Pain Management

Arthritis frequently affects the low back and the sacroiliac joint, which connects the base of the spine to the hip joint. Often arthritis pain can mimic low-back or buttock pain.

Types of Arthritis

Osteoarthritis is a common condition among those over 50. The cartilage that cushions your joints (such as the knees or hips) gradually breaks down. Then the bones rub against each other. It can cause pain due to disc degeneration, bone spurs, and spinal stenosis. Learn more about osteoarthritis.

Rheumatoid Arthritis is a condition that causes joint inflammation. Over time, this inflammation may destroy the joint tissues. Rheumatoid arthritis is more common in women than in men and often begins between the ages of 40 and 60. Learn more about rheumatoid arthritis.

Juvenile Idiopathic Arthritis (JIA) is a childhood disease that causes inflamed, swollen joints. This makes joints stiff and painful. Some children with JIA grow out of it after they get treatment. Others will need ongoing treatment as adults. There are several types of JIA. Learn more about JIA.

Symptoms of Arthritis

The main symptoms of arthritis are:

• Pain
• Stiffness
• Swelling in the joints of the hands, wrists, elbows, feet, ankles, knees, or neck

Less common symptoms include muscle weakness, reduced range of motion, and joint deformity.

Rheumatoid arthritis usually affects both sides of the body at the same time. In rare but severe cases, it may affect the eyes, lungs, heart, nerves, or blood vessels. Sometimes the disease can cause bumps called nodules to form over the elbows, knuckles, spine, and lower leg bones.

Symptoms of JIA may also include problems walking, fever, and rash.

Treatment Options for Arthritis

There are many treatments for arthritis that can help with the pain and make it easier to move. You and your doctor will work together to find what works best for you.

• Exercise
• Physical therapy
• Anti-inflammatory medications, including NSAIDs and steroids
• Surgery, such as radiofrequency ablation

Why Choose Weill Cornell Medicine?

The physicians at the Weill Cornell Medicine Division of Pain Management specialize in treating pain and symptoms associated with all types of arthritis.

Our care team uses the latest research, the most advanced equipment, and innovative therapies to diagnose pain and develop customized pain management plans for each patient.

Weill Cornell Medicine often offers clinical trials, giving patients access to treatments that may not be available elsewhere. Learn more about Pain Management's current clinical trials.

We also work closely with a broad team of specialists to provide the highest quality care.

Contact us today to schedule a consultation.

Common Types of Back and Neck Pain

Back and neck pain can occur in many forms. Some types of pain are more serious than others, so it is important to seek evaluation and care from an expert.

Lumbar (back) or cervical (neck) strain can occur after any event that stresses the tissues and can range in severity. This soft-tissue injury can occur due to trauma, improper use, or overuse. Injuries often heal within days or weeks and are referred to as acute. Those injuries lasting longer than three months are considered chronic.

The most common types of back and neck pain are detailed below.

Herniated Disc

Herniated discs are often referred to as slipped or ruptured discs. The condition results from a tear in the outer layer of a disc (the rubber-like section between the spaces in the spine). It can happen in any part of the spine but is most common in the lumbar (lower back) or cervical (neck) regions of the spine. Herniated discs can happen to people of ages, including children, and affect both men and women.

Herniated Disc Symptoms

Botox for Pain

Botulinum toxin A is a protein produced by the bacteria clostridium botulinum. When injected into the muscle in tiny amounts, botulinum A (Botox) can stop or reduce muscle spasm by blocking nerve signals to the muscle.

Conditions Treated with Botox

Botox has many medical uses. It is most commonly known for smoothing wrinkles and minimizing signs of aging, but it can be used for many other purposes, including:

• Relieving severe muscle spasms around the eyes and in the neck, arms, legs, hands, and feet
• Minimizing severe muscle contractions associated with cerebral palsy
• Alleviating chronic low-back pain

Currently, the use of Botox for low-back pain is experimental. The limited research means that it is impossible to guarantee that botulinum toxin injection is an effective and safe treatment for you.

Multidisciplinary Pain Relief Treatment at Weill Cornell Medicine

Talk to a pain management specialist about the risks and benefits of Botox and its unlabeled use. If you would like to find out more about using Botox to treat low-back pain, please contact us today to schedule a consultation.

Chronic abdominal pain is pain that is present for more than three months. It may be present all the time, or it may come and go (referred to as “recurrent pain”). Causes include:

• Lactose intolerance
• Constipation
• Irritable bowel syndrome (IBS)
• Peptic ulcers
• Cancer
• Menopause

Functional Chronic Abdominal Pain

Functional chronic abdominal pain is real pain that exists for more than six months and occurs with no evidence of a specific physical disorder. It is also not related to body functions (such as menstrual periods, bowel movements, or eating), a drug, or a toxin. Functional pain can be severe and typically interferes with a person’s life.

Exactly what causes the pain is unknown. But the nerves of the digestive tract may become oversensitive to sensations.

Chronic Abdominal Pain Symptoms

Symptoms of chronic abdominal pain vary from patient to patient, and they may change with each episode. The most common symptoms include:

• Sharp or dull pain
• Severe pain that causes you to become sweaty, cry or bend over in pain
• Pain that lasts a few minutes or hours
• Pain in the belly button area or anywhere in the belly
• Pain that may or may not be related to eating
• Pain that occurs any time of the day or night
• Abdominal pain that occurs with vomiting, headaches, or pain in the arms or legs
• Not being hungry like usual or skipping meals, usually without losing weight

Symptoms that require a doctor’s immediate attention include a high fever, loss of appetite or weight, pain that awakens the person, blood in stool or urine, jaundice, severe nausea and vomiting, difficulty swallowing, and swelling of the legs or abdomen.

