Pain Management

Dr Thaker’s Pain Management Philosophy

Just because the exact cause of pain has not been determined by prior doctors the patient has seen, this does not mean that a ‘pain generator’ does not exist. The patient is still in pain despite the lack of an exact diagnosis. It is not the patient’s fault medicine in the 21st century can not always determine its exact cause. Would someone short of breath be dismissed by physicians simply because they could not determine its cause? Yet this is what happens to patients who experience pain without an exact cause, every day across the country. This pain can and must be treated for the patient regardless. This is the cornerstone of Dr Thaker’s pain management philosophy. Contact us here for an appointment.

Diagnostic Strategies

Listening

It may surprise some patients and perhaps many doctors, but listening is the key to diagnosis in pain management. More so than any complex technology or even the physical examination. Your evaluation by Dr Thaker begins with a thorough directed history that you provide. We ask also that you arrive with relevant treatment records in hand and or the contact details to obtain them. In fact, most of the time in medical practice, a diagnosis comes from a careful history. Further exam and sophisticated technology serves only to confirm this diagnosis. Thus simple listening is first and perhaps most valuable to a pain management treatment plan.

Point of Care Ultrasound

Apart from careful and focused physical examination, Dr Thaker offers in the comfort of our very same offices the ‘point of care’ or ‘bedside’ ultrasound. No separate trip is needed to the radiology center lasting many hours. This can be used to examine painful areas of the body, joints, limbs and the musculoskeletal system. As well handheld ultrasound serves as image guidance for injections or other therapies to joints and soft tissues, to aid precision and safety. Further imaging can be obtained from your choice of radiology centers where needed, and also through your insurance plan.

Nerve conduction studies

Dr Thaker also offers specialized diagnostic studies called ‘nerve conduction studies’- electromyograms and nerve conduction velocities. This extends the physical exam of the pain management patient. These studies allow examination of the nerves of the body, their connection to the muscles at the neuromuscular junction, as well as the muscles themselves. A small device produces small electrical impulses, to measure electrical nerve signals from nerves and muscles. The tiny needles used have no bore or ‘hole’ and often do not produce even a single drop of blood. In fact, some practitioners claim these needles and their small electric impulses are an advanced form of ‘accupunture’. Dr Thaker uses these studies for diagnostic purposes, where their usage is well established to play an important role in diagnosis of pain in limbs and other areas.

Conservative care

As a private practice physician, Dr Thaker has the freedom to use all of the valley’s health care resources for pain management, without regard to the company or ‘brand’ of the resource. Other doctors are often contractually obligated to select their own company’s services and staff first , or even exclusively. This does not benefit the patient when other resources may be better suited for simple reasons such as quality, location or even cost itself. To this end, Dr Thaker has a variety of diagnostic and therapeutic treatments to offer in our own offices. These services are garnered from his seven years of training in surgery and medicine, as well as pain management training, specialized for office-based patients. When physical therapy, further diagnostic methods, other specialists, or even inpatient care is required, Dr Thaker has the freedom of private practice to work with any other offices for the best results for you.

Visco-elastic supplementation

Visco-elastic supplementation can be used for joint pain that has failed prior therapies, and to tremendous effect. This is injection of natural components found in healthy joint fluid, in a prepared product, such as into the knee joint. Many patients think of treatments as ‘oiling up the knee’. Hyaluronate is the key substance injected. It is found in healthy joints, and provides the lubricating and shock-absorbing quality to the fluid. Hyaluronate is essential for the proper functioning of joints. After other treatments have been tried, it is generally covered by insurances over a period of several effective treatments.

Anesthetic and anti-inflammatory treatments

At times injecting a substance into the spine, joint, or other area of the musculoskeletal system is of great value. These medications include lidocaine, such as for trigger point injections. Trigger points are painful areas of muscle and related tissue, that can produce pain. They can even be physically felt by a skilled examiner. Of course steroid injections are well known to calm inflamed joints and tissues. They are often effective alone or in combination with lidocaine, and in conjunction regenerative medicine treatments. Treatment areas may include trigger points of muscles, joint spaces including the knee, hip, foot and ankle, shoulder, elbow, wrist, hand; the sacroiliac joints at the gluteal area, facet joints or other spine related injections.

Regenerative Medicine

At the forefront of regenerative therapy for pain management is Platelet-rich plasma or ‘PRP therapy’, a 100% natural way to harness your body’s own regenerative powers. PRP takes a small sample of the patient’s own blood, and processes this sample in a special centrifuge to concentrate the growth factors that are derived from the platelets. This ‘PRP’ is then injected into the areas of concern, such as a painful joint, stimulating your natural regenerative processes.

Dr Thaker finds that the key for determining how best to use PRP, is asking the most specific question possible. Thus, not ‘does PRP work for joint pain?’ The answer is it may work, it depends. Rather, following a thorough evaluation by Dr Thaker, the question becomes ‘would PRP work for medial compartment degenerative joint disease of this specific patient’s knee?’ By making a specific diagnosis and developing a unique treatment plan using regenerative therapies, Dr Thaker can thus best produce lasting results to relieve pain. There are even a few highly specific diagnoses that are covered fully by insurances for PRP, as a testament to its effectiveness in these areas, that Dr Thaker can determine by evaluation.

Medications

With the variety of treatments above, medication usage may be minimized or avoided all together for many patients. Dr Thaker has even taken the extra step of obtaining a special permit, called DEA-X certification. This allows safe discontinuance of opioid usage, in select cases where the patient is in need of rehabilitation from prior usage. Where longer term medications are required, the safety of a carefully structured treatment plan, with frequent face to face visits for reassessment and monitoring, is fundamental to our approach.
For procedural pain management, we offer:

  • peripheral joint injections
  • lumbar spine procedures
  • nerve blocks, botox, and trigger point injections
  • neurodiagnostics- EMG and NCS
  • musculoskeletal ultrasound
  • PRP (platelet rich plasma) and regenerative therapies
  • viscoelastic supplementation
  • advanced wound care and grafting
  • personal injury, attorney lien
  • disability evaluation, independent medical exam, case review
  • migraine and complex pain syndrome care
  • detoxification for apropos procedural cases (DEA X permit)

Towards this end, Dr Thaker is board certified by both ABFM (an ABMS board), and Pain Management by the AAOPM (non ABMS), as well completed five years of surgical training (2 general, 3 orthopedic) with training in both operative and nonoperative pain treatment. For insurances accepted, see here.

Dr Thaker also enjoys teaching fellow doctors and staff, his techniques in PRP, botox, and other pain treatments as a continuing medical education course director. He has taught several hundred students, when time permits him to direct courses throughout the region several times a year. If you are a clinician and would like to arrange a one on one preceptorship with Dr Thaker, please contact us.

No guarantee of results is made or implied. Individual results may vary. Some photos may contain models, not practice patients. All sales final. Other terms may apply, inquire.