Interventional Pain Medicine

510 Superior, Suite 290, Newport Beach, CA 92663

(949) 764-1411

About
Conditions Treated
Treatment Options
Meet the Team

Treatment Options

Treatment plans often include:

Spine Injections
Peripheral Nerve Blocks
Joint/Muscle Injections
Botulinum toxin (Botox) Injections for Chronic Migraine or Limb Spasticity
Medication Management
Pain Neuropsychology
Consultation with Spine Surgeons, Neurologists, and Rheumatologists as Needed
Physical/Aqua/Occupational Therapy
Referral to Chiropractic, Acupuncture, or Complementary Medicine
Advanced Pain Intervention

Spine and Nerve Blocks

Epidural Steroid Injection (Cervical/Thoracic/Lumbar)
Transforaminal Epidural/Selective Nerve Root Blocks
Occipital Nerve Blocks
Facet Joint Steroid Injections (Cervical/Thoracic/Lumbar)
Medial Branch Blocks (Cervical/Thoracic/Lumbar)
Sympathetic Blocks (Stellate Ganglion Blocks, Lumbar Sympathetic Blocks, Ganglion Impar Injections)
Interscalene Blocks
Intercostal Nerve Blocks
Ilioinguinal/Iliohypogastric Blocks
Piriformis Injections
Pudendal Nerve Blocks
Epidural Blood Patch

Joint and Muscle Injections

Shoulder Injections
Knee Injections (Steroid or Viscosupplementation/Gel Injections)
Hip Injections
Ankle Joint Injections
Trigger Finger Injections
Elbow Injections
Thumb Joint Injections
Trigger Point Injections: These injections in muscles are designed to help relieve pain associated with Myofascial Pain Syndrome, a condition in which regional muscle pain is experienced.

Advanced Pain Procedures

Spinal Cord Stimulation Trial/Implant: a technology in which a battery and one or more electric wires are implanted in the body. The wires are placed in the epidural space, near to the spinal cord. When activated, these wires carry electric impulses that can block or disrupt ordinary pain impulses via the Gate Control Theory. Patients may feel a tingling sensation when this device is on. Note: this is not the same as a TENS unit.
Peripheral Nerve Stimulation Trial/Implant: a technology in which an electric wire is implanted in the body. The wires are placed adjacent to peripheral nerves. When activated, these wires carry electric impulses that can block or disrupt ordinary pain impulses. Patients may feel a reduction in pain along the distribution of the peripheral nerve which can reduce pain along the knee, ankle/foot, shoulder, head/neck or lower back regions.
Radiofrequency Ablation/Neurotomy of Medial Branch (cervical/thoracic/lumbar): involves stunning and/or burning of small nerves that supply the facet joints of the spine. This procedure can provide 6-24 months of pain reduction if successful. The nerves that are burned in this procedure are expected to regrow with time and this procedure can be repeated.

The Chronic Pain & Neuropathy Program at Hoag focuses on a comprehensive approach to pain management, treating various types of chronic pain including chronic pain, back pain, cancer pain, orofacial pain and headaches.

Chronic Pain & Neuropathy Program

Chronic pain, one of the most common reasons adults seek medical care, is linked to numerous physical and medical conditions that negatively impact individuals, families and society as a whole. According to the Centers for Disease Control, more than 20 percent of Americans suffer from chronic pain, with some estimates being as high as 40 percent. Neuropathic or nerve pain, often described as a shooting or burning pain felt in the arms, legs, feet, hands or other areas of the body, is a common form of chronic pain affecting more than 10 percent of the U.S. population. The prevalence of chronic and neuropathic pain is rising due to the aging population as well as an increase in diabetes.