Treatment Options for Chronic Abdominal Pain

Treatment depends on the cause. If a physical cause is known, treating the cause is the first step.

When a physical cause is not found, treatment focuses on helping people return to normal daily activities and minimizing discomfort. These measures include:

• Lessening stress and anxiety with medications, relaxation techniques, biofeedback, hypnosis, or other methods
• Relieving pain with medications
• High-fiber diet or fiber supplements
• Reducing muscle spasms in the digestive tract with medications or peppermint oil

Why Choose Weill Cornell Medicine?

Our physicians at the Weill Cornell Medicine Division of Pain Management use the latest research, the most advanced equipment, and innovative therapies to diagnose pain and develop customized pain management plans for each patient.

We are experts in diagnosing and treating chronic abdominal pain and its many causes.

Weill Cornell Medicine also offers clinical trials, giving patients access to treatments that may not be available elsewhere. Learn more about Pain Management's current clinical trials.

Contact us today to schedule a consultation.

Pain is your body’s normal reaction to an injury or illness, a warning that something is wrong. When your body heals, you usually stop hurting.

For some, pain continues after the initial cause is gone. About 25 percent of people with chronic pain will go on to have a condition called complex (chronic) pain syndrome. This takes a toll on both physical and emotional health.

Chronic pain syndrome is complex and poorly defined. Most doctors consider pain that lasts longer than six months as chronic pain syndrome.

Chronic Pain Syndrome Symptoms

In addition to pain that lasts “longer than it should,” patients are affected by many other symptoms:

• Depression
• Fatigue
• Libido reduction
• Changes in everyday behavior
• Onset of dependent behavior or drug and alcohol abuse

Chronic Pain Syndrome Treatments

Chronic pain syndrome can be hard to treat, but it’s not impossible. A mix of treatments like counseling, physical therapy, and relaxation techniques can help relieve your pain and the other symptoms that come with it. The most effective treatments include:

• Psychological treatment
• Biofeedback
• Physical and occupational therapy
• Application of heat or cold, massage, ultrasonographic therapy, stretching, traction, manipulations
• Transcutaneous electrical nerve stimulation
• Spinal cord stimulation

Why Choose Weill Cornell Medicine for Chronic Pain Syndrome Treatment?

Chronic pain is a challenging and life-changing disease. At Weill Cornell Medicine Division of Pain Management, our physicians are experts in treating difficult, complex pain, including chronic pain syndrome.

Our team uses the latest research, the most advanced equipment, and innovative therapies to diagnose pain and develop customized pain management plans for each patient.

We work closely with a broad team of specialists to help our patients regain independence, functionality, and improve their quality of life.

Weill Cornell Medicine also offers clinical trials, giving patients access to treatments that may not be available elsewhere. Learn more about Pain Management's current clinical trials.

Contact us for a consultation today.

At Weill Cornell Medicine Division of Pain Management, our expert physicians put your quality of life first.

Chronic muscle pain is often difficult and complex to treat: there is no cure or single treatment that provides relief. Our highly trained pain management physicians use a multidisciplinary approach and tailor every treatment plan to each individual patient.

Our Unique Approach to Treating Muscle Pain

We take the time to understand each patient’s pain, symptoms, and goals before creating an individualized treatment plan. This treatment may include:

• Medications
• Trigger-point injections
• Spinal cord stimulation or other forms of neuromodulation
• Acupuncture or other alternative therapies

Our goal is to first identify the specific sources of pain and inflammation and then employ a variety of treatments to minimize discomfort associated with repeated injury or overuse of muscle tissue.

By combining multifaceted treatments with compassionate care, our patients achieve remarkable results. Our physicians and entire care team work closely with all muscle pain patients to help them live happy, active, and pain-free lives.

Expert Muscle Pain Treatment at Weill Cornell Medicine

Our physicians are leading experts in a wide spectrum of pain disorders, including muscle pain.

Weill Cornell Medicine also offers clinical trials, giving patients access to treatments that may not be available elsewhere. Learn more about Pain Management's current clinical trials.

If you would like to find out more about our Comprehensive Muscle Pain Program, please contact us today to schedule a consultation.

At Weill Cornell Medicine Division of Pain Management, our team of expert physicians understands the importance of making an accurate diagnosis for pain. We understand that pain is complex and challenging to live with — and that receiving a diagnosis and treatment plan can be a great source of comfort in and of itself.

Medical Evaluation with Pain Management Specialists

When you meet with a pain management physician at Weill Cornell Medicine, he or she will take the time to understand your medical history, including any history of illness, injury, or surgery.

You will be asked several questions about your pain, as well as your goals for improving your quality of life. Your doctor may order blood tests for additional information.

Diagnostic Tests

The nervous system is a complex, highly specialized network. It organizes, explains, and directs interactions between you and the world around you. The nervous system controls:

• Sight, hearing, taste, smell, and feeling (sensation)
• Voluntary and involuntary functions, such as movement, balance, and coordination
• Regulation of most other body systems, such as blood flow and blood pressure
• Ability to think and reason

There are many different types of nervous system disorders, including scoliosis and spina bifida, which cause pain.

Why Choose Weill Cornell Medicine?

The physicians at Weill Cornell Medicine Division of Pain Management are experts in helping those with nervous system disorders alleviate pain.

Using the latest research, the most advanced equipment, and innovative therapies, the physicians diagnose pain and develop customized pain management plans for each patient. We work closely with a broad team of specialists to help our patients regain independence, functionality, and improve their quality of life.

The collaborative team at Weill Cornell Medicine’s Center for Comprehensive Spine Care draws on clinical knowledge from neurology, neurosurgery, rehabilitation medicine, and pain management.

