click here to view the goals we aim to achieve with our patients.
Our Patient Goals
The goal for all of our patients is five-fold:
1. Improve quality of life
2. Improve functional status
3. Improve ability to participate in activities of daily living
4. Avoid or wean from opioid analgesic medications
5. Avoid major surgical interventions unless absolutely indicated
This is what we strive for in each patient. The best way we can achieve this is for patients to come see us early in their pain process. The ideal time for a patient suffering from pain to visit us is prior to surgery and prior to being placed on prescription pain medications. It is much easier to prevent a patient from using opioid analgesics than it is to taper a patient off from them. Pain also tends to typically be easier to treat if we are able to see the patient prior to any procedures such as injections or surgery. While injections and surgeries are at times indicated for pain, they can at other times be counter-productive and exacerbate symptoms.
We understand that being able to see a patient early in his or her process will not always be possible and that many chronic pain patients have received multiple surgeries and are currently using prescription pain medications to provide relief. We are happy to help with these patients as well. Please keep in mind, however, that we cannot write for opioid analgesics during the first visit and there is no guarantee that prescription pain medications will be written for at subsequent visits. There are strict criteria in place for patients receiving prescription pain medications and when written for, must only be written for by one provider at a time.
Since the cause of pain tends to frequently be multidimensional in nature, we tend to follow a multidisciplinary team approach. A team consisting of us, you, physical and/or occupational therapy and others (when indicated) is what is often necessary. Our direct treatment and diagnostic options include the following:
1. Customized Rehabilitation Therapy
2. Electromyography and Nerve Conduction Studies
3. Optimizing Medication Management
4. Image-Guided Targeted Injections
5. Minimally Invasive Procedures
In order to facilitate this team environment, we will continuously keep you updated on the treatments we choose and on the progress of our patient. We programmed our EHR system to deliver our consult note to you quickly and you will receive it shortly after our patient is seen. We have found that communication between providers is an integral part of optimizing patient care and we promise to do our part to support this. If you ever need to contact us, we can be reached by phone 24 hours per day and are more than happy to receive your call.