Interventional Pain Management

Dr. Gruber, DO Interventional Pain Management Specialist

Impact Med is happy to introduce double-certified Dr. Robert Gruber, DO, our interventional pain management specialist. Dr. Gruber is a board-certified PM/R physician who specializes in interventional pain management and has served Tampa Bay for over 30 years. He has served as Medical Director for many “world-class” spine practices and is an expert at identifying the primary cause of a patient’s pain and which modality of treatment would be best from chiropractic care to surgery

Restore Function & Relieve Pain with Interventional Pain Management

Pain is caused by various issues such as injury, surgery, nerve damage, and car accidents. Dr. Gruber plays an essential role in coordinating pain management techniques such as chiropractic care, physical therapy, and rehabilitation programs for our patients.

Interventional pain management uses several methods to reduce pain and improve a patient’s quality of life. These treatments are minimally invasive and are used by patients who may have tried other therapies that have not been successful.

Dr Robert Gruber Interventional Pain Management

Dr. Gruber specializes in the following treatments to manage pain:

Cervical/Thoracic/Lumbar Discography

Discography tests are used to determine which disc or discs in the lumbar spine (lower back), cervical spine (neck), and thoracic spine (mid-back) that are causing pain and if there is any degeneration.

First, dye is injected into the center of the discs, and x-rays are taken. Second, we determine the location and intensity of the pain, and which discs, if any, are causing the pain.

Cervical/Thoracic/Lumbar Epidural Steroid Injections

Epidural injections deliver anti-inflammatory steroids into the space around the spinal nerve roots to help relieve back, leg, or other pain in the body that is caused by irritated spinal nerves.

Take note: an epidural steroid injection is not a cure for back or leg pain, rather it gives patients enough pain relief to be able to move forward with their rehabilitation program.

Cervical/Thoracic/Lumbar Facet Injection

Facet joints are the small joints found at each segment of the spine that provide stability and guide motion. They can become inflamed or painful due to arthritis, stress, or injury to the back.

During a facet joint injection, a small amount of local anesthetic (a numbing agent) and/or steroid medication is used to anesthetize the facet joints and help block pain. Facet joint injections are meant to relieve pain so that patients can better tolerate physical therapy exercises and rehabilitation.

Cervical/Thoracic/Lumbar Radio-Frequency Ablation

Radiofrequency ablation (RFA) is a procedure where injections are used to treat several conditions including chronic back or neck pain. RFA involves heating part of the pain-transmitting nerves with a radiofrequency need to create a lesion. This lesion prevents the nerve from sending pain signals to a patient’s brain.

RFA can:

Reduce back and neck pain for longer periods of time
Avoid or delay surgery

Improve back and neck function and allow for more range of motion

Reduce the need for pain medications

Percutaneous Discectomy

Percutaneous discectomy is a minimally invasive procedure that reduces the pain from herniated discs. The procedure is done with a small needle and eliminates the need for an incision. The needle is guided to the disc and a probe with a rotating tip is inserted through the needle sing fluoroscopy (live x-ray).

When the probe is turned on, it removes small portions of the disc nucleus to allow the disc to reabsorb the herniation and relieve pressure on the nerve.

Cervical/Thoracic/Lumbar Diagnostic

Discography is used to diagnose back and neck problems and helps identify if an abnormal disc in the spine is the cause of pain.

During a diagnostic discogram, a dye is injected into the center of one or more discs, and the patient will be asked to describe their pain level as the injection is performed. The injection may trigger more intense pain or may feel similar to the daily pain that a patient experiences. Imaging will show if there are tears or fissures in the lining of the disc.

Selective Nerve Root Blocks

Selective nerve root block injections (SNRB) are long-lasting cortisone injections that are injected around the nerve root as it exits the spinal column.

Cortisone injections reduce the inflammation and pain caused by compression or pressure on the nerve. It can also be used by doctors as a diagnostic tool to help determine whether the nerve is irritated by numbing the nerve.

Herniated discs that cause low back and leg pain (sciatica) if one of the most common conditions that benefit from SNRB.

Sacroiliac Injections and Ablations

The goal of a sacroiliac joint injection (SIJ) is to help improve spine motion and pain relief. During the procedure, anti-inflammatory medication and anesthetics are injected into the joint capsule of the sacroiliac joint to help treat pain in the lower back, upper leg, and buttocks.

SIJ ablations (RFA) involve heating part of the pain-transmitting nerves with a radiofrequency needed to create a lesion. This lesion prevents the sacroiliac nerve from sending pain signals to a patient’s brain.

Diagnostic Pain Mapping

As a diagnostic, pain mapping uses electrical stimulation applied to specific spinal nerves to produce a tingling sensation in the location of a patient’s usual location of pain.

Similar to diagnostic nerve root injections, pain mapping uses a specialized needle that contains a stimulating electrode to send gentle electrical signals to the nerve under live x-ray (fluoroscopy).

When the patient feels the painless tingling sensation in their leg, chest, or arm, they are asked if it is in the same location as their usual pan. If it is, it is considered concordant pain reproduction and the source of pain has been accurately diagnosed.

Conscience Sedation

During conscious sedation, a patient will be lightly asleep or slightly awake. They will be able to respond to questions but may not be able to remember the procedure. Conscious sedation can help to minimize discomfort and anxieties during medical procedures and wears off quickly once the procedure is completed.

Car Accident Injury Care

If you have been involved in an accident, we recommend that you consult with a personal injury patient (PIP) doctor within 14 days. Even minor car accidents can lead to neck, spine, muscle, and back injury and pain. Whether injuries are minor or significant, Dr. Gruber can provide pain management and solutions for patients suffering from car crash-related injuries.