After assessing your case, we will tailor a treatment plan that may include medication, pain management, and physical therapy. When surgery is part of the plan, we offer the most advanced minimally invasive techniques.

Weill Cornell Medicine also offers clinical trials, giving patients access to treatments that may not be widely available. Learn more about Pain Management's current clinical trials.

Scoliosis

Scoliosis is a large curvature of the spine. It may be caused by a spinal abnormality or by a difference in leg length.

If this curve is severe, it can cause pain and make breathing difficult. Learn more about scoliosis.

Scoliosis Symptoms

Because the severity of scoliosis can vary from person to person, the symptoms of scoliosis will vary in intensity. A curve of more than 20 degrees may require treatment.

Common signs and symptoms include:

• Uneven shoulder blades; sometimes one shoulder blade will stick out further than the other
• Head off-center from the pelvis, along with an uneven alignment or asymmetrical-looking spine
• Unevenly aligned hips; one hip may be higher than the other
• Uneven rib cage
• Uneven waist
• Overall leaning to one side
• Difficulty breathing (especially in cases of severe congenital or neuromuscular scoliosis)

Mild cases of scoliosis usually go unnoticed, but if there is pain or visible symptoms, it is important to see a doctor for proper diagnosis and treatment. Pediatricians may note signs of possible scoliosis during routine checkups.

Scoliosis Treatments

Mild cases of scoliosis usually do not need treatment. Some people may use nonprescription medicines such as ibuprofen and naproxen to treat back pain. While these medicines may relieve symptoms of back pain for a brief time, they do not heal scoliosis or back injuries.

Along with medication, other steps that help to support or promote good health, such as regular exercise and proper back care, may help relieve back pain for some adults. Your doctor may recommend physical therapy to help you learn ways to move and rest that will help ease the pain, as well as ways to stay active without increasing your symptoms. If the pain makes it hard to do your daily activities, your doctor may recommend surgery.

For actively growing children with scoliosis curves between 20 and 50 degrees, bracing is recommended. An external torso brace is worn for a prescribed number of hours. The brace applies corrective pressure to the growing spine, preventing further worsening of the scoliosis.

Spina Bifida

Spina bifida is a type of birth defect that occurs when the bones of the spine (vertebrae) don’t form properly around part of the baby’s spinal cord. Spina bifida can be mild or severe. When severe, it may be accompanied by nerve damage to the nerves that supply the lower part of the body. Learn more about spina bifida.

Spina Bifida Symptoms

The symptoms of a nervous system problem depend on which area of the nervous system is involved and what is causing the problem. Nervous system problems may occur slowly and cause a gradual loss of function (degenerative).

Most children with the mild form of spina bifida don’t have any problems from it. Children with the most severe form of spina bifida often have spine and brain issues that cause serious problems. They may have:

• Little or no feeling in their legs, feet, or arms
• Bladder or bowel problems
• Fluid buildup in the brain (hydrocephalus)
• A curve in their spine, such as scoliosis

Spina Bifida Treatments

Most children with the mild form of spina bifida do not need treatment. In severe cases, surgery by a neurosurgeon is done within the first 48 hours of life. This surgery involves closing the defect.

As children with severe spina bifida grow, other treatments and surgeries may be needed to manage problems that arise. The musculoskeletal imbalances resulting from spinal cord defect are managed with a combination of physical therapy for strengthening and stretching, braces to support the knees and ankles while standing, and surgery to correct any structural misalignment.

There are many specialists involved in the care of a child with spina bifida. These children are often best managed through a multidisciplinary approach, including neurosurgery, orthopedics, urology, orthotics, pain management, physical therapy, occupational therapy, primary care, and nutrition.

Schedule a Consultation Today

Contact us to learn more about the ways we treat disorders of the nervous system, including scoliosis and spina bifida.

The dorsal root ganglion is the cluster of nerves located at the dorsal root of the spinal cord. In the mid-2010s, devices to stimulate the dorsal root ganglion were developed as an additional tool for treating chronic pain. This is a type of neuromodulation, similar to spinal cord stimulation.

At the Weill Cornell Medicine Division of Pain Management, our team includes leading experts in neuromodulation and dorsal root ganglion stimulation.

With dorsal root ganglion stimulation, a non-rechargeable stimulation device is implanted over the dorsal root ganglion cluster of cells. The device can be adjusted to deliver the preferred amount of pain-relieving stimulation.

Advantages of Dorsal Root Ganglion Stimulation

Neuromodulation has been proven to be safe and effective for managing chronic pain. Despite being a new treatment option, dorsal root ganglion stimulation has also proven to provide pain relief.

The main advantages of dorsal root ganglion stimulation are:

• The ability to treat areas that cannot be treated effectively with spinal cord stimulation, such as the hands, chest, knees, feet, abdomen, or groin
• Can effectively treat pain associated with neuropathy, including diabetic neuropathy
• The ability to deliver pain relief to a highly specific area

Expert Neuromodulation Pain Treatment at Weill Cornell Medicine

Our physicians are leading experts in neuromodulation, including dorsal root ganglion stimulation. This treatment, when combined with our multifaceted and compassionate care, delivers a high level of pain relief for our patients.

Learn more about Pain Management's current clinical trials.

If you would like to find out more about dorsal root ganglion stimulation to relieve pain, please contact us today to schedule a consultation.

Ehlers-Danlos syndrome (EDS) is a group of inherited disorders that weaken connective tissues. Connective tissue is a complex mixture of proteins and other substances that provide strength and elasticity to the skin, bones, blood vessels, and other organs.

There are several types of EDS. They can range from mild to life-threatening. About 1 in 5,000 people has EDS.

