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Chronic pain can affect any part of the body and take many different forms. Led by Dr. Youmna DiStefano, the team at Pain Management Specialists can properly diagnose a wide range of conditions and then provide personalized treatment solutions designed especially for your specific situation.

Our minimally invasive pain intervention procedures, combined with a host of complementary alternative modalities, can effectively treat almost any chronic pain condition including the following specific issues, grouped by body location:

Pain Centralized in the Back and Spine

(please click on each condition for a brief description)

Degenerative Disc Disease

A common condition in caused by wear and tear on the gel-like cushioning discs that sit between the vertebrae. Often caused by genetic factors or aging, damage to these discs creates pain in the back and buttocks, and also in the thighs and neck.

Herniated Disc

While many are familiar with this term, it is more complex than most know. Treatment can vary widely depending on both the cause and the severity of the issue. Potential causes include aging, spinal trauma, and repetitive stress as well as behavioral influences including carrying too much body weight, eating a diet poor in nutrition, or smoking. Genetics can also play a role. Patients may experience pain in the back or neck or radiating pain that extends through extremities. They may also have weak muscles and/or numbness that make walking difficult.

Post Laminectomy Syndrome (Failed Back Surgery Syndrome, or FBSS)

This general term is used to describe a variety of chronic pain situations that arise out of unsuccessful spine surgery. The risks vary depending on what type of surgery was done, but—typically—the more invasive the surgery, the greater the risk of failure. Symptoms of FBSS can range from physical (chronic pain at, above, or below the treated area), limited mobility, dull or sharp pains in the extremities, etc.) to mental (anxiety and depression).

Facet Arthropathy

The facet joints are on the back of your spine and counterbalance the discs inside the spine’s vertebrae. Facet arthropathy is a centralized, dull aching pain that is generally caused by wearing down of those joints as well as arthritis. This condition can be the result of normal aging or other factors such as osteoarthritis, facet joint injury, or a synovial cyst.

Spinal Stenosis

Sometimes referred to as canal stenosis, this condition that generally affects the cervical (in the neck) and/or lumbar (lower back) sections of the spine. The condition causes a narrowing of the spinal canal, which contains the spinal cord and nerve roots. The result is pain or weakness in either the legs and/or thighs. While natural aging can cause spinal stenosis, other factors can also come into play including bulging or herniated discs, bone spurs, and spondylolisthesis (a degenerative spine condition).


Also called spinal osteoarthritis, spondylolysis is a generic term that refers to a variety of degenerative conditions that affect the spine, typically as a result of the natural wear and tear of the aging process. It can also refer to a stress fracture affecting a lower-back vertebra. Symptoms can vary widely in terms of location and severity, but general stiffness and pain are common. In addition to aging, other potential causes include carrying an unhealthy weight, trauma (often due to high-impact sports), and genetic predisposition.

Vertebral Fracture

As the name indicates, this condition refers to a break in a vertebra, which could cause pain in the lower back. Unlike ligament and muscle strains (such as whiplash), a vertebral fracture occurs when too much pressure is put on a bone, and it breaks. This is often the result of sudden downward force. In more severe cases, the impact can force bone fragments into the spinal canal, which is called a burst fracture. This condition is usually caused by trauma—a car accident, fall, sports injury, or other event.

Pain In the Extremities (Arm & Hand)

Degenerative Joint Disease (Osteoarthritis)

The chronic, gradual deterioration of the soft, flexible tissues and cartilage that surround the ends of the bones in shoulder, elbow, or wrist joints. With the cartilage gone, the bare bone surfaces grind together, causing inflammation, pain, and stiffness that greatly restricts movement and can also cause bone spurs. Primarily caused by natural aging, factors such as obesity, smoking, overexertion, and illness can exacerbate the condition.

Calcific Tendonitis of the Shoulder

The gradual build up of calcium deposits in the muscles or tendons of the shoulder. This creates inflammation and stiffness that can be very painful and can greatly restrict the range of arm movement that is possible. Causes of this common condition include genetics, abnormal cell growth or thyroid activity, and some metabolic diseases such as diabetes.

