The science behind your relief.

Radicular leg or arm pain · disc herniation · stenosis

Randomized data show meaningful short- and medium-term relief of radicular pain, often enough to participate in therapy and defer surgery.

Cohen SP, et al. Epidural steroid injections, conservative treatment, or combination treatment for cervical radicular pain: a multicenter, randomized, comparative-effectiveness study. Anesthesiology. 2014.

For you · If a pinched nerve is sending pain down your leg or arm, this reduces the inflammation faster than medication and therapy alone.

Axial neck and low back pain from facet arthritis

When diagnostic medial branch blocks confirm facet-mediated pain, radiofrequency ablation of those nerves produces significantly greater pain and function improvement than sham or conservative care, typically lasting 6–18 months.

Nath S, et al. Percutaneous lumbar zygapophysial (facet) joint neurotomy using radiofrequency current, in the management of chronic low back pain: a randomized double-blind trial. Spine. 2008. · van Kleef M, et al. Spine. 1999.

For you · We confirm the joint is the culprit with a test block first — so ablation is only offered to people it is likely to help, and it can be repeated when pain returns.

Vertebrogenic low back pain with Modic changes

A sham-controlled and an active-comparator randomized trial both showed large, durable improvements in disability and pain for chronic low back pain arising from the vertebral endplates, sustained at 2 and 5 years.

Fischgrund JS, et al. Intraosseous basivertebral nerve ablation for the treatment of chronic low back pain: a prospective randomized double-blind sham-controlled multi-center study. Eur Spine J. 2018.

For you · A specific kind of deep, aching low back pain that shows on MRI as endplate changes — often missed for years — has its own targeted, one-time procedure.

SI joint dysfunction · buttock and posterior pelvic pain

For confirmed SI joint pain, minimally invasive SI joint fusion outperformed non-surgical management in randomized trials; image-guided injections and lateral branch ablation serve both diagnostic and therapeutic roles.

Polly DW, et al. Randomized controlled trial of minimally invasive sacroiliac joint fusion using triangular titanium implants vs non-surgical management (INSITE): 12-month outcomes. Int J Spine Surg. 2016.

For you · Buttock pain misdiagnosed as “sciatica” for years is often the SI joint — and it has a defined treatment ladder.

Lumbar spinal stenosis with neurogenic claudication

Randomized and prospective comparative studies of the Superion interspinous spacer and of minimally invasive lumbar decompression show durable improvement in walking distance and leg symptoms in appropriately selected patients, without open surgery.

Patel VV, et al. Superion interspinous spacer versus X-STOP for moderate lumbar spinal stenosis: randomized controlled trial. Int J Spine Surg. 2015. · Staats PS, et al. MOTION study: MILD versus conventional medical management. Pain Pract. 2018.

For you · If you can only walk a short distance before your legs give out, there are options between injections and a laminectomy.

Chronic back and leg pain · post-laminectomy pain

A randomized trial found high-frequency (10 kHz) stimulation superior to traditional stimulation for both back and leg pain, with responder rates maintained at 24 months and no paresthesia.

Kapural L, et al. Comparison of 10-kHz high-frequency and traditional low-frequency spinal cord stimulation for the treatment of chronic back and leg pain: 24-month results from a multicenter, randomized, controlled pivotal trial. Neurosurgery. 2016.

For you · For pain that persists after back surgery — historically one of the hardest problems in medicine — this is among the best-supported options available.

Painful diabetic peripheral neuropathy of the feet

In a randomized trial against best conservative medical management, 10 kHz spinal cord stimulation produced substantially higher rates of significant pain relief, with improvements in sleep and quality of life sustained at 24 months.

Petersen EA, et al. Effect of high-frequency (10-kHz) spinal cord stimulation in patients with painful diabetic neuropathy: a randomized clinical trial. JAMA Neurol. 2021.

For you · Burning feet from diabetes that medications have not controlled is now a treatable target, not something to simply endure.

CRPS · causalgia · focal neuropathic pain of the limb

The ACCURATE randomized trial demonstrated higher treatment success with DRG stimulation than conventional spinal cord stimulation for CRPS and causalgia of the lower limb, with better pain-relief specificity.