Ehlers-Danlos Syndrome Symptoms

The most common signs and symptoms include:

• Overly flexible, loose joints
• Joint pain and dislocations
• Soft, velvety, stretchy skin that bruises easily
• Abnormal scar formation and wound healing

A more severe form of the disorder, called vascular Ehlers-Danlos syndrome, can cause the walls of your blood vessels, intestines, or uterus to rupture.

Ehlers-Danlos Syndrome Treatments

There is no cure for Ehlers-Danlos syndrome. Treatment involves managing symptoms, often with medicines and physical therapy, as well as taking measures to protect joints and prevent injuries. Common treatment options include:

• Over-the-counter pain relievers
• Blood pressure medications
• Physical therapy
• Braces

Why Choose Weill Cornell Medicine for Ehlers-Danlos Syndrome Treatment?

The physicians at Weill Cornell Medicine Division of Pain Management are experts in Ehlers-Danlos syndrome.

Our team of pain management experts use the latest research, the most advanced equipment, and innovative therapies to diagnose pain and develop customized pain management plans for each patient. We work closely with a broad team of specialists to provide the highest quality care.

Weill Cornell Medicine also offers clinical trials, giving patients access to treatments that may not be widely available. Learn more about Pain Management's current clinical trials.

Contact us today to learn more about the ways we treat Ehlers-Danlos Syndrome.

Failed back surgery syndrome (FBSS) is a generalized term used to describe the condition of patients who have not had a successful result with back or spine surgery and experience continued pain after surgery.

Development of FBSS

Multiple factors can contribute to the development of FBSS, including:

• Recurrent spinal disc herniation
• Persistent pressure on a spinal nerve after surgery
• Altered joint mobility and scar tissue (fibrosis)
• Pre-existing conditions, such as diabetes, autoimmune disease, and vascular disease

Postoperative pain is normal, but this pain should begin to fade after a week or two, even if it does not entirely diminish. If the pain and symptoms do not lessen, or if they start to worsen over time, you may be suffering from failed back surgery syndrome.

Failed Back Surgery Syndrome Symptoms

The most obvious sign of failed back surgery syndrome is persistent, dull, and aching pain involving the back or legs not associated with the healing process. Other symptoms include:

• New pain at a level different from the location treated
• Inability to recuperate
• Restricted mobility
• Sharp, stabbing back pain
• Numbness or pain radiating through the lower back into the legs
• Back spasms
• Anxiety, depression, and sleeplessness
• Potential dependence on pain medication

Failed Back Surgery Syndrome Treatment Options

Diagnosing where the pain is coming from is the first step in reducing pain and restoring function. Treatments may include:

• Non-steroidal anti-inflammatory (NSAID) medications
• Physical therapy
• Exercise
• Microcurrent electrical neuromuscular stimulator
• Nerve blocks
• Transcutaneous electrical nerve stimulation (TENS)
• Membrane stabilizers
• Spinal cord stimulation
• Implantable pumps

If your chronic pain persists after several weeks or months of conservative treatment, a surgery may be recommended.

Why Choose Weill Cornell Medicine for Muscle or Joint Pain Treatment?

Muscle and joint pain can be challenging and difficult to live with. The physicians at the Weill Cornell Medicine Division of Pain Management use the latest research, the most advanced equipment, and innovative therapies to diagnose pain and develop a customized pain management plan for each patient.

Weill Cornell Medicine also offers clinical trials, giving patients access to treatments that may not be widely available. Learn more about Pain Management's current clinical trials.

We work closely with a broad team of specialists to help our patients regain independence, functionality, and improve quality of life. After assessing your case, we will tailor a treatment plan that may include medication, pain management, and physical therapy. When surgery is part of the plan, we offer the most advanced, minimally invasive techniques.

Why Choose Weill Cornell Medicine for Failed Back Surgery Syndrome?

The physicians at Weill Cornell Medicine Division of Pain Management are experts in helping patients with failed back surgery syndrome. Our team uses the latest research, the most advanced equipment, and innovative therapies to diagnose pain and develop a customized pain management plan for each patient.

We work closely with a broad team of specialists to provide the highest quality care, often in our spa-like, office-based setting. We collaborate with the Center for Comprehensive Spine Care in New York City, which consists of neurology, pain management, neurosurgery, psychiatry, radiology, and psychology specialists who provide personalized and precise treatment plans.

Fibromyalgia is widespread pain in the muscles and soft tissues above and below the waist and on both sides of the body. People with fibromyalgia feel pain, tenderness, or both even when there is no injury or inflammation.

Fibromyalgia Can Cause Long-Lasting (Chronic) Pain

It has no cure, but most patients are able to work and do their regular activities with comprehensive, expert care. When it is not controlled, patients lack energy, experience depression, or have trouble sleeping.

The cause of fibromyalgia is not known. It is believed to result from over-sensitive nerve cells, a chemical imbalance in the brain, or a hormonal disruption of the deep phase of sleep.

Fibromyalgia Symptoms

The main symptoms of fibromyalgia are:

• Deep or burning pain in your trunk, neck, low back, hips, and shoulders
• Tender points (or trigger points) on the body that hurt when pressed

People with fibromyalgia may have other problems, such as:

• Anxiety and depression
• Sleep problems and tiredness
• Headaches
• Morning stiffness
• Trouble concentrating
• Irritable bowel syndrome

Symptoms tend to come and go. You may have times when you hurt more, followed by times when symptoms happen less often, hurt less, or are absent (remissions). Some people find that their symptoms are worse in cold and damp weather, during times of stress, or when they try to do too much.

