Dr. Tanuj Palvia
Sports Medicine is the study of the influence of exercise, training, and lack of exercise on the body. Sports Medicine specialists are concerned with the prevention and rehabilitation of sports-related injuries affecting muscles, ligaments, tendons, and bones. These specialists may also treat chronic illnesses or conditions that can affect physical performance.
Our physiatrist who is a board-certified Physical Medicine and Rehabilitation specialist works in conjunction with Physical Therapists, Chiropractors, Nutritionists, board-certified Anesthesiologists, and Interventional Pain Medicine Physicians to provide optimal care for each patient. Using state-of-the-art diagnostics, and imaging including x-ray, C-T scan, and /or MRI when necessary, our team of specialists develop personalized treatment plans designed to relieve, reduce, and manage pain, promoting an improvement in your condition and your overall quality of life.
Trigger Points are fibrous bands or “knots” of scar tissue that are felt over a muscle. When the layer of tissue overlying our muscles called the myofascia becomes injured or over used, the resulting scar tissue can be painful and refer pain to nearby areas of the body. An effective way to treat these trigger points is by receiving either ultrasound guided or unguided injections of simple sterile saline and a local anesthetic into the trigger point in order to break up the adhesion’s and relive the pain.
Epidural Steroid Injections are an effective method in treating pain caused by herniated or degenerated discs of the spine. When a disc becomes herniated it compresses the neighboring nerve, causing it to become inflamed. These nerves branch out and downward all the way to the toes and pain can be felt in the back, legs, and even the feet. During an Epidural Injection, fluoroscopy is used to precisely place the needle into the epidural space, which lies beyond the vertebrae, and deliver the medication. The medicine relieves the pressure on the nerves caused by the encroachment of the disc by reducing their inflammation.
Facet Joints are small joints all along either side of the spine that allow for the gliding of the individual bones during movement. Like all joints, facets are encapsulated. When the joint becomes damaged or irritated the capsule becomes inflamed, causing pain. Sometimes, this inflammatory process reaches the surrounding nerves. Facet Joint Injections are done under fluoroscopic guidance, administering anti-inflammatory medicine to help relieve the cause of pain. When the nerve is involved, the same methods of treating the fact joint can also treat its medial nerve.
The Sacroiliac Joints connect the sacrum and the hips. These joints act as a shock absorber and damage or dysfunction of the sacroiliac joints can mimic the pain caused by sciatic nerve injury or a herniated lumbar disc, which is why it is important to determine the true source of pain. These injections can be either diagnostic or therapeutic. An injection to the sacroiliac joint is done under fluoroscopic guidance, delivering anti-inflammatory medicine to the joint space to reduce the pain.
Joints are necessary for several functions of the musculoskeletal anatomy including smooth motion and shock absorption. There are multitudes of ways in which a joint can become injured or damaged, but if there is an injury, a joint injection can provide both short and longer term pain relief. Joint injections are given under either ultrasound imaging guidance or fluoroscopic guidance, depending on the location and size of the joint. Joint injections can treat acute or chronic inflammation in large joints like hips, shoulders and knees as well as intermediate and small joints like elbows, ankles, wrists and even the tiny joints of the fingers and toes.
The signal of pain that a nerve sends to the brain can be interrupted using anesthetics. Nerve blocks can be performed to manage acute pain of the extremities or headaches caused by occipital nerves as well as for diagnostic purposes such as a selective nerve root block, which can help determine a specific cause of pain in the spine. Nerve blocks are performed under ultrasound imaging guidance.
Radiofrequency Ablation is a procedure in which, under fluoroscopic guidance, a needle is placed near the targeted nerve and an electrode is passed through to stimulate the nerve. Once the targeted nerve is identified, a small current of radiofrequency is administered, which heats the nerve effectively disrupting its conduction. With the activity of the treated nerve now interrupted, the signal of pain is not produced. RFA can provide longer lasting relief when other more conservative methods have failed.
Spinal Cord Stimulation involves the implantation of a tiny, programmable generator, which is placed under the skin and emits electrical currents to the spinal column. Soft, thin wires with electrical leads on their tips are placed through a needle in the back near the spinal column under fluoroscopic guidance. In Spinal Cord Stimulation, the generator will then be programmed by the physician and adjusted as necessary to provide optimal pain relief. Patients will learn how to control the stimulation on their own and adjust it to their pain levels.
The major joints of the body (Hip, Shoulder, Knee) can become damaged, more specifically, the cartilage that overlies the bone. This is called osteoarthritis and can be caused by normal wear and tear, sports injuries or significant over use. The cartilage can begin to erode not only causing pain and inflammation but also compromising the health of the entire joint. One way to avoid surgical replacement of the joint is to try and maintain the health of the osteoarthritic joint with visco-supplemenation. A viscous material, usually hyaluronic acid, mimics the material found naturally inside the joint and helps to coat the cartilage. This allows the cartilage to glide more smoothly in instances where its surface is rough because of erosion.