Frequently Asked Questions.

An interventional pain management physician specializes in diagnosing and treating conditions that cause chronic or complex pain. Unlike approaches that focus only on symptom relief, interventional pain specialists evaluate the underlying source of pain and develop individualized treatment plans. Dr. Michael Ghermezi treats a wide range of conditions involving the spine, nerves, joints, and musculoskeletal system. Depending on the diagnosis, treatment may include conservative strategies, minimally invasive procedures, rehabilitation recommendations, or coordination with other specialists.

Patients may benefit from seeing a pain management specialist when pain persists despite conservative treatments, interferes with daily activities, affects sleep or mobility, or has not been clearly diagnosed. A pain specialist can help evaluate conditions such as chronic neck and back pain, sciatica, nerve pain, arthritis-related pain, spinal conditions, and other musculoskeletal disorders. Early evaluation may help identify the source of symptoms and provide a more targeted approach to treatment.

Pain management physicians treat a wide variety of conditions affecting the spine, nerves, joints, and musculoskeletal system. Common conditions include chronic neck and back pain, herniated discs, sciatica, lumbar and cervical radiculopathy, spinal stenosis, facet joint pain, arthritis-related pain, peripheral neuropathy, and complex regional pain syndrome. Treatment recommendations depend on the specific diagnosis, severity of symptoms, previous treatments, and the patient's individual goals.

The first visit focuses on understanding your symptoms and identifying the potential source of your pain. Dr. Ghermezi will review your medical history, previous treatments, imaging studies when available, and how your pain affects your daily activities. A physical examination is performed to evaluate movement, strength, sensation, and other findings that may help determine the cause of symptoms. After the evaluation, treatment options are discussed and a personalized care plan is developed.

Not always. While imaging studies such as MRI, CT scans, or X-rays can provide valuable information, they are only one part of the overall evaluation. Imaging findings must be interpreted in the context of a patient's symptoms and physical examination because abnormalities on imaging do not always directly cause pain. If additional imaging or diagnostic testing is appropriate, recommendations can be made during the evaluation process.

Interventional pain procedures are generally considered safe when performed by appropriately trained physicians using proper techniques and patient selection. Like any medical procedure, risks and benefits should be discussed before treatment. Dr. Ghermezi carefully evaluates each patient's medical history, diagnosis, and treatment goals to determine whether a specific procedure is appropriate. When indicated, image guidance such as fluoroscopy may be used to improve procedural accuracy and safety.

The length of a procedure depends on the treatment being performed. Many injections and nerve blocks can be completed relatively quickly, while procedures such as radiofrequency ablation, spinal cord stimulation, peripheral nerve stimulation, or endoscopic spine procedures may require additional time. Patients should also account for preparation and post-procedure observation when planning their visit.

The duration of pain relief varies depending on the procedure, the underlying condition, and the individual patient. Some injections may provide temporary relief, while treatments such as radiofrequency ablation or neuromodulation may provide longer-lasting improvement in appropriately selected patients. Diagnostic procedures may intentionally provide only short-term relief because their purpose is to help identify the source of pain and guide the next step in treatment.

Interventional pain specialists can evaluate and treat many forms of spine, joint, musculoskeletal, and nerve-related pain. This includes neck and back pain, radiating arm or leg pain, sciatica, joint pain, nerve pain, and certain chronic pain syndromes. Treatment is based on identifying the underlying source of the symptoms rather than simply treating pain as an isolated symptom.

This depends on the procedure and the individual patient. Many interventional pain procedures can be performed using local anesthetic alone, while light or moderate sedation may be appropriate for certain procedures. Some procedures require the patient to remain responsive so the physician can communicate with them during treatment. Your physician will discuss the appropriate anesthesia or sedation plan beforehand.

Most interventional pain procedures are designed to minimize discomfort. Local anesthetic is commonly used to numb the treatment area, although patients may still experience temporary pressure, aching, or a brief increase in their usual symptoms during certain procedures. The amount of discomfort varies according to the procedure and the individual patient.

Recovery varies considerably depending on the treatment. Many patients undergoing injections or nerve blocks return to normal activities relatively quickly, while more advanced procedures may require a longer recovery period and temporary activity restrictions. Your physician will provide specific instructions based on the procedure you undergo.

Whether you can drive depends on the procedure, medications used, and whether you receive sedation. Patients who receive sedation should not drive themselves home and will generally need a responsible adult to provide transportation. Certain procedures may require a driver even without sedation. You will receive specific instructions before and after your procedure.

Many patients can return to routine activities relatively soon after an injection or minor procedure, although strenuous exercise may be temporarily restricted. More advanced procedures may require a longer period of activity modification. Because recovery recommendations vary, follow the post-procedure instructions provided for your specific treatment.

Temporary soreness around the treatment area is common after many interventional procedures. Depending on the treatment, pain relief may occur immediately, gradually over several days, or over a longer period. You will receive instructions regarding activity, medications, wound or injection-site care when applicable, and symptoms that should prompt you to contact your physician.

Mild soreness or a temporary increase in pain can occur after some injections and interventional procedures. This typically improves as the treatment area settles. The expected course varies depending on the procedure. Severe or progressively worsening pain, new weakness or numbness, fever, or other concerning symptoms should be reported promptly according to your post-procedure instructions.

It depends on the procedure. Local anesthetic may produce relief within minutes, while corticosteroid injections can take several days to reach their full effect. Radiofrequency ablation may also require time before the full benefit becomes apparent. Diagnostic procedures are different: their effectiveness may be assessed during a specific period immediately after treatment to determine whether the targeted structure is contributing to the patient's pain.

A procedure that does not provide the expected relief can still provide useful information. Your physician may reconsider the suspected source of pain, review additional diagnostic information, modify the treatment plan, or discuss another therapeutic approach. Pain management is often a stepwise process, and not every procedure is appropriate or effective for every patient.

In some patients, minimally invasive pain treatments can provide sufficient improvement in pain and function to postpone or potentially avoid surgery. However, this depends on the underlying condition, severity of symptoms, neurological findings, and response to treatment. Certain conditions are better treated surgically, and interventional pain management should not be viewed as a replacement for surgery when surgery is medically indicated.

There is no single number that applies to every patient or procedure. The appropriate frequency depends on the type of treatment, medications used, the patient's medical history, response to previous treatment, and the risks and benefits of repeating the procedure. Your physician will determine whether repeat treatment is appropriate based on your individual circumstances.

Some interventional pain procedures require certain anticoagulant or antiplatelet medications to be temporarily held, while others may not. The decision depends on the medication and the procedure being performed. Do not stop a prescribed blood thinner on your own. Your pain physician will provide instructions and, when appropriate, coordinate with the clinician who prescribed the medication.