Treatment Options for Fibromyalgia

Treatment is focused on managing pain, fatigue, depression, and other symptoms. You may be able to control your symptoms with:

• Regular exercise
• Medications to manage symptoms
• Counseling
• Good self care, including managing stress, sleeping well, and eating well
• Complementary therapies, such as tai chi, acupuncture, massage, behavioral therapy, and relaxation techniques

Why Choose Weill Cornell Medicine for Fibromyalgia Treatment?

Fibromyalgia is a challenging and life-changing disease. The physicians at Weill Cornell Medicine Division of Pain Management are experts in diagnosing fibromyalgia, as well as helping patients manage the disease to improve their quality of life.

Our team uses the latest research, the most advanced equipment, and innovative therapies to diagnose pain and develop customized pain management plans for each patient.

Weill Cornell Medicine also offers clinical trials, giving patients access to treatments that may not be widely available. Learn more about Pain Management's current clinical trials.

We also work closely with a broad team of specialists to help our patients regain independence, functionality, and improve their quality of life.

Contact us today to schedule a consultation.

Tension Headaches

Tension headaches are the most common type of headache. They are often caused by stress and emotional strain. Most adults have tension headaches from time to time, and everyone may feel pain in different areas.

Tension Headache Symptoms and Treatments

Tension headaches can feel like a band around your head, causing mild to moderate pain.

Tension headaches can often be treated effectively with over-the-counter pain relievers, including acetaminophen or aspirin. Your doctor may prescribe other medication for chronic tension headaches. Other treatment options include exercise and relaxation techniques.

Cluster Headaches

Cluster headaches are recurring headaches that can occur multiple times a day and last from 15 minutes to three hours. A “cycle” of attacks can continue from six to 12 weeks.

Cluster Headache Symptoms and Treatments

Cluster headaches appear suddenly and cause severe, debilitating pain in or around one eye, along with a watery eye and nasal congestion on the affected side of the head. Unlike other types of headaches, cluster headaches get worse when lying down.

Over-the-counter pain medicines usually don’t work for cluster headaches. However, triptans, which are commonly used to treat migraines, are an effective treatment for an acute cluster headache.

Preventive therapies may be used at the onset of the cluster episode. These include calcium channel blockers and corticosteroids.

Dealing with repeated cluster headaches can lead to stress and depression, which can continue the headache cycle. Finding ways to cope with stress (such as with regular exercise and relaxation techniques) and improve depression may reduce the severity or frequency of your cluster headaches.

Migraine Headaches

Migraine headaches can cause severe throbbing pain or a pulsing sensation, usually on just one side of the head. Warning symptoms, known as aura, may occur before or with a headache. These can include:

• Flashes of light
• Blind spots
• Tingling on one side of the face or in your arm or leg

Migraine Symptoms and Treatments

Infusion therapy is a safe and effective treatment option for a variety of conditions. After a careful diagnosis of your pain and diagnosis, your pain medicine doctor will determine an effective medication and dosage. An intravenous (IV) catheter is placed in your arm or hand and then the medication will be infused over a set amount of time while you are monitored.

This treatment option is safe and proven to be effective in reducing pain levels to promote greater function and a higher quality of life.

Conditions Treated with Infusion Therapy

Infusion therapy is used to treat:

• Fibromyalgia
• Neuropathy, including diabetic neuropathy
• Pain related to stroke or spinal injuries

The most common medications used in infusion therapy are:

• Lidocaine
• B vitamins
• Ketamine
• Magnesium

Comprehensive Pain Management Care at Weill Cornell Medicine

Our physicians are leading experts in pain management treatments, including infusion therapy. This treatment, when combined with our multifaceted and compassionate care, delivers a high level of pain relief for our patients.

If you would like to find out more about infusion therapy to relieve spinal stenosis pain, please contact us today to schedule a consultation.

Intrathecal Pump Pain Treatment

Intrathecal pumps are tools implanted in the spinal cord that deliver pain medication to a specific area of the body. Depending on the condition, the pump may administer an opioid, like morphine, or a muscle relaxant, such as baclofen.

Advantages of Intrathecal Pumps

The main advantages of intrathecal pumps include:

• Effectiveness: Many patients have experienced significant pain relief using an intrathecal pump.
• Targeted relief: Before implanting the pump, a trial period tests the type of medication to ensure effective pain relief.
• Low dose of medication: Since the medication is delivered directly to the source of pain, patients need less pain medication. For example, to provide equivalent effects on pain, roughly 300mg of morphine would need to be given for 1mg of Intrathecal morphine.
• Fewer side effects associated with medication: Since a very low dose of medication is required, patients do not experience any severe side effects, such as sedation, nausea, and vomiting.

Conditions Treated with Intrathecal Pumps

This tool can provide effective pain relief for:

• Failed back surgery syndrome
• Cancer pain
• Complex regional pain syndrome
• Peripheral neuropathy
• Cerebral palsy
• Multiple sclerosis
• Stroke
• Brain injury
• Spinal cord injury

Comprehensive Pain Management Care at Weill Cornell Medicine

Our physicians are leading experts in pain management treatments, including intrathecal pumps. This treatment, when combined with our multifaceted and compassionate care, delivers a high level of pain relief for our patients.

If you would like to find out more about intrathecal pumps to relieve pain, please contact us today to schedule a consultation.

Spinal stenosis is a condition caused by changes in the shape and size of the lower (lumbar) spinal canal. This can be caused by many factors, including a buildup of excess bone or ligament tissue. Spinal stenosis typically occurs because of aging and natural wear and tear.

