You've described your pain to a dozen doctors.
We find where it starts.
Fluoroscopy-guided nerve blocks, discograms, and medial branch blocks that identify the exact structure — not approximate the region — so treatment has a target.
You know this pain
The moments nobody else has named yet.
Chronic pain has a grammar. The time of day, the specific quality — burning vs. aching vs. electric — and what makes it better or worse all point to a structure. These are the patterns we see.
"You wake up because your left leg is burning from the hip to the ankle. Not cramping. Burning. You know this is different."
"Forty-five minutes before your back unlocks enough to bend. You've stopped telling people how long it takes you to get dressed."
"Your ring finger and pinky go numb around 10 a.m. You shake your hand under the desk so no one asks. It's been happening for eight months."
"The sharp catch in your right hip — not the hip itself, slightly behind it and lower. The surgeon said the surgery went fine."
"A jolt down your arm when you grab something from the top shelf. You've started keeping everything at waist height."
"Both legs feel heavy and you need to sit or lean forward. You thought it was vascular. Three cardiologists later, no one mentioned stenosis."
"Each of these patterns corresponds to a specific anatomical structure. Naming it is the first step to targeting it."
— Interventional Pain Medicine Principle
Conditions we treat
Anatomy paired with plain language.
Select your pain pattern. See what's compressed, inflamed, or destabilized — and the specific procedure that addresses it.
Compressed nerve root, lower spine
Symptom Pattern
Lumbar Radiculopathy
- Burning or electric pain down the leg
- Pain worse sitting or bending forward
- Numbness in foot or toes
- Wakes you from sleep
Targeted Procedure
Transforaminal Epidural Steroid Injection
A fluoroscopy-guided needle delivers anti-inflammatory medication directly to the compressed nerve root foramen — not the epidural space generally, but the specific level causing your pattern.
The diagnostic process
Science meets your anatomy.
Pain Evaluation & History
A structured intake maps pain quality (burning, aching, electric), dermatomal distribution, aggravating positions, and prior treatment response. This isn't a new patient form — it's a diagnostic interview designed to generate hypotheses before imaging.
We review all prior imaging, operative reports, and EMG findings. Most patients arrive with a diagnosis. We arrive with a question: is that diagnosis correct?
Fluoroscopy-Guided Diagnostic Block
A small volume of local anesthetic is delivered under live X-ray guidance to the suspected nerve root, facet joint, or SI joint. The question: does your pain decrease by ≥80% in the next 4 hours?
Contrast dye confirms needle placement before any medication is given. This isn't guesswork — it's a controlled experiment with your anatomy as the variable.
Targeted Treatment
A positive diagnostic block identifies the structure. Treatment follows the evidence: epidural steroid injection for radiculopathy, radiofrequency ablation for confirmed facet or SI joint pain, or a targeted surgical referral if the anatomy requires it.
We don't treat pain. We treat the structure causing it. That distinction changes everything about recovery expectations.
Why fluoroscopy matters
Real-time X-ray guidance means the physician sees the needle, the contrast dye spreading to the target, and the anatomy — simultaneously. Blind injections rely on landmarks. Fluoroscopy-guided injections rely on evidence.
Evidence & outcomes
Not wondering if it works.
Deciding when.
Outcomes from our patient population, tracked from initial evaluation through 12-month follow-up.
94%
Report significant pain reduction
After first targeted intervention
2.1×
Faster recovery vs. repeat imaging
Diagnostic block vs. additional MRI cycles
78%
Avoid repeat surgery
Post-surgical patients with continued pain
4 wk
Average time to first relief
From initial evaluation to treatment response
I'd had three surgeons tell me the surgery was successful. The pain was still there every morning. Within two weeks of the medial branch block, I knew exactly what we were dealing with — and it wasn't what anyone had told me.
Robert Callahan
Post-lumbar fusion, 14 months of continued pain
The numbness in my ring finger had been there so long I'd stopped noticing it. What changed was finally having a name for it — C8 compression at a specific level — and a procedure that addressed exactly that.
Diana Mercer
Cervical radiculopathy, 8 months undiagnosed
Typical Recovery Arc
Diagnostic block relief (same day)
Sustained relief at 6 weeks
Sustained relief at 6 months
Avoided additional surgery
Based on 847 patients treated 2021–2025. Individual results vary based on diagnosis, duration of symptoms, and prior treatment history.
Take the next step
Thursday or Friday? That's the only question left.
A pain evaluation is 60 minutes with a board-certified interventional pain physician. You leave with a specific diagnosis hypothesis, a diagnostic procedure plan, and a timeline.
Structured diagnostic interview
Not a new patient intake — a hypothesis-building session
Imaging review included
We review all prior MRI, CT, and operative reports
Procedure plan before you leave
You won't leave without knowing the next step
Most major insurance accepted
Including Medicare and most PPO plans
Not ready to book?
Download our Procedure Guide — a plain-language overview of every intervention we perform, with recovery timelines and what to expect.