Tel: 313-998-8662
TREATMENTS
SPINAL CORD STIMULATOR
A spinal cord stimulator is a minimally-invasive procedure that is a form of neuromodulation therapy. It is a device that sends low levels of electricity into the spinal cord to relieve pain. It is useful for a variety of conditions including failed back surgery syndrome, spinal stenosis, diabetic neuropathy, sciatica and CRPS. It involves a trial period where you have the opportunity to try the therapy for about 1 week and if it provides relief, you can proceed with implantation of the device. Implantation is an outpatient procedure that typically takes about an hour and you go home shortly after the procedure.
DORSAL ROOT GANGLION
STIMULATION
This is a novel therapy offered to patients with difficult-to-treat chronic pain in specific areas of the body, such as complex regional pain syndrome (CRPS), peripheral nerve injury, post-amputation pain, and many others. This therapy requires specific training and is offered by very few physicians in Michigan. It involves a trial period where you have the opportunity to try the therapy for about 1 week and if it provides significant relief, you can proceed with implantation of the device. Implantation is an outpatient procedure that typically takes about an hour and you go home shortly after the procedure.
JOINT INJECTIONS
Therapeutic joint injections are a treatment option used to relieve pain caused by inflammatory joint conditions such as arthritis. Additionally, we offer genicular nerve radiofrequency ablation or rhizotomy for chronic knee pain.
TRIGGER POINT INJECTIONS
Trigger point injections are a treatment option for pain in areas that contain trigger points, or knots of muscle that form when muscles do not relax.
PERIPHERAL NERVE BLOCKS & STIMULATION
A nerve block is a procedure used to treat or diagnose severe pain resulting from a peripheral nerve injury. Often times, a peripheral nerve stimulator can be utilized to provide longterm relief
SYMPATHETIC NERVE BLOCKS
Sympathetic nerve blocks result in the relief of pain specific regions of the body. This can be secondary to pain from CRPS or chronic abdominal pain, among other things. If you are experiencing non-specific pain, come in for a full evaluation with Dr. Toma to determine the best treatment pathway.
EPIDURAL STEROID INJECTIONS
Epidural steroid injections are a minimally invasive treatment that can be used to treat low back pain with sciatica. A steroid is a strong anti-inflammatory medication which eases nerve inflammation caused by nerve impingement from a herniated disc or degeneration. They often provide months to years of relief for our patients. It is helpful for a variety of spinal conditions such as spinal stenosis and sciatica (radiculopathy).
RADIOFREQUENCY ABLATION (RHIZOMY)
Cervical and Lumbar rhizotomy are a minimally invasive procedure that are used to treat axial neck or low back pain. It involves the use of radio waves, along with electric current, to deactivate the sensory nerves that supply the facet joints of the spine. This allows the patient to experience significant pain relief. The facet joints connect the vertebral levels of the spine and are commonly affected by arthritis like other joints in the body. These nerves are also known as medial branches.This procedure often provides up to a year or more of relief for our patients, at which point it can be repeated for sustainble pain relief. This is an extremely safe and effacacious procedure that does not involve the use of steoirds.
EPIDURAL BLOOD PATCH
An epidural blood patch is an injection of your own blood into the epidural space, which surrounds the spinal cord. It is done for patients experiencing acute or chronic headache secondary to intracranial hypotension.
KETAMINE INFUSION
Ketamine is a medication that has many advantageous uses. In our practice, we utilize ketamine for its analgesic properties as well as its behavioral effects. Studies have shown that ketamine is effective for chronic pain conditions such as CRPS, fibromyalgia, ehlers danlos syndrome, neuropathy, and many other conditions. Additionally, data has shown ketamine is very effective at treating depression, anxiety, and PTSD. Dr. Toma is a board certified Ansethesiologist with extensive experience utilizing ketamine therapy to treat his patients.
MILD PROCEDURE (VERTOS MEDICAL)
Minimally Invasive Lumbar Decompression (MILD) is a novel evidence based procedure that is used to treat central canal spinal stenosis with neurogenic claudicaiton. It is an effective treatment for patients with low back and leg pain that is worse with activity such as standing and walking but improved with sitting or flexion of the spine. It involves partial removal of the ligamentum flavum which is a significant contributor to spinal stenosis. The procedure is done on an outpatient basis where you can go home the same day. The procedure is minimally invasive and performed through a 1 cm incision. You can go home shortly after the procedure finishes with no activity restrictions.