Common symptoms of lumbar spinal stenosis include:

• Pain in the legs, buttocks, lower back or groin regions
• Increased difficulty walking or standing, especially for long periods of time
• Increased relief when sitting or in a flexed position
• Numbness, weakness, cramping, or stiffness in the legs or buttock

MILD® Procedure for Treating Spinal Stenosis

Aches and pains in our bones, joints, and muscles may be caused by everyday wear and tear, overuse, or aging. This pain can also be the result of injury or illness. No matter the cause, the pain medicine experts at Weill Cornell Medicine can help alleviate pain and improve quality of life.

Muscle and Joint Pain Symptoms

Muscle Pain

This pain is more intense and severe the feeling of soreness. It is normal to experience sore muscles several hours after intense exertion; this feeling goes away after 48 hours.

Muscle pain, however, occurs quickly and lasts for more than several days. Contact a physician as soon as possible if you experience these symptoms because it may be a sign of injury.

Joint Pain

Caused by overuse or injury, the most common examples of joint pain are tennis elbow and knee injury. Symptoms include:

• Sudden, severe pain
• Swelling
• Numbness
• Tingling
• Weakness
• Changes in temperature or color
• Changes in your range of motion

Sore and achy joints are a sign of osteoarthritis, an inflammatory condition that is more common with age. The cartilage that normally cushions the joints wears away, leaving the joints inflamed and painful.

Treatment Options for Muscle and Joint Pain

It can be difficult to determine the cause of muscle or joint pain. Our expert pain management physicians take the time to understand the possible causes and develop a targeted treatment plan to address the cause and minimize symptoms.

Most patients find relief through conservative treatments. These may include:

• Indirect ice and heat therapy
• Over-the-counter pain medications
• Exercise
• Physical therapy

Injections, nerve blocks, or surgery may be considered if other options are not successful.

Weill Cornell Medicine also offers clinical trials, giving patients access to treatments that may not be widely available. Learn more about Pain Management's current clinical trials.

Why Choose Weill Cornell Medicine for Muscle or Joint Pain Treatment?

Muscle and joint pain can be challenging and difficult to live with. The physicians at the Weill Cornell Medicine Division of Pain Management use the latest research, the most advanced equipment, and innovative therapies to diagnose pain and develop a customized pain management plan for each patient.

We work closely with a broad team of specialists to help our patients regain independence, functionality, and improve quality of life. After assessing your case, we will tailor a treatment plan that may include medication, pain management, and physical therapy. When surgery is part of the plan, we offer the most advanced, minimally invasive techniques.

Most people have muscle pain from time to time. Chronic myofascial pain is an ongoing or longer-lasting pain that can affect the connective tissue (fascia) of a muscle or group of muscles.

The source of myofascial pain is called a “trigger point.” Trigger points are usually in fascia or a tight muscle. The cause of this pain is unknown.

Myofascial Pain Symptoms

The primary symptom of chronic myofascial pain is ongoing or longer-lasting muscle pain, in areas such as the low back, neck, shoulders, and chest. You might feel the pain, or the pain may get worse when you press on a trigger point. The muscle may be swollen or hard (“knot”).

Symptoms of myofascial pain may include:

• A muscle that is sensitive or tender when touched
• Muscle pain that occurs when pressure is applied to a trigger point
• Pain that feels like aching, burning, stinging, or stabbing
• Reduced range of motion in the affected area
• Perceived weakness in the affected muscle

People with chronic myofascial pain may have other health problems, such as tension headaches, depression, sleep problems, and fatigue. These problems are common in people who have chronic pain.

Treatment Options for Myofascial Pain

Myofascial pain often goes away with conservative treatment, including:

• Cognitive-behavioral therapy
• Cooling spray
• Massage therapy
• Physical therapy
• Trigger point anesthetic shots (injections)
• Transcutaneous electrical nerve stimulation (TENS)

Your doctor may also recommend nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or aspirin, for pain. Antidepressants or muscle relaxants can help relax muscles and relieve sleep problems related to myofascial pain. Acupuncture may also be an effective treatment.

Why Choose Weill Cornell Medicine for Myofascial Pain?

The physicians at Weill Cornell Medicine Division of Pain Management use the latest research, the most advanced equipment, and innovative therapies to diagnose pain and develop customized pain management plans for each patient. 

Weill Cornell Medicine also offers clinical trials, giving patients access to treatments that may not be widely available. Learn more about Pain Management's current clinical trials.

We work closely with a broad team of specialists to provide the highest quality care. Our team includes experts in myofascial pain. We help many patients live with less pain and less severe symptoms.

Contact us today to schedule a consultation.

Neuropathic pain is caused by injury or disease to the nervous system. There are several different types of neuropathy, including diabetic, central, and peripheral neuropathy.

The nerve damage that causes this pain can be caused by:

• Diabetes
• Facial nerve pain
• Toxins, such as chemotherapy and radiation
• Shingles
• Nerve impingement due to disc herniation, carpal tunnel syndrome, and spinal stenosis
• Vitamin deficiency

Neuropathy Symptoms

Symptoms include changes in sensation, including burning pain, tingling, or numbness. Some people describe their pain as “pins and needles.”

Treatment Options for Neuropathic Pain

There is no cure for neuropathy or the accompanying pain. Treating this pain can be difficult and complex, so it is important to seek an experienced pain management expert for care.

Medications

• Antidepressants and antiepileptics have been found to help relieve pain by interfering with chemical processes in your brain and spinal cord that cause you to feel pain
• Topical preparations including anesthetics like lidocaine, or topical anti-inflammatory agents, can improve peripheral neuropathy symptoms
• Capsaicin cream has modest effects when used for neuropathic pain
• Botox injections are helpful in the treatment of small areas of localized neuropathic pain
• NMDA antagonists, such as ketamine and dextromethorphan, may reduce spinal neuron sensitization

Other Therapies

• Physical therapy
• Neuromodulation (nerve stimulation) can be effective for neuropathic pain that doesn’t respond to other treatments

Why Choose Weill Cornell Medicine for Neuropathic Pain?