Chronic Pain

Chronic pain is long standing pain that persists beyond the usual recovery period or is related to a chronic health condition. It may affect people to the point that they can’t work, eat properly, take part in physical activity, or enjoy life, even impacting mental health. A multidisciplinary approach to pain management is often required to provide the needed interventions through the use of medication, procedures and attention to mood. Some common types of chronic pain treated are: Neck and back pain Joint pain (shoulder, hip, elbow, knee) Headaches Myofascial pain Muscle spasms Peripheral neuropathy Complex regional pain syndrome (CRPS) Cancer pain Arthritis Neuropathic pain (shingles, post herpetic neuralgia, trigeminal neuralgia) Postsurgical/postoperative pain

Peripheral Neuropathy

Damage to the peripheral nerves—those extending outside of the brain and spinal cord—is called peripheral neuropathy. It often causes weakness, numbness and pain, usually in the hands and feet. People with peripheral neuropathy generally describe the pain as stabbing, burning or tingling. Peripheral neuropathy can result from traumatic injuries, infections, metabolic problems, inherited causes and exposure to toxins. Some treatments for peripheral neuropathy include: Over-the-counter pain medications Prescription pain medication Topical treatments such as capsaicin cream and lidocaine patches Intravenous immune globulin and plasma exchange Physical therapy Spinal Cord Stimulation for pain relief

A Multidisciplinary Team

At the Hoag Chronic Pain & Neuropathy Program, we help reduce or eliminate the pain and improve our patients’ quality of life. Our team of experts provides a comprehensive and evidence-based approach to the evaluation and treatment of chronic pain and neuropathy. We collaborate with various specialists including physical/occupational therapists, acupuncturists, psychologists and surgical colleagues to offer the best treatment plan for our patients. These treatments include: Pain medicine Neurology Psychology and psychiatry Physical medicine and rehabilitation Physical and occupational therapy Medical devices

Doctor and patient using virtual reality

Our leadership team

Aaron Przybysz, MD, PhD

Medical Director for the Center for Pain Management, John L. Curci Family Endowed Chair in Pain Management

Kunal Sinha, MD

Pain Physician, Center for Pain Management

Tammy Chen, NP-C

Nurse Practioner, Center for Pain Management

Sarah Vargas, PA-C

Physician Assistant, Center for Pain Management

Mitch Fallon, PA-C

Physician Assistant, Center for Pain Management

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Pain Conditions

Acute/Chronic Pain

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Headache

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Trigeminal Neuralgia (TGN)

Often called tic douloureaux (French for “painful tic”), TN or TGN is an excruciatingly painful condition that affects one side of the face in the divisions of the fifth cranial (trigeminal) nerve.

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Pain Conditions

Hoag’s team consists of physicians, physician assistants, and nurse practitioners who have specialized training in pain management. They treat various types of chronic pain in both an outpatient and inpatient setting including:

Back and Neck pain due to injuries or degenerative arthritis
Lumbar and Cervical Radiculopathy (aka “Sciatica”)
Post-laminectomy syndrome (aka “Failed Back Surgery Syndrome”)
Cancer pain
Complex regional pain syndrome (aka “Reflex Sympathetic Dystrophy”)
Arthritis
Headaches
Orofacial Pain
Myofascial (Muscular) pain syndromes
Neuropathic pain including diabetic neuropathy and post shingle neuropathy
Lumbar Spinal Stenosis due to Ligamentum Flavum Hypertrophy
Coccydynia (tailbone pain)
Pelvic pain
Post traumatic or post surgical acute pain

If a full work-up of pain has not been performed, the team will refer for appropriate diagnostic procedures. The clinic has the capability to perform Nerve Conduction Studies/Electromyography to diagnose neuropathy or radiculopathy. Additionally there are diagnostic blocks which can help identify the source of pain in some cases. These include medial branch blocks and lateral branch blocks to diagnose facet and sacroiliac joint pain, respectively. Discography of the cervical or lumbar discs can be utilized to identify the most symptomatic disc and may help guide surgical intervention.

Hoag’s team employ a multi-disciplinary approach to complex chronic pain conditions since clinical studies have demonstrated that this approach is superior than any single modality.

Chronic Pain & Neuropathy

Meet Out Chronic Pain & Neuropathy Team

Yasir N. Jassam, MD

Multiple Sclerosis & Neuroimmunology Program Director, Neurology, Multiple Sclerosis, Neuroimmunology & Myeloneuropathy

C. Philip O'Carroll, MD

Program Director, Neurobehavioral Medicine Program at Hoag Pickup Family Neurosciences Institute

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Interventional Pain Medicine

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