Carpal Tunnel Syndrome

Compression of the nerve that runs through the carpal tunnel, which is a narrow passage that runs along the palm side of the wrist. The result is pain, numbness, or tingling. Symptoms typically emerge over time, and can come and go. Caused by pressure on the nerve, carpal tunnel syndrome can be the result of anything that squeezes or otherwise irritates that nerve.

Frozen Shoulder

Also known as adhesive capsulitis, this condition usually presents as stiffness and tightening in the shoulder joint and the resultant pain and loss of movement. The condition worsens over time, often lasting several years. This condition can develop in people with other diseases such as diabetes. Risk of occurrence rises for patients who have undergone surgery that incapacitates the arm for an extended period (such as for a stroke or a mastectomy).

Golfer's Elbow

Technically called medial epicondylitis, this condition is characterized by pain that is felt on the medial epicondyle bone that runs between the elbow and wrist on the inside, or medial, side of the elbow. Generally caused by damage to the tendons due to overuse and excessive force, this condition is often an issue for people who regularly participate in certain sports (golf, baseball, tennis) or perform repetitive tasks such as chopping wood with an ax or a chainsaw, or carrying heavy items repeatedly.

Shoulder Sprain

A stretching or tearing of the acromioclavicular (AC) ligament, which supports the shoulder. This causes pain, swelling, and restriction of movement. Typically, this condition is cause by trauma such as a direct blow or a fall.  

Shoulder Tendinopathy or Tendonitis

An inflammation injury to the rotator cuff in the shoulder, which causes swelling, pain, and reduces range of motion. The primary cause is repeated “micro trauma” to the rotator cuff. This kind of trauma is often the result of engagement in a repetitive task of some kind.

Tennis Elbow (Lateral Epicondylitis)

A condition that most often arises from overuse, tennis elbow is pain that occurs over the lateral epicondyle bone, which is located on the outside of the elbow. This is where the tendons of the forearm connect to the bony bump on the outside of the elbow. In some cases, pain radiates to the forearm and wrist, and—in general—the pain can make simple actions like holding an object or turning a doorknob difficult. Not just caused by participation in racket sports, this condition can also be caused by the repetitive movements associated with tasks like painting, driving screws, or using a computer mouse.

Wrist Sprain

This common injury stretches or tears the ligaments that support the wrist. Frequently experienced by athletes, a wrist sprain is often the result of putting the hand out to break a fall. The injury results on pain and swelling that limits motion.

Pain In the Extremities (Leg & Foot)

Degenerative Joint Disease (Osteoarthritis)

A chronic and painful gradual deterioration of the tissue and cartilage that surround and protect the ends of bones spanning a hip, knee, or ankle joint. Without appropriate cushioning, the ends of these bones rub together, causing inflammation, pain, and stiffness, and sometimes leading to complications such as bone spurs. Primarily caused by natural aging, factors such as obesity, smoking, overexertion, and illness can exacerbate the condition.

Ankle Sprain

Typically caused by a rolling, twisting, or turning of the angle, an ankle sprain is stretching or tearing (either partial or complete) of the ligaments that support and stabilize the ankle. The injury causes pain, tenderness, swelling, bruising, and restricts the range of motion.

Patellofemoral Pain Syndrome

This condition presents as pain either at the front of the knee or under the kneecap (patella). Sometimes called “runner’s knee,” it is most noticeable during exercise, walking up or down stairs, kneeling or squatting, or when sitting with a bent knee for prolonged periods of time. This condition is associated with overuse (often running or jumping, anything that puts repetitive stress on the knee joint), misalignment of the muscles around the knee, injury, and sometimes knee surgery.

Sciatica (Lumbar Radiculopathy)

Occurring in the lower back, this irritation or pinching of the sciatic nerves can cause shooting pain, tingling, and/or numbness down one or the other leg. This condition can be caused by a narrowing of the space in which the nerve roots exit the spine, which in turn can be caused by stenosis, bone spurs, a herniated disc, or other conditions.