Weill Cornell Pain Management physicians use the latest research, the most advanced equipment, and innovative therapies to diagnose pain and develop customized pain management plans for each patient.

We work closely with a broad team of specialists to help our patients regain independence, functionality, and improve their quality of life. After assessing your case, we will tailor a treatment plan that may include medication, pain management, and physical therapy. When surgery is part of the plan, we offer the most advanced minimally invasive techniques.

Weill Cornell Medicine often offers clinical trials, giving patients access to treatments that may not be available elsewhere. Learn more about Pain Management's current clinical trials.

To learn more about the ways we treat neuropathic pain, contact us today.

Healthy bones can support quite a bit of pressure, but when vertebrae become soft or weakened by osteoporosis, they can fracture easily. Osteoporosis causes bones to lose their density and become very brittle. Fractures can happen even from simple movements that don’t seem dangerous. Osteoporosis is the most frequent cause of a vertebral compression fracture and its subsequent pain.

Osteoporosis Symptoms

Not everyone with a vertebral compression fracture experiences the same symptoms. Sometimes patients only experience minimal or mild pain.

The most common symptoms of osteoporosis and vertebral compression fractures include:

• A curved or hunched spine called kyphosis or a “dowager’s hump”
• Loss of height
• Back fatigue, due to excess muscle strain used to hold up the spine
• Leg weakness
• Bladder or bowel incontinence
• Sudden, severe back pain that radiates around the waist and gets worse when you are standing or walking with some relief when you lie down
• Difficulty twisting or bending your body, difficulty getting out of bed

Treatments

Most vertebral fractures will heal after weeks of rest, over-the-counter pain medication, and a gradual increase in activity. The pain should subside as the bone begins to repair itself.

However, for some people, osteoporosis pain can last longer, and other therapies may be necessary. These include:

• Prescription medications for pain
• Bracing to stabilize the spine and reduce pain
• Physical therapy to strengthen the core muscles surrounding the spine and encourage newer, pain-free ways of moving
• Antidepressant medication to help deal with chronic pain
• Biofeedback to learn relaxation skills and ease pain

If medication, physical therapy, rest, or other techniques don’t work for your pain, your doctor may recommend surgery. See Surgery for Spinal Compression Fractures for more details about these surgical procedures.

Why Choose Weill Cornell Medicine for Osteoporosis Pain?

The expert physicians at the Weill Cornell Medicine Division of Pain Management work closely with a broad team of specialists to help our patients suffering from pain associated with osteoporosis and vertebral compression fractures. Our focus is on helping our patients regain independence, functionality, and improve quality of life.

Our specialists take a multi-disciplinary, patient-centered approach to care. After assessing your case, we will tailor a treatment plan that may include medication, pain management, and physical therapy. When surgery is part of the plan, we offer the most advanced minimally invasive techniques.

Weill Cornell Medicine often offers clinical trials as well, giving patients access to treatments that may not be available elsewhere. Learn more about Pain Management's current clinical trials.

The Center for Comprehensive Spine Care is made up of Neurology, Pain Management, Neurosurgery, Physiatry, Radiology, and Psychology — providing personalized, precision medicine. We employ some of the most sought-after vertebral compression fracture doctors in New York City.

At Weill Cornell Medicine, children and teens with pain disorders receive comprehensive and compassionate care from an expert pediatric specialist. 

Specialized Care for Kids and Teens with Pain Disorders

Dr. Veronica Carullo treats both primary and secondary pediatric pain disorders and helps patients and their families determine the best ways to manage their pain. Possible treatments include medications, physical therapy, psychological therapies like cognitive behavioral therapy, or interventional therapies.

Dr. Carullo often coordinates care with pediatric primary care physicians and other pediatric specialists.

Why Choose Weill Cornell Medicine?

Dr. Carullo has more than a decade of experience in treating pediatric pain disorders. And unlike most physicians — who translate their adult experiences to children — Dr. Carullo is specially trained to treat child and adolescent pain.

In addition to her training, Dr. Carullo is one of the few physicians board-certified in general pediatrics, anesthesiology, pediatric anesthesiology, pain medicine, and palliative medicine. 

To schedule an appointment with Dr. Carullo or to learn more about our pediatric pain management services, please contact us today.

Peripheral nerves make up the peripheral nervous system, the network of nerves that connect the entire body to the brain and spinal cord. These nerves are responsible for movement, motor coordination, and sensation.

Peripheral nerve stimulation is a type of neuromodulation, similar to spinal cord stimulation. At the Weill Cornell Medicine Division of Pain Management, our team includes leading experts in neuromodulation and peripheral nerve stimulation.

With peripheral nerve stimulation, a non-rechargeable stimulation device is implanted next to one of the peripheral nerves to deliver rapid electrical pulses. The device can be adjusted to deliver the preferred amount of pain-relieving stimulation.

Conditions Treated with Peripheral Nerve Stimulation

Peripheral nerve stimulation is a treatment option for:

• Some types of back pain
• Complex regional pain syndrome
• Migraine headaches

Advantages of Peripheral Nerve Stimulation

With peripheral nerve stimulation, the stimulation device can be placed on a trial basis before it is implanted. This helps ensure that the right area receives the pain-relieving stimulation.

As with all neuromodulation, this treatment therapy reduces or even eliminates, the need for oral pain medications.

Expert Neuromodulation Pain Treatment at Weill Cornell Medicine

Our physicians are leading experts in neuromodulation, including peripheral nerve stimulation. This treatment, when combined with our multifaceted and compassionate care, delivers a high level of pain relief for our patients.

