The Center for Spine, Sports, Pain,
Management, and Orthopedic Regenerative Medicine
Management, and Orthopedic Regenerative Medicine
TREATMENT & THERAPIES
IMAGES OF PROCEDURES
Trigger Point Injection
Radiofrequency Neurolysis
Joint Injections
Treatment Methods (at a glance):
- Acupuncture
- Botox Injections
- Costovertebral Joint Injections
- Discograms
- Intradiscal Electro Thermocoagulation (IDET)
- Intradiscal Restoration Procedures
- Laser Therapy
- Manipulation and Manual Medicine
- Mesotherapy
- Minimally Invasive Spinal Surgical Techniques
- Nerve Blocks
- Occupational & Physical Therapy
- Radiofrequency Neurolysis
- Regeneration Injection Therapy (RIT)
- Sacroiliac joint Injections
- Selective Nerve Blocks
- Spinal Cord Stimulation
- Thoracic Epidural Injections
- Vitamin and Nutritional Guidance
- Acupuncture
This is a technique where we place a fine needle into acupuncture points used to block pain or change energy flow throughout the body where there are blocked meridians. It has been demonstrated that electric currents travel thru the facial planes of the body and makes contact with the skin thru acupuncture points where there is a connection of veins, nerves and arterioles on the surface and on a deeper level these meridians connect with organs and other structures. Every cell and organ has a positive and a negative polarity which is necessary to maintain integrity and function.
When these meridians are blocked by trauma, or illness a chain reaction can occur and these energy channels become blocked where the energy flow to the organ system can be affected further. To restore health acupuncture tries to normalize this energy flow. It is not my belief that Acupuncture cures the dysfunction, but that it gives a "tune up" to the body which allows the immune system and organ system to work more efficiently to allow the body to heal itself more efficiently.
return to top - Botox Injections
Botulinium toxin is used in medicine to relieve pain, get rid of wrinkles as a cosmetic use and to relax chronic muscle spasm. It has proven to be a safe procedure. It works by permanently binding to the receptors that carry nerve conduction to the muscle. Thus they block the nerve causing a relaxation of the muscle. Since nerves tend to grow back the beneficial effect can last up to 6 months.
We use it for chronic neck or back spasms, writer's cramp, piriformis syndrome where the sciatic nerve is trapped in the buttock muscles, RSD pain, chronic nerve pain affecting the skin area, and muscle tension or migraine headaches. We also use it to reduce spasticity in patients that have abnormal muscle tone after a stroke or spinal cord injury or multiple sclerosis. Yes we also use it for reducing facial wrinkles. When we inject Botox we often use nerve conduction, EMG, Ultrasound or fluoroscopic guidance for added accuracy of placement in the muscle or adjacent to the nerve. Since Botox pound for pound is one of the most expensive substances on earth we do not want to waste any in the wrong locations.
return to top - Costovertebral Joint Injections
The small joints connecting the ribs to the sternum in the front or spinal column in the back can be a source of pain which is sometimes confused for a heart attack in the chest area or feel like a knife is stuck in the back. With fluoroscopically guided injections with a variety of medications we can alleviate this pain.
return to top - Thoratic Epidural Injections
These are specialized injections of anesthetic and cortisone used to reduce nerve pain or pain from a painful disc. Pain relieving medication can be delivered directly to the site of injury to provide rapid relief in either the neck, mid, or lower back. Dr. Magaziner is able to do this thru a variety of methods to better target the individual problem. When necessary he can pass a very fine catheter into the spine and steer it to the site of injury for pin point precision.
return to top - Selective Nerve Blocks
both peripheral and spinal, selective joint, muscle, ligament or tendon injections. These are often performed using either real time ultrasound or fluoroscopy for accuracy.
return to top - Discograms
This is a test to answer the questions where MRI falls short. It is an anatomic and functional test. The Disc in the spine can cause low back or leg pain. With this test we put a very fine needle into the center of the disc and we measure the pressure and test it to not only look for a cause of pain but also to look for tears, cracks and herniations in the disc not visible with MRI scanning
return to top - Intradiscal Electro Thermocoagulation (IDET)
Sometimes a painful disc is not herniated but merely torn on the inside. There are tiny nerves inside which can cause chronic back or leg pain. Only the discogram can make this diagnosis. To treat this we can place a coiled wire into the disc and heat it to a critical temperature which can cauterize the painful nerve endings and provide pain relief.
return to top - Intradiscal Restoration Procedures
This is an exciting new area. Rather than remove a painful disc sometimes you can inject the disc with medications to repair the disc or deaden the nerves causing pain inside the disc. Richard Derby, a well known spinal researcher from California, perfected this technique.