Deer TR, et al. Dorsal root ganglion stimulation yielded higher treatment success rate for complex regional pain syndrome and causalgia at 3 and 12 months: a randomized comparative trial. Pain. 2017.

For you · For pain concentrated in one foot, knee, groin, or hand, this targets that exact territory instead of a broad region.

Shoulder, knee, foot, post-surgical and post-amputation pain

Prospective studies of temporary 60-day percutaneous systems report clinically meaningful relief that persists after the lead is removed, including in post-amputation and chronic shoulder pain.

Gilmore C, et al. Percutaneous 60-day peripheral nerve stimulation implant provides sustained relief of chronic pain following amputation: 12-month follow-up. Reg Anesth Pain Med. 2020.

For you · A temporary implant with nothing left behind — a low-commitment way to treat one stubborn area.

Refractory cancer pain · severe spasticity and non-cancer pain

A randomized trial in cancer pain found implantable intrathecal drug delivery achieved better pain control with fewer drug side effects than comprehensive medical management, and was associated with improved survival at six months.

Smith TJ, et al. Randomized clinical trial of an implantable drug delivery system compared with comprehensive medical management for refractory cancer pain. J Clin Oncol. 2002.

For you · Medication delivered directly to the spinal fluid works at a fraction of the oral dose — which means far less sedation, nausea, and fog.

Acute painful vertebral compression fracture

In a placebo-controlled randomized trial of acute severe osteoporotic fractures, vertebral augmentation produced significantly greater pain reduction than placebo; large registry and comparative data show reduced disability and, in some analyses, lower mortality versus non-surgical care.

Clark W, et al. Safety and efficacy of vertebroplasty for acute painful osteoporotic fractures (VAPOUR): a multicentre, randomised, double-blind, placebo-controlled trial. Lancet. 2016.

For you · For a fresh, severely painful spinal fracture, timing matters — treated early, this can shorten weeks of misery to days.

Lumbar spinal stenosis with ligamentum flavum hypertrophy · neurogenic claudication

A randomized controlled trial comparing MILD with epidural steroid injection found significantly greater improvement in function and pain at one year, sustained at two years in follow-up, with a safety profile comparable to injection and no reported device-related complications.

Staats PS, et al. MiDAS ENCORE: randomized controlled clinical trial report of 6-month results. Pain Physician. 2016; and Benyamin RM, et al. Pain Physician. 2016.

For you · If walking is limited by leg heaviness that eases when you lean forward, this can restore walking distance without an implant, general anesthesia, or a hospital stay.

Degenerative disc disease with disc height loss

Registry and prospective single-arm data report improvement in pain and function after intradiscal allograft supplementation. Randomized controlled evidence is not yet mature, and we say so before offering it.

Beall DP, et al. Viable disc tissue allograft supplementation: one- and two-year outcomes from a prospective multicenter study. Pain Physician. 2021.

For you · A newer option we will discuss honestly — including what is not yet proven — rather than sell.

Knee osteoarthritis pain · persistent post-replacement knee pain

Randomized trials show radiofrequency ablation of the genicular nerves produces greater pain relief and function than intra-articular steroid injection at 6 and 12 months in knee osteoarthritis.

Davis T, et al. Prospective, multicenter, randomized, crossover clinical trial comparing the safety and effectiveness of cooled radiofrequency ablation with corticosteroid injection in the management of knee pain from osteoarthritis. Reg Anesth Pain Med. 2018. · Choi WJ, et al. Pain. 2011.

For you · If you are not ready for a knee replacement — or had one and still hurt — the nerves carrying that pain can be treated directly.

Shoulder, hip, knee arthritis and bursitis

Ultrasound or fluoroscopic guidance improves injection accuracy and outcomes compared with landmark-guided injection; corticosteroid provides reliable short-term relief, and viscosupplementation offers modest benefit in knee osteoarthritis in selected patients.

Sibbitt WL, et al. Does sonographic needle guidance affect the clinical outcome of intraarticular injections? J Rheumatol. 2009.

For you · Where the needle goes matters. Guided injections hurt less, work more often, and tell us more about the diagnosis.