Pain in the Body’s Core (Chest and Abdomen)


This localized pain exists at the front of the chest wall where the rib bone is connected to the breastbone by cartilage. The pain is caused by inflammation of that cartilage and can be reminiscent of a heart attack. The sharp or pressure-like pain typically occurs on the left side and worsens with deep breathing or coughing. While there is no clear cause of costochondritis, it can be related to an injury or physical strain, arthritis, or a joint infection.

Pelvic Pain

Typically lasting six months or longer, this dull or sharp pain affects the lowest part of the abdomen and pelvis including intestines, bladder, and reproductive organs. The pain can be constant or intermittent, runs a full range of severity, and can be exacerbated by certain activities. The potential causes are many and include everything from miscarriage and ovarian cysts to appendicitis, constipation, fibromyalgia, and prostatitis.

Post-thoracotomy (or Video-Assisted Thoracoscopy – VATS) Pain

Relatively common in patients after chest surgery, this persistent pain presents in the upper back, ribs, or chest and can be either sharp and shooting or more of a burning. Usually, the pain is fairly moderate, but it can become severe.

Post-mastectomy Pain

Patients who undergo breast surgery may experience post-mastectomy pain in the chest or ribs. This pain might be sharp and shooting or more of a burning. It is typically manageable, but in some severe cases can become incapacitating.

Post Hernia Repair Pain

Patients recovering from a hernia may experience chronic pain in the lower abdomen, sometimes radiating to the groin area. This pain might be sharp and shooting or more of a burning, and it can range in terms of severity.

Postherpetic Neuralgia

This condition results as a complication of shingles, which is in turn caused by the chickenpox or herpes zoster virus. Postherpetic neuralgia causes a persistent burning pain along nerve fibers and skin, and it can well beyond recovery from the rash and blisters associated with shingles. Typically, this presents along one side of the trunk.

Pain in the Head and Neck

Cervical Myelopathy

  • Resulting from severe compression of the spinal cord, this condition can cause a variety of symptoms including pain, abnormalities in sensation, difficulty with fine motor skills, and difficulty walking. Typically caused by degenerative spinal conditions, this condition can also be brought on by disc herniations, autoimmune disorders, and other factors such as hernias, cysts, and spinal injury.

Cervicogenic Headache

The pain related to this condition is typically felt at the base of the neck up through the head. It is, however, actually believed to be caused by disorder of various elements (bone, disc, tissue) in the cervical spine. In addition to the pain and discomfort, this condition can reduce the range of motion in the neck and pain can radiate to the front of the head or behind the eyes.

Migraine Headache

These severe, recurring headaches causes throbbing pain and are often accompanied by light sensitivity, nausea, disturbances in vision, and even vomiting. They can cause significant pain that lasts for hours or even days, effectively incapacitating the patient. While there is no definitive cause of migraines, genetics and environmental factors do seem to influence their occurrence. Migraines can be triggered by many different things including hormonal changes, certain foods, alcohol, stress, and certain medications.

Occipital Neuralgia

This throbbing or piercing pain is typically felt at the back of the head and through the upper neck. The pain can also sometimes seem to radiate toward one eye, and the condition also often results in hyper sensitivity in the scalp making the merest touch extremely painful. Sometimes occurring spontaneously, this condition can also result from a pinched nerve or arthritis.

Tension Headache

Most commonly linked to stress and/or muscle contraction, a tension headache is felt as steady pained pressure that is mild to moderate and focused across the forehead, on the sides, or at the back of the head. Chronic tension headaches may list for hours and occur repeatedly for many days or even months. Causes and triggers vary widely.


A chronic and involuntary contraction of the neck muscles, which causes the head to turn to one side. This results in pain and stiffness that can restrict movement.

Trigeminal Neuralgia

The trigeminal nerve carries sensation from the face to the brain. This chronic condition causes intense, episodic pain in the face that can feel like an intense jolt of shock-like pain. While this condition may start out with fairly mild attacks, over time the attacks can become more intense and last longer. The underlying cause is pressure on the trigeminal nerve, which can be the result of aging or some other issue such as multiple sclerosis.

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