The International Spinal Injection Society has reported the research in this area and Dr. Magaziner has added this to his armamentarium. In the future we will be adding new medications which carry growth factors and stem cells to repair and regenerate the disc. This research is ongoing.
return to top - Laser Therapy
Lasers have been used in medicine for years. Depending on the power and wavelength of light used they can either be used for healing, cutting or destruction of tissue. Dermatologists use one type to get rid of acne and another type to provide skin rejuvenation which causes new collagen growth. Others are used for hair growth. Its beneficial effect is indisputable. We use the latest generation IV laser device which is the most powerful laser for healing available.
It is not to be confused with the cold laser. The Avicenna laser is almost 100 times more powerful than the older cold or generation III lasers and is much more effective. The penetration is up to 6 inches which allows the healing laser light to be able to penetrate deep into joints or the discs of the spine. They can be used to get rid of pain from arthritis and provide regeneration of tissue, tendons, ligaments and cartilage. Photons of light penetrate deep into the cells and accelerate cellular reproduction, metabolic processes and growth.
It increases fibroblast and collagen formation. It promotes new blood vessel formation and angiogenesis. It blocks pain by reducing inflammation and blocking nerve sensitivity and promotes new growth. It has a direct effect on immunity by boosting immunoglobulins. What it does in effect is speed up the cells natural healing process. I have seen wounds heal in half the time. Many of the professional sports teams keep one or two of these lasers in their training room for healing injuries faster.
return to top - Manipulation and Manual Medicine
A joint can be either loose or hypermobile, normal,or stif also known as hypomobile. Either extremes can be painful. For hypermobile problems we use the regeneration therapies. For a stuck or hypomobile joint you need to stretch it or manipulate it to normalize function.
return to top - Mesotherapy
This is a medical treatment discovered in France over 50 years ago now widely practiced around the world. Dr. Magaziner was one of the first 20 physicians trained in this technique in the US by Dr. Lionell Bisson who brought this treatment over from Europe and was one of the first to be Board Certified. He is one of the founding members of the American Board of Mesotherapy and was one of the first in NJ to perform this technique.
This treatment can be used for pain management or for cosmetic purposes to get rid of fat and cellulite or provide skin tightening. It was discovered that the skin had what is called a redundant circulation such that if we inject medications under the skin it will sit there for up to 7 days to provide a prolonged effect. It is like a skin patch only more powerful. Depending on the type of medication used we can reduce nerve or joint pain, or melt fat and cellulite, or nourish the skin with vitamins to cause skin tightening and rejuvenation. - Minimally Invasive Spinal Surgical Techniques
Unlike open spine surgery which requires an incision, removal of bone and frequently a hospitalization, new technological advances have miniaturized the tools needed for spine surgery. Now, trained pain management physicians are performing these procedures. There are 4 methods of removing a disc herniation. " Nucleoplasty", uses a special wand which carries electrical energy into the disc creating a plasma field which melts the disc which contacts the wand turning it into a gas thus removing or decompressing the disc.
The" Dekompressor" is a device which drills into the disc grabbing disc material along the way and removing it thru repeated entries. "Hydrocision", also known as Hydrodiscectomy, uses a high pressure water jet which cuts thru the disc and then sucks out the disc fragments thru a suction port. In effect, vacuuming out the disc. All of these procedures are done under real time fluoroscopic guidance using a 360*view into the spine. The newest technique is called Laser Assisted Endoscopic Discectomy. This technique is similar to Arthroscopy of the knee only the tools have been miniaturized to be used in the spine. The spinal scope, which has a working channel, is placed into the disc and is attached to a large video monitor allowing us to look inside the disc on the big screen. Thru this can we place either a laser, or radiofrequency heating device to vaporize it or we use a grabbing device to pull out the disc. You have the added advantage of being able to remove scar tissue and disc pressing on the nerve and remove bone spurs in the way if they are narrowing the canal where the nerve passes.
