Treatments For Pain

Improve your quality of life by reducing pain and restoring function

A More Responsible Approach To Pain Management

For over 20 years, Lags Medical Centers is leading the way in musculoskeletal care and state-of-the-art pain treatments. Now with 47 locations across California, Nevada, Oregon and Florida, our mission remains unchanged: improving our patients’ quality of life by reducing pain and restoring function using the latest evidence-based, minimally-invasive, interventional treatments.

We understand that everyone is different and pain affects us in different ways, so we work to create individualized treatment plans to effectively manage and alleviate pain. With constant advances in medicine, Lags realizes that you have to heal the whole person with the use of classic, holistic, and modern treatments. This led our founder and Chief Medical Officer Francis Lagattuta, MD to create the MAP protocol – a new way of looking at, and treating the sources of pain. This helps us to reduce the total cost of care by avoiding emergency room visits, unnecessary surgery, procedures, and pharmacy costs.

Diagnostics

Finding the right path for your treatment involves diagnosing the sources of your pain.

Electromyography (EMG) is a test for evaluating and recording the electrical activity of your muscles using an instrument called an electromyograph to produce a record called an electromyogram.

Epidermal Nerve Fiber Density Skin Biopsy (ENFD) is an accurate method of recording small fiber peripheral neuropathy by quantifying the terminal branches of peripheral nerves within the epidermis.

Quantitative Sweat Measurement (Q-Sweat) is a test that measures the nerves that control sweating and helps to discover nervous system disorders, peripheral neuropathies, and other pain disorders.

Autonomic Reflex Screening is a non-invasive test that measures how the nervous system works to control blood pressure, blood flow, heart rate, skin temperature, and sweating.

Treatments

Everyone responds to pain differently. Together we’ll find the best treatment to reduce yours.

Topical Ointments are medicines applied directly to your skin that can reduce the inflammation in specific areas of your body.

Therapeutic Solutions use methods such as exercise, massage, and heat treatment and physical therapy to alleviate pain.

Mindful Behavioral Therapy enhances awareness of your physical and mental sensations and helps reduce pain by teaching you how to better manage and control your mental reactions from painful physical sensations.

Integrated Medicine Using engineered tissue and molecular biology we can help to create a “process of replacing, engineering or regenerating human cells, tissues or organs to restore or establish normal function” using the latest advances in regenerative and integrated therapies.

Interventional Pain Management Less-invasive procedures such as injections, nerve blocks and even cognitive behavioral health therapies are utilized to reduce pain symptoms and treat pain sources in order to avoid costly and unnecessary surgeries that sometimes leave patients feeling worse.

Pain Medication Management While opioid-based medications are sometimes part of a treatment plan, they may not be best for long term use – used in combination with interventional approaches and sometimes psychological support to help patients achieve the best possible quality of life – we strive for responsible and appropriate dosage MME counts.

Transforaminal Epidural Steroid Injections (TFE) are an outpatient procedure that’s performed to relieve pain in the upper or lower back.

Facet Joint Injections help diagnose the source of a patient’s pain if located on both sides of the back of the spine. It can also relieve pain and inflammation in the same area.

Fluoroscopy Guided Injections use an imaging device called a fluoroscope to more precisely guide the needle to the target location and deliver pain-reliving medication.

Botox Injections are used to treat chronic pain in specific targeted areas and works by relaxing the muscles that are contributing to your pain.

Steroid Injections are used to relive pain in joints and muscles in the body by reducing inflammation for extended periods of time.

Sacroiliac Joint (SI) Injections contain a mixture of local anesthetic and corticosteroid intended to provide immediate pain relief and long-term relief by reducing inflammation.

Trigger Point Injections may help to treat chronic pain related to trigger points, which are highly sensitive bundles muscle, or “knots” that can cause intense pain in the arms, legs, neck or back.

Ultrasound Guided Injections are injections assisted by an ultrasound, allowing the doctor to see and deliver the medicine exactly where it’s needed most.

Platelet Rich Plasma Injections are formulated using your own platelets from drawn blood to help accelerate your body’s natural ability to heal itself.

Brachial Plexus Blocks is an administration of a dose of local anesthetic into the neck, collarbone or upper arm in order to provide continuous pain relief in the shoulder or upper arm.

Celiac Plexus Blocks provides pain relief in the abdomen commonly due to cancer or chronic pancreatitis by administering medication to the bundle of nerves that surrounds the aorta, the main artery into your abdomen.

Cervical Blocks inject a pain-relieving fluid into the neck and the combination of local anesthetic and anti inflammatory medications numb the pain while reducing swelling.

Medial Branch Blocks (MBB) are performed by having an anesthetic injected near small medial nerves connected to specific facet joints along the spine to locate the specific joint causing the pain.

Third Occipital Nerve Blocks is performed mainly for diagnosis or treatment of C2 or C3 zygapophysial joint pain and chronic headaches.

Radiofrequency Neurolysis (Nerve Ablation) uses heat to reduce or stop the transmission of pain signals to your brain by burning the end of the nerve that is causing the pain.

Spinal Cord Stimulators are implantable devices, similar to a  pacemaker, that send electrical impulses to specific areas of the spinal cord to relieve pain.

Think one of these tests or treatments might help you? Let’s get you seen.

Our MAP program attacks the pain source

Founded by Dr. Lagattuta, MAP stands for metabolic, anatomical and psychological, which we consider the three pillars of treating pain sources. This protocol aims to restore function by minimizing pain. By addressing the underlying causes of pain, rather than just masking the symptoms with opioids, the pain specialists at Lags use the MAP protocol to minimize the need for highly-invasive surgeries and additional prescriptions.

MAP Protocol Treatment Pillars

Metabolic

Metabolic Pain Causes: Small Fiber Neuropathy, Diabetes or Metabolic Syndrome, Obesity or Pre-diabetes, Autoimmune or Infectious Disease

Metabolic Assessments: ENFD, Blood Panel, Diabetes Risk Assessment

Medications: Trental & Topamax

Treatments: Exercise, Weight loss, a-Lipoic Acid & L-citruline, Diabetes Prevention Program

Anatomical

Anatomical Pain Causes: Disease, Physical Trauma, Physical Injury

Anatomical Assessments: Physical Examination, Imaging: X-ray, MRI, Ultrasound, SDAF, EMG/Nerve Conduction Velocity Test

Treatments: Nerve Blocks, Guided Injections: Fluoroscopy & Ultrasound, Acupuncture, PRP, Stem Cell-Based Therapy

Psychological

Psychological Pain Causes: Depression, Anxiety/Stress, Isolation, Substance Abuse Disorder, Childhood Trauma

Psychological Assessments: ACE Evaluation, ASI Evaluation, Clear Assessment

Treatments: Mental health counseling, Substance abuse counseling, Mindfulness meditation classes

Lags patients use an average of 69% LESS opioids than the national average.

With a national average of 120 MME (Morphine Milligram Equivalents), LAGS takes a sensible approach to pain medication management. IN 2018 our providers prescribed an average of 37.65 MME, nearly 2/3 lower than the national average.

Note: All Morphine Milligram Equivalent (MME) conversions are recalculated to show a monthly average. The Conversion data is reprinted from CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016, by Dowell, Haegerich, & Chou, retrieved from http://dx.doi.org/10.15585/mmwr.rr6501e1

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