Medical Consultation

Our patient delivers a written history, pre-existing medical records, as well as existing outside X-Rays or other tests.  We interview and physically examine the patient, and then order additional tests as appropriate.  We formulate a diagnosis or a working diagnosis.  We recommend treatment based on our patient’s condition and plans.

Clinical follow-up

The patient returns for re-evaluation.  We evaluate how well the patient followed the plan, and how well the plan worked.  Thereafter, we reformulate a new or modified plan, if needed, or continue the previous treatment.

Physical Management Programs

Patients are instructed in optimum postures for different physical tasks, and regarding which postures and activities to avoid.  Patients receive progressive flexibility and conditioning exercises to enhance body physical capability and to prevent re-injury.

Medication Prescriptions

Medications are individually tailored to the types of symptoms experienced, and their severity.  Our service is willing to work with more aggressive medication requirements than the average physician, although we will generally steer away from shorter acting opioids and rely instead on the non-exhilarating and less habit-forming long acting opioids.  Muscle tension versus burning versus sharp pains may each respond best to their own specific appropriate medication classes. 

Provision of braces, supports, or mobility aids

Our Rehabilitation background is a great help in assessment of potentially beneficial braces and postural aids.  Coordinated assessments of mobility problems with Physical Therapists, or self-care problems with Occupations Therapists may help you establish exercise programs, new techniques of performing daily tasks, or devices that may ease physical stress from your daily activities.

Activity Release or Restriction

An adequately detailed work release may prevent further injury, as well as guide your employer to redesign work to fit your limitations.

Functional Evaluation

An adequately detailed work release may prevent further injury, as well as guide your employer to redesign work to fit your limitations.

Filling out patient disability forms

Someone has to do it.  Some forms will require an additional fee.  Also, we can’t just sign anything – patients do not always qualify for the benefits they seek.  We’ll try to explain why, if that is the case.

Work Comp Primary Treatment and Management

We’re pretty good at this, in a California system that is increasingly harsh to the injured worker.  We can’t make the insurance companies cooperate, but we’ll express what we are requesting and why, and gladly give you copies of our records, so that you’ll have documentation, if you want to protest a rejection of requested medical treatments.

Electrodiagnosis EMG/NCS

Electrodiagnostic testing includes EMG (electromyography), where a thin needle is inserted into various muscles, each supplied by different nerves and/or nerve roots, to help us search for signs of nerve or muscle injury or disease.  NCS, or NCVs (nerve conduction studies/velocities) measure speed and strength of nerve conduction, to look for signs of nerve disease, irritation, or entrapment.  We offer mild conscious sedation for this procedure, which many patients find quite uncomfortable.  

Injection Diagnostics and/or therapies

Injections into joints, or around nerves of the limbs and spine are our specialty.  Many injections utilize fluoroscopic (live x-ray imaging) guidance for safety and accuracy.  Some injections are to diagnose the source and/or type of pain, others are more for therapy, and some are for both.  We perform cervical (neck), thoracic (chest), lumbar (low back) injections, including epidural paramedian or selective, facet (intra-joint or medial branch), or sympathetic (stellate, lumbar plexus, etc.), as well as lumbar discography, IDET, and radiofrequency procedures.  Peripheral joint injections are in some cases performed under fluoroscopy, and include the steroid/anesthetic variety, as well as Synvisc injections for knee degeneration.