SUPERION INTERSPINOUS SPACER (VERTIFLEX)
Vertiflex interspinous spacer is a novel level-one evidence based and minimally invasive procedure that address central, lateral recess, and foraminal lumbar spinal stenosis. It is redefining the treatment of lumbar spinal stenosis for patients. This is an outpatient procedure where you go home shortly after the procedure concludes. It involves implanting a small device in the spine that increases the space between spinal levels, thereby decreasing the effects of spinal stenosis. It is most effective for patients who have back and leg pain with standing and walking that is improved with flexion of the spine or sitting. Studies have shown sustained pain relief at greater than 5 years and counting. Dr. Toma is one of only a handful of physicians in the state that offer this cutting edge treatment.
INTRACEPT
Intracept basivertebral nerve ablation is a novel evidence based minimally invasive treatment for vertebrogenic low back pain. It is specifically for patients who have inflammatory changes of the vertebral bones of the spine. It is an outpatient procedure where you can go home shortly after the procedure concludes with little to no activity restrictions. Studies have shown sustained pain relief at greater than 5 years and counting. Dr. Toma is one of only a handful of physicians in the state that offer this cutting edge treatment.
MIGRAINE/HEADACHE TREATMENT
Migraines and headaches can cause debilitating pain that causes signficant stress on ones life. Dr. Toma employs many modalities in order to control these symptoms. Treatments may include medication therapy, botox injection for headaches, as well as other interventional and evidence based treatments. Come in today for an evaluation and to generate a treatment plan that is centered toward you.
SACROILIAC JOINT FUSION
Sacroiliac joint inflammation is an extremely common cause of low bcak pain. Particularly pain that is worse with sitting and transitioning from sitting to standing. Dr. Toma may recommend sacroiliac joint steroid injection and physical therapy. If these conservative measures fail, sacroiliac joint fusion may be recommended. This is a minimally invasive procedure that involves fixation of the sacroiliac joint which therefore provides relief of chronic sacroiliac joint pain. This is an outpatient and evidence based procedure where you can go home shortly after the procedure concludes. Dr. Toma is one of only a handful of physicians in the state that offer this cutting edge treatment.
SACROILIAC JOINT INJECTION
The sacroiliac joint connects the lower portion of the spine known as the sacrum with the ilium. This joint is a common cause of chronic low back pain. Arthritis and degeration of this joint results in inflammation. Often these patients complain of low back pain while sitting as well as pain when transitioning from a seated to standing position. The procedure involves injection of an anti-inflammatory steroid solution inthe the joint. Furthermore, for some patients, we may offer radiofrequency ablation of the sensory nerves that supply this joint.
PIRFORMIS INJECTION
The piriformis muscle is located in the buttock area. Piriformis syndrome is a condition where the piriformis muscle causes irritation of the sciatic nerve as it travels through it. This can result in pain with sitting or with activity. Treatment involves physical therapy, and on occasion an intramuscular steroid injection.
GENICULAR NERVE RADIOFREQUENCY ABLATION
The genicular nerves supply a significant amount of the sensory innervation of the knee. These nerves can be targeted with radio frequency ablation which deactivates the nerves for 9-12 months causing significant pain relief in patients knee osteoarthritis. This is a minimally invasive treatment that is a great treatment option for patients who complain of knee pain and are not a candidate or prefer to avoid knee replacement.
STELLATE GANGLION BLOCK
The stellate ganglion is a sympathetic nerve plexus that can be targeted to relieve sympathetically mediated pain. Examples of sympathetically mediated pain includes CRPS of the arms or hands. Additionally, data has shown stellate ganglion blocks to be effective treatments for depression, anxiety, and PTSD.
KYPHOPLASTY/VERTEBROPLASTY
Kyphoplasty and vertbroplasty are forms of vertebral augmentation that treat compression fractures. They often result in immediate pain relief for patients with compression fractures. It is an outpatient procedure where the patient is sent home shortly after the procedure concludes. This is an evidence based procedure that involves the injection of cement into the area of the compression fracture which results in stabilization and strengthening of the fracture which results in immediate relief for patients and restoration of vertebral height.
OCCIPITAL NERVE BLOCK
The occipital nerves are common culprits of headaches. The greater occipital nerve originiates from the second and third cervical vertebrae in the neck. These nerves provide sensation to the back and top of your head. When this nerve is injured, it can result in pain radiating across its path resulting in chronic headaches and migraines. An occipital nerve block is a minimally invasive and effective treatment option for occipital neuralgia that involves injection of a local anesthetic and steroid over the nerve, which decreases the inflammation around the nerve and relieving symptoms.