Advanced Pain Management
For appointments phone
(619) 330-8771
Advanced Pain Management
For appointments phone
(619) 330-8771

Advanced Pain Management

For appointments phone


At Advanced Pain Management, we will design a program of wellness that fits your individual needs. Your doctor will get to know you as well as possible through conversation, relevant history and detailed examination. In caring for your specific condition, your doctor will create an integrated pain management program that is customized specifically for you.

We offer advanced, up-to-date pain management treatments that can drastically improve your quality of life. Your Pain Management Program may include any or several of the treatment options listed below.

To help determine what’s causing your pain and establish a treatment that best suits your needs, Dr. Gupta and his expert pain management team complete a physical exam. They review your symptoms and medical history, and may order blood tests, X-rays, MRIs, CT scans, or other imaging procedures to find the root cause of your discomfort.

Please click the listed treatments for more information

Anti-inflammatory Medication

Anti-inflammatory drugs are members of a drug class that doctors use to reduces pain, decreases fever, prevents blood clots, and in higher doses, decreases inflammation.

NSAIDs — nonsteroidal anti-inflammatory drugs — are a type of pain reliever. At prescription doses, these drugs also curb inflammation. They all reduce pain and inflammation, but you might find that you get more relief from one NSAID over another, and some NSAIDs may have fewer side effects than others. The effect differs from person to person. Some NSAIDs also may be more convenient, since you only need to take them once or twice a day.


Cervical Epidural Steroid Injections

A cervical epidural steroid injection may be performed to relieve pain associated with inflammation around the nerves in the neck. The epidural space surrounds the dura. The dura is the sac around the nerve roots that contains cerebrospinal fluid and spinal cord and nerves. The nerves in the neck travel through the cervical epidural space before extending down through the shoulders and into the arms and hands. An injection into this space delivers medication directly to coat the nerves in the area. A number of cervical spine conditions can affect the nerves as they exit the spine through small holes on each side of the vertebrae.

A cervical epidural injection is often done with the goal of providing enough pain relief so that the patient can progress with a rehabilitation program.

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Intradiscal Electrothermocoagulation

Intradiscal electrothermocoagulation, also known as annuloplasty (IDET)is a new innovation employed in the management of low back pain. This procedure is used in patients who have pain in the lower part of their back which has been confirmed to be caused by positive discography studies and with a disk as the main source of the pain. This procedure is normally carried out using a catheter which is inserted into the pulposus compartment through a posterolateral approach. In this process an electrothermal device is threaded and inserted anteriorly in the wall of the nucleus and then posteriorly to the walls of the annulus. 

Lumbar Epidural Injections

Lumbar Epidural Steroid Injections (ESIs) are a common treatment option for many forms of lower back pain and leg pain. They have been used for decades and are considered an integral part of the nonsurgical management of sciatica and lower back pain. The injection is named an epidural steroid injection because it involves injecting a local anesthetic and a steroid medication directly into the epidural space that surrounds the spinal cord and nerve roots. The role of the injection is typically to provide sufficient pain relief to allow a return to everyday activities and to make progress in physical therapy.

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Nerve Blocks

Nerve blocks are used for pain treatment and managementOften a group of nerves, called a plexus or ganglion, that causes pain to a specific organ or body region can be blocked with the injection medication into a specific area of the body. The injection of this nerve-numbing substance is called a nerve block. Although many kinds of nerve blocks exist, if your pain isn’t related to pain in a single or small group of nerves, nerve blocks may not be right for you. Your doctor can advise you as to whether this treatment is appropriate for you

Neurolytic Nerve Block Therapy

Neurolytic blocks allow individuals diagnosed with end-stage cancer to enjoy a higher quality of life. This procedure may be preferred to strong painkillers and narcotics, which can oftentimes cause over-sedation and disorientation. A neurolytic block is a type of nerve block injection that uses alcohol to intentionally numb nerves and achieve pain relief. This type of injection is used specifically to achieve long-term pain relief of areas in the torso. Unlike nerve blocks, neurolytic blocks are not used to treat pain in the arms, legs, hands, or feet. Neurolytic block injections differ from nerve block injections in that they aim to destroy the nerve, instead of numbing it for temporary pain relief.

Osteopathic Medicine and Manipulation

Osteopathic Manipulative Treatment, or OMT, is a set of hands-on techniques used by osteopathic physicians (DOs) to diagnose, treat, and prevent illness or injury. Using OMT, a DO moves a patient’s muscles and joints using techniques that include stretching, gentle pressure and resistance.

OMT can help people of all ages and backgrounds. The treatment can be used to ease pain, promote healing and increase overall mobility. Although often used to treat muscle pain, the treatment can also help patients with a number of other health problems. When appropriate, OMT can complement, and even replace, drugs or surgery. 

Percutaneous Discectom

Percutaneous discectomy, sometimes called a Dekompressor discectomy because of the tools used, is a minimally invasive procedure used to reduce a herniated disc. The procedure uses a small needle to reach the disc, eliminating the need for an incision. The needle is guided to the disc by fluoroscopy (live x-ray) and a probe with a rotating tip is carefully inserted through the needle.

When the probe is turned on, its rotating tip removes small portions of the disc nucleus, creating empty space, allowing the disc to reabsorb the herniation and relieving pressure on the nerve. Because only enough of the disc is removed to reduce pressure inside the disc, the spine remains stable.

The procedure is usually reserved for patients who have not had success with conservative treatments like medications, physical therapy and nerve blocks. Typically, the patients are not candidates for surgery because the disc bulge is very small.