If you would like to find out more about peripheral nerve stimulation to relieve pain, please contact us today to schedule a consultation.

Radiofrequency ablation is a minimally invasive procedure that uses radiofrequency to treat nerves causing pain. Local anesthetic is applied before the procedure. A thin, hollow needle is inserted into the spine at the location responsible for the pain, typically with the assistance of a special x-ray (fluoroscope) for better visual accuracy. A radiofrequency current is passed through the needle, burning the section of the nerve that causes pain.

Conditions Treated with Radiofrequency Ablation

Radiofrequency ablation is commonly used to treat:

• Back and neck pain
• Knee pain
• Pelvic pain
• Peripheral nerve pain

This procedure is known to be highly effective for patients who have had past success with a diagnostic nerve block.

Benefits of Radiofrequency Ablation

The primary benefit of radiofrequency ablation is that it provides pain relief for up to two years by preventing pain signals from reaching the brain. Other benefits include:

• Minimally invasive procedure
• Fast recovery
• Minimized need for oral pain medications
• The procedure can be repeated as needed

Expert Pain Treatment at Weill Cornell Medicine

Our physicians are leading experts in radiofrequency ablation. This treatment, when combined with our multifaceted and compassionate care, delivers a high level of pain relief for our patients.

If you would like to find out more about radiofrequency ablation to relieve pain, please contact us today to schedule a consultation.

Sciatica (lumbar radiculopathy) refers to symptoms of pain, tingling, numbness or weakness that travel down the low back and into the leg or extremity. The sciatic nerve is the largest nerve in the body and exits the spinal cord as several nerve roots which join to form the sciatic nerve.

Sciatica is not in itself a disease, but a symptom of an underlying medical condition. Sciatica most commonly occurs when a herniated disk or narrowing of the spine (spinal stenosis) compresses part of the nerve. The nerve, and the accompanying pain, radiate from the low back to travel behind the thigh and often below the knee to the ankle or foot.

In addition to disc herniation, the sciatic nerve may become irritated by adjacent structures, such as bone, muscle, tumors, infections, injury, or bleeding.

Symptoms of Sciatica

Symptoms are usually based on the location of the pinched nerve. They may include:

• Constant pain in only one side of the buttock or leg
• Pain that is worse when sitting
• Leg pain that is often described as burning or tingling
• Weakness, numbness, or difficulty moving the leg, foot, or toes

Pain that radiates down the leg and possibly into the foot and toes (radiculopathy).

Sciatica Treatments

Neuromodulation

Spinal cord stimulation (SCS) is available to patients at Weill Cornell Medicine, as part of the individualized and multidisciplinary approach to pain treatment at the Division of Pain Management.

SCS is a type of neuromodulation. This system works by applying small electrical impulses to the spinal cord to alleviate pain. It is used most often to treat complex or unmanageable back pain and neuropathy.

Neuromodulation

Neuromodulation is a technique to treat pain by directly stimulating the nervous system with electrical signals. The neuromodulation team at Weill Cornell includes specialized physicians and researchers from the Pain Management and Neurosurgery departments. It is one of the largest and busiest in New York City.

We perform spinal cord stimulation to treat:

• Failed back syndrome
• Radicular pain syndrome
• Post-laminectomy pain
• Peripheral neuropathy
• Complex regional pain syndrome

Nevro Senza HF10 Therapy

Weill Cornell Medicine Division of Pain Management was one of the first hospitals to adopt and offer the Nevro Senza SCS system HF10 Therapy, which was approved by the FDA in May 2015. The Senza SCS system uses electrical impulses to alleviate:

• Chronic back pain
• Neck pain
• Pain in the extremities

Currently, this therapy is the only SCS system with FDA approval to:

• Deliver pain relief without paresthesia (a constant tingling sensation that is the basis of SCS)
• Use without restrictions on operating motor vehicles

Multidisciplinary Pain Relief Treatment at Weill Cornell Medicine

Our expert pain management physicians offer the advanced Nevro Senza HF10 Therapy, building on their extensive experience with other spinal cord stimulation treatments for relieving chronic pain.

Nevro Senza HF10, other SCS systems, and all the treatments we offer are part of our multidisciplinary approach to pain management. They are important tools for designing individualized treatment and pain management programs we design to help each of our patients.

Since we promote an individualized approach to pain management, SCS and the HF10 therapy may or may not be the right option for you. If you would like to find out more, please contact us today to make an appointment.

Spinal stenosis is a condition caused by changes in the shape and size of the spinal canal. This typically occurs because of aging and natural wear and tear.

Common symptoms of spinal stenosis include:

• Pain in the legs, buttocks, or groin regions
• Increased difficulty walking or standing
• Increased relief when sitting or in a flexed position
• Numbness, weakness, cramping, or stiffness in the legs or buttock

Vertiflex Superion Treatment for Spinal Stenosis

Weill Cornell Medicine Pain Management offers a new technology to treat spinal stenosis and minimize the painful symptoms. Vertiflex superion is a device that is implanted into the area of the spine causing pain and relieves pressure on the affected nerves.

The major advantages of the Vertiflex superion device include:

• Implanting the device is a minimally invasive procedure with a short recovery time
• The device is available in multiple sizes for a variety of body types
• A safe and effective treatment option that does not involve surgery

Comprehensive Pain Management Care at Weill Cornell Medicine

Our physicians are leading experts in pain management treatments, including the Vertiflex superion device. This treatment, when combined with our multifaceted and compassionate care, delivers a high level of pain relief for our patients.

If you would like to find out more about the Vertiflex superion device to relieve spinal stenosis pain, please contact us today to schedule a consultation.