This is the future of spine surgery, and when Dr. Magaziner performs this technique he has a spine surgeon he works together with. In his team he also uses another physician or technologist who performs real time spinal electophysiologic monitoring for added safety. All of these procedures are done as same day surgery at the Middlesex Surgical Center, and you get to go home afterwards. Typically, you are back to work in 1-2 weeks.
return to top - Nerve Blocks
Not all pain is of spinal origin. When a peripheral nerve is injured often we need to do a nerve block with an anesthetic and anti-inflammatory to block the pain and reduce the pain cycle.This is usually done with ultrasound, fluoroscopic or electromyographic guidance for safety and accuracy. Often we can pin point where the problem is and direct treatments to the region to ameliorate the problem.
return to top - Physical and Occupational Therapy
Lack of exercise, poor posture, and structural faults can lead to injury and pain problems. Conversely, when your in pain its hard to exercise and reverse the problem. Our goal is to reduce or eliminate the pain. . We work closely with the best therapists in the area and design therapy programs targeted to get people back on the road towards functional restoration.
return to top - Radiofrequency Neurolysis
This technique uses a special needle which can be heated to a precise temperature placed adjacent to the nerve going to the facet joint in the spine used to cauterize it and alleviate pain for up to 24months.
return to top - Regeneration Injection Therapy (RIT)
also known as Prolotherapy (Prolo) also uses growth factor technology and science to heal soft issue injuries and arthritis pain. With this treatment we use medications which stimulate the injured tissue creating a local inflammation which attracts the growth factors like a magnet to the site setting in motion the bodies normal repair process. Healing usually occurs in 5-7 monthly sessions.
How does this work many people ask. Well, the body has the capacity to heal itself. It does it every day. When we cut our skin it heals. When we break a bone it heals. If we sprain our ankle it heals. If we go for surgery the body heals itself if the surgeon just lines up the tissue with some stitches. For healing to occur we must create some positive local inflammation which wakes up or sets in motion the body's normal healing process.
This principle is also used in other areas of medicine as well. For example, how is it possible if you go to the Dermatologist for a laser peel or a chemical peel where they burn your face or even dermabrasion with sandblasting of the skin that the body responds underneath by growing new healthy looking skin? Well, we know and it is proven, like Prolotherapy, that it causes a local controlled inflammation which releases and attracts growth factors to the area to create new collagen growth and new skin. Skin and tissue biopsies and have proven this.
This treatment is also performed using ultrasound or fluoroscopically guided injections to the injured site. It can be used for any type of joint, tendon, ligament, back or neck problem, the achy back syndrome and disc pain, Rib or TMJ pain. It can literally tighten up loose joints and get rid of hypermobility problems. Dr. Magaziner now has a running series of pediatric patients and teenagers who have frequent shoulder dislocations and have been diagnosed with instability of the shoulder with surgery being the recommended treatment. One of these patients went to the Hospital of special Surgery and was told they needed surgery which would have created a disfiguring scar. In 7 out of 8 cases so far we have been able to stop the dislocations and return these kids to a normal healthy life style. Back to playing their baseball, field hockey, gymnastics, or succor without reoccurrence.
return to top - Sacroiliac joint Injections
These joints are located below the waist and between the hips. They transfer all the body weight from the spine to the legs and can be a source of pain when there is slippage or weak ligaments surrounding the joint. Under fluoroscopic guidance we can inject the joint with a variety of medications to alleviate the pain.
return to top - Spinal Cord Stimulation
In failed back syndromes where there is chronic scar tissue and leg pain we can implant a pair of electrodes on the outside of the spinal column and attach it to an implantable stimulator. This exchanges a light pleasant electrical sensation which can block the pain signals from reaching the brain. The stimulation is fully adjustable by remote control and the batteries can last 10 years or more.
return to top - Vitamin, Nutritional Guidance
Diet and nutrition is a key factor in maintaining and restoring health. The immune system, digestive system, circulatory system , joints, muscles and nervous system are all dependent upon it. Many diseases including arthritis, chronic fatigue and fibromyalgia can be exacerbated by metabolic and hormonal imbalances. The body needs optimal nutrition to heal itself.
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Copyright © 2010, Dr. E. Magaziner. All Rights Reserved.