Physical Therapy

Physical therapy (PT), is provided by physical therapists who promote, maintain, or restore health through physical examination, diagnosis, prognosis, patient education, physical intervention, rehabilitation, disease prevention and health promotion.  Your doctor might suggest this type of treatment if you’ve had an injury or illness that makes it hard to do daily tasks.

In addition to clinical practice, other aspects of physical therapist practice include research, education, consultation and health administration. Physical therapy is provided as a primary care treatment or alongside, or in conjunction with, other medical services. 

Percutaneous Discectomy

Percutaneous Discectomy (sometimes called a Dekompressor discectomy because of the tools used)is a minimally invasive procedure used to reduce a herniated disc. The procedure uses a small needle to reach the disc, eliminating the need for an incision. The needle is guided to the disc by fluoroscopy (live x-ray) and a probe with a rotating tip is carefully inserted through the needle.

The procedure is usually reserved for patients who have not had success with conservative treatments like medications, physical therapy and nerve blocks. Typically, the patients are not candidates for surgery because the disc bulge is very small.

Prescription Medication in Adjunctive Therapy

Adjunctive Therapy one or more secondary interventions used concurrently with a primary intervention to enhance treatment effectiveness. For example, medication may be used concurrently with cognitive behavior therapy, with the latter as the primary form of intervention; group therapy may be used secondarily to individual psychodynamic psychotherapy, with each intervention bringing its own characteristic perspectives and methods to bear on the client’s mental awareness and healing.


PRP Therapy

PRP treatment, or a platelet-rich plasma treatment, is a helpful therapy for many health problems, including arthritis. PRP therapy is based on the idea that the body has the ability to heal itself. By isolating platelet-rich plasma in the body’s blood, doctors can treat damaged cartilage, tendons, ligaments, muscles, and bones. Many people are seeing the benefits of this therapy, especially as it may save them from having to endure a surgery.

As with most things in medicine, each person will experience healing from treatment in their own way. The exact amount of time the PRP injections last will naturally vary from patient to patient. Additionally, overall outcomes from these treatments will vary from situation to situation.

Radiofrequency Ablation (Neurotomy)

Radiofrequency neurotomy uses heat generated by radio waves to target specific nerves and temporarily turn off their ability to send pain signals. The procedure is also known as radiofrequency ablation.

Needles inserted through your skin near the painful area deliver the radio waves to the targeted nerves. Your doctor will use imaging scans during radiofrequency neurotomy to make sure the needles are positioned properly.

Radiofrequency neurotomy is most commonly used for pain in the back, neck and buttocks (sacroiliac joint). It may also be helpful for long-term knee or hip joint pain.

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Sacroiliac Joint Injections

A sacroiliac joint injection is designed to diagnose and treat pain and inflammation from sacroiliac joint dysfunction. Either too much or too little movement in one of the sacroiliac joints, which are located at the bottom of the spine on each side of the sacrum, can cause lower back pain and/or leg pain.

An injection in the sacroiliac joint usually has two goals: to confirm the sacroiliac joint as the source of the pain, and to alleviate that pain.

The procedure begins with the patient lying on his or her stomach. The area around the sacroiliac joint is numbed with an injection of a local anesthetic.Then, using fluoroscopy dye and X-rays to assist in guiding the injection, a needle is inserted into the sacroiliac joint to deliver medicine directly to the source of pain. The medication injected into the joint can be a local anesthetic, such as lidocaine or bupivacaine, and may also include an anti-inflammatory medication, such as a corticosteroid. If the local anesthetic provides immediate pain relief, it diagnoses the sacroiliac joint as the source of the patient’s pain.

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Soft Tissue and Bursa Injections

Soft tissue injections are shots into an area of the body that is not a bone or a joint. They may be used in areas such as a tendon, a muscle, or a bursa. (A bursa is a sac of fluid that cushions and lubricates areas where tendons, ligaments, skin, muscles, or bones rub against each other.) These injections are often used to treat problems such as inflamed tendons (tendinitis) and bursas (bursitis).

These shots may be used to put in one or more medicines. Examples are local anesthetics that can help with short-term pain relief or steroid medicines that can give longer-term relief.

Spinal Cord Stimulator

A  Spinal Cord Stimulator is an implanted device that sends low levels of electricity directly into the spinal cord to relieve pain. Spinal cord stimulators consist of thin wires (the electrodes) and a small, pacemaker-like battery pack (the generator). The electrodes are placed between the spinal cord and the vertebrae (the epidural space), and the generator is placed under the skin, usually near the buttocks or abdomen. Spinal cord stimulators allow patients to send the electrical impulses using a remote control when they feel pain. Both the remote control and its antenna are outside the body.

Surgery Proceedure

There are non-invasive and invasive surgical procedures for pain management. If there is a need for a surgery for treating your condition, the procedure must be tailored to your specific symptoms and condition. 

You and your physician may discuss surgery as a way to correct your condition upon diagnosis. This decision is based on careful evaluation of your personal medical history and subsequent medical tests, such as blood tests, X-rays, MRI, CT scan, electrocardiogram, or other laboratory work performed to determine the exact diagnosis. Types of surgery depending on the diagnosis, a patient has several surgery options based on your case.


Trigger Point Injections

Trigger point injection (TPI) may be an option for treating pain in some patients. TPI is a procedure used to treat painful areas of muscle that contain trigger points, or knots of muscle that form when muscles do not relax. Many times, such knots can be felt under the skin. Trigger points may irritate the nerves around them and cause referred pain, or pain that is felt in another part of the body.

TPI is used to treat many muscle groups, especially those in the arms, legs, lower back, and neck. In addition, TPI can be used to treat fibromyalgia and tension headaches. The technique is also used to alleviate myofascial pain syndrome (chronic pain involving tissue that surrounds muscle) that does not respond to other treatments.

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Phone (619) 330-8771

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