Surgical & Interventional Pain Management

The physicians and staff at The Center for Pain Management at the Neurological Institute of New Jersey are dedicated to providing patients with relief from chronic and persistent pain.  Our medical team is lead by neurosurgeon Dr. Ira M. Goldstein, and anesthesiologists Andrew Kaufman, MD and Anthony Sifonios, MD. We offer a comprehensive, multidisciplinary approach to pain relief and rehabilitation therapies coordinated to manage chronic, cancer, and spinal pain syndromes. We also perform spinal cord stimulation for treating patients with failed back syndrome, radicular pain syndrome, post-laminectomy pain, peripheral neuropathy and complex regional pain syndrome.

Services at The Center are provided by physicians who are board certified and have specialized training in pain management. We provide care for and specialize in:

  • Neck & back pain
  • Headache & facial pain
  • Pelvic pain
  • Arthritis pain
  • Shingles pain
  • Post-accident pain
  • Sports injury pain
  • Post-surgical pain
  • Cancer pain
  • Abdominal pain
  • Fibromyalgia
  • CRPS (Complex Regional Pain Syndrome)

Procedures Available (Most procedures are performed under fluoroscopic guidance):

  • Epidural Steroid Injection
  • Facet Joint Injection
  • Sacroiliac Joint Injection
  • Stellate Ganglion Block , Lumbar Sympathetic Nerve Blocks, Celiac Plexus Blocks
  • Medial Branch Block  & Lateral Branch Blocks
  • Selective Nerve Root Block
  • Radiofrequency Neurolysis
  • Trigger Point Injection
  • Discogram (Diagnostic)
  • Spinal Cord Stimulators
  • Intrathecal Medication Pumps
  • Percutaneous Disc Decompressions & Minimally Invasive Lumbar Decompressions

Epidural Steroid Injection - Epidural injection is perhaps the single most useful intervention for chronic pain available at The Center for Surgery. The epidural space allows unique access to the spinal cord and nerve roots at every level of the spine. Epidural injections provide a safe, low-risk, nearly painless means of delivering a variety of medications directly to the nervous system. Once delivered into the epidural space, these medications may block pain impulses, stabilize irritated nerve structures, reduce inflammation and swelling, and reverse the biochemical changes that are known to occur within the nervous system when pain persists.

Selective Nerve Root Block - A selective nerve root block is an injection placed into the sheath surrounding a nerve root in the spine. The exam uses therapeutic steroid and local anesthetic to decrease pain and inflammation. Pain relief from the procedure varies from minimal to long-term, depending on the specific symptoms.

Facet Joint Injection - Facet joints are numerous, with two at each spinal level. These small, delicate joints provide stability and help guide motion. They are prone to injury, deterioration, and inflammation, and they sometimes become sources for chronic neck and back pain. A cervical (neck), thoracic (upper back), or lumbar (lower back) facet joint injection involves injecting an anti-inflammatory medication, such as a steroid, and local anesthetic, which can numb the facet joints, decrease inflammation and block the pain. If multiple levels of pain exist at multiple facets, several injections can be performed to pinpoint the source of pain in each location

Sacroiliac Joint Injection - A sacroiliac injection places local numbing and steroid medication in the sacroiliac joint (the lower region of your back and buttocks), where your pelvis joins the spine. Once those joints become irritated, they may cause pain in the lower back, buttocks, abdomen, groin, or legs. Cortisone (a steroid) will help to reduce the inflammation that may exist within the joint, thus offering relief from pain.

Stellate Ganglion Block - A Stellate Ganglion block is a procedure that involves placing local anesthetic on the nerve ganglion in the neck. The block from the anesthetic increases the blood flow to the arms and hands and decreases excessive nerve firing and is useful in treating pain in the head, neck, arms, or hands.

Medial Branch Block - Medial Branch Blocks are used as a diagnostic tool and usually give temporary relief of pain symptoms. Medial branch nerves are small nerves that supply from the facet joints in the spine and carry pain signals from those joints. Facet joint injections are often used to identify a pain source; however, these injections do not always provide lasting pain relief. In such cases, it is beneficial to confirm that the facet joint is the source of a patient's pain. A medial branch nerve block temporarily interrupts the pain signal being carried by the medial branch nerves that supply a specific facet joint. If the patient has the appropriate duration of pain relief after the medial branch nerve block, that individual may be a candidate for radiofrequency neurolysis.

Peripheral Nerve Block - Injury or damage to peripheral nerves can result in neuralgia, neuritis, and certain neuropathic pain "states" implying that pain is emanating from damaged nerves that are sending inappropriate pain impulses in the absence of an underlying tissue injury. Identification of a damaged peripheral nerve as the source for ongoing pain is possible using nerve block techniques.

Radiofrequency Neurolysis - In modern medical practice, radiofrequency nerve ablation is a useful treatment option for certain types of chronic pain including head and neck pain from whiplash injury, chronic lumbar facet joint pain, and certain types of neuralgia. Diagnostic nerve blocks are routinely performed as a screening test before nerve ablation by radiofrequency is considered. Radiofrequency neurolysis can be performed as an outpatient procedure.

Trigger Point Injection - Trigger points are tender areas within skeletal muscle that may result from primary abnormality of the muscle itself, or as a secondary phenomenon when nerves that supply muscles become irritated. Pain from trigger points may be mild or severe. When trigger point pain is severe and refractory to conservative measures, trigger points may be injected with steroids and local anesthetic using tiny needles of variable lengths placed through the skin and into the substance of the muscle. Five to ten trigger points may be injected in one session. Many patients respond with long lasting benefits from a single session of trigger point injections.

Discogram - Lumbar or cervical discogram is a pre-surgical diagnostic study used to determine if your pain is generated by a disc. The study is designed to provide a pain "road map" and can help your doctor decide whether or not surgery is necessary. You will be given light sedation and x-ray guidance will be used to assure accurate placement of the needle. After proper placement has been established, x-ray contrast is injected into the disc. The pressure in the disc is monitored and recorded during the injection. A report will be sent to your physician as soon as possible and a recommended course of treatment will be decided by your referring physician.

If you or someone you know has persistent pain, the medical and health care professionals at The Center for Pain Management may be able to help.