Knee osteoarthritis · tendinopathy

Meta-analyses of randomized trials in knee osteoarthritis show PRP superior to hyaluronic acid and saline for pain and function at 12 months. Evidence for other joints and for stem cell therapies is less consistent and still developing.

Dai WL, et al. Efficacy of platelet-rich plasma in the treatment of knee osteoarthritis: a meta-analysis of randomized controlled trials. Arthroscopy. 2017.

For you · Good support in the knee, thinner support elsewhere — and often not covered by insurance. We will tell you which category you are in.

Chronic migraine (15+ headache days per month) · muscle spasm

The pooled PREEMPT randomized program showed significant reductions in headache days and migraine days versus placebo, with sustained benefit over repeated cycles.

Dodick DW, et al. OnabotulinumtoxinA for treatment of chronic migraine: pooled results from the double-blind, randomized, placebo-controlled phases of the PREEMPT clinical program. Headache. 2010.

For you · If headaches take half your month, this is an FDA-approved, well-studied preventive — not a cosmetic add-on.

Pancreatic and upper abdominal cancer pain

A randomized double-blind trial found neurolytic celiac plexus block reduced pain more than systemic analgesic therapy alone in unresectable pancreatic cancer, with less opioid requirement.

Wong GY, et al. Effect of neurolytic celiac plexus block on pain relief, quality of life, and survival in patients with unresectable pancreatic cancer: a randomized controlled trial. JAMA. 2004.

For you · One procedure can meaningfully reduce both the pain and the medication load during cancer treatment.

Pelvic, rectal, perineal and tailbone pain

Prospective series demonstrate substantial pain reduction and decreased opioid use for cancer-related and chronic non-cancer pelvic pain, with a low complication profile.

Plancarte R, et al. Neurolytic superior hypogastric plexus block for chronic pelvic pain associated with cancer. Reg Anesth. 1997.

For you · Pelvic and tailbone pain that seems to have nowhere to go often has a specific nerve target.

CRPS · sympathetically maintained limb pain · vascular pain

Evidence is largely from prospective series rather than large randomized trials: blocks provide diagnostic information and can produce significant relief that enables aggressive physical therapy, which remains the cornerstone of CRPS recovery.

Harden RN, et al. Complex Regional Pain Syndrome: practical diagnostic and treatment guidelines, 5th edition. Pain Med. 2022.

For you · Used as part of a rehabilitation plan — the block opens a window; therapy is what makes the gain last.

Post-surgical and post-thoracotomy nerve pain

Diagnostic local anesthetic blocks reliably identify the culprit nerve; pulsed radiofrequency, cryoneurolysis, or targeted neurolysis of that nerve provides durable relief in prospective series.

Cohen SP, Mao J. Neuropathic pain: mechanisms and their clinical implications. BMJ. 2014.

For you · Pain along a surgical scar is usually one small injured nerve — identifiable, and treatable.

Occipital neuralgia · cervicogenic headache

Randomized and prospective data support significant short- to medium-term reduction in headache intensity and frequency, and the block usefully confirms the diagnosis before ablation is considered.

Naja Z, et al. Repetitive occipital nerve blockade for cervicogenic headache: expanded case series including 47 adults. Pain Pract. 2006.

For you · A headache that starts at the base of the skull is often a nerve — and a quick block both confirms and treats it.

Trigeminal neuralgia refractory to medication

Large long-term case series report high rates of initial pain relief with percutaneous radiofrequency rhizotomy, with predictable recurrence rates and the option of repeat treatment.

Kanpolat Y, et al. Percutaneous controlled radiofrequency trigeminal rhizotomy for the treatment of idiopathic trigeminal neuralgia: 25-year experience with 1600 patients. Neurosurgery. 2001.

For you · For electric-shock facial pain when medication fails or its side effects are intolerable, this is a well-established option.

Cluster headache · migraine · facial pain

Randomized and prospective studies of repetitive sphenopalatine ganglion blockade show reduced headache intensity and abortive benefit in selected patients, with minimal risk.

Cady R, et al. A double-blind, placebo-controlled study of repetitive transnasal sphenopalatine ganglion blockade with Tx360 for chronic migraine. Headache. 2015.

For you · A low-risk, in-office option that can be repeated — often used while a preventive medication or Botox cycle takes effect.