Introduction

Every painful condition is unique—but the principles behind effective treatment are the same. Understanding these principles empowers you to make informed decisions about your care and choose the option that best aligns with your goals. The aim of this article is to give you a general overview of some of the interventions we offer here at OCSS, as well as a look under the hood at the rationales behind these treatments.

Pain can be reduced by addressing the injured or inflamed area directly, or by calming the nerves responsible for sending pain signals.

There are several ways to accomplish this:

• Injections (steroids, platelet-rich plasma/PRP, peptides, stem cells)
  
  
• Nerve blocks (temporary numbing of targeted nerves)
  
  
• Radiofrequency ablation (“nerve burning” to provide longer-term relief)
  
  
• Stimulation therapies such as Spinal Cord Stimulation (SCS) that modify pain signals before they reach the brain
  
  

Some treatments reduce pain and others also help promote healing.

• Steroid injections, nerve blocks, and spinal cord stimulation are designed to reduce or interrupt pain signals, helping you feel better and function better—but they typically do not directly repair damaged tissues.
  
  
• Regenerative injections such as Platlet Rich Plasma (PRP), peptides, and stem cells contain biological factors that support healing, recovery, and tissue repair in addition to relieving pain.
  (See Dr. Babaria’s articles for more details on PRP and BMAC)
  
  

Physical therapy and home exercises are essential for long-term success.

Many painful conditions are influenced by mechanical imbalances—weakness, stiffness, muscle imbalance, or altered movement patterns.

• Restoring proper mechanics through strength, flexibility, and stability training is the only long-lasting way to correct the underlying imbalances.
  
  
• No matter which procedure you choose, a consistent home exercise program is what creates durable, meaningful improvement.
  
  

Non-Surgical Treatments Offered at OCSS

Steroid Injections (“Cortisone Shots”)

What they do:
Steroids decrease inflammation and calm irritated nerves, providing effective pain relief.

Common uses:

• Joint arthritis
• Tendon or ligament inflammation
• Neck or back pain with or without radiating (“sciatic”) pain

Pros:

• Fast, straightforward procedure
• Relief can last weeks to months

Cons:

• Reduces pain but does not repair injured tissue
• Side effects from frequent steroid use

Regenerative Injections (PRP, Stem Cells, Peptides)

What they do:
These injections use your body’s own biological cells or growth factors to reduce pain and support healing of damaged tissues.

Common uses:

• Same conditions treated with steroid injections
• Often used when the goal is longer-term improvement or tissue repair
• Best evidence-supported conditions for PRP over steroids:
  • Mild/moderate knee osteoarthritis
  • Lateral epicondylitis (tennis elbow)
  • Rotator cuff tendinopathy

Pros:

• Addresses pain and helps promote healing/regeneration
• Less systemic side effects like elevated blood sugar, loss of bone density, tendon/cartilage weakning, etc., compared to steroids

Cons:

• Usually an out-of-pocket expense
• Stem cell and peptide treatments are still considered investigational as research evolves
  
  

Nerve Blocks & Radiofrequency Ablation (RFA)

What they do:
A nerve block temporarily numbs the nerve. If the nerve block provides relief, RFA can precisely heat the targeted nerve, disrupting its ability to send pain signals. With a successful ablation, you can expect anywhere from 6–18 months of relief. 

Common uses:

• Joint arthritis
• Persistent pain after joint replacement or spine surgery
• Vertebrogenic low back pain (see main website for more information on the "Intracept" procedure)

Pros:

• Longer-lasting relief than steroid shots
• Great option for patients who cannot receive steroids or cannot have surgery

Cons:

• The procedure is slightly longer and can be more uncomfortable than simple injections
  
  

Spinal Cord Stimulation (SCS)

What it is:
A small device placed near the spine that uses electrical impulses to reduce pain signals before they reach the brain. Every patient completes a one-week trial before deciding on permanent placement.

Common uses:

• Persistent pain after spine surgery
• Chronic neck, back, or “sciatic” pain 
• Diabetic peripheral neuropathy
• Complex regional pain syndrome (CRPS)

Pros:

• Can provide long-term, life-changing improvement in pain, function, and quality of life
• Reduces dependence on medications for pain relief
• Minimally invasive outpatient procedure
• The device can be easily removed if not helpful
• Multiple stimulation programs are available that are customizable to your needs

Cons:

• Requires a minimally-invasive procedure to implant the device
• Battery replacement typically needed every 3–10 years depending on the model
• Not every trial leads to permanent implantation
• May limit ability to get MRIs depending on the device
  
  

Medications

Options may include:

• NSAIDs or Tylenol
• Topical creams or patches
• Nerve pain medications
• Muscle relaxers
• Oral steroids
• Opioid-related medications (used sparingly and only when appropriate)
  
  

Final Thoughts

Meaningful, lasting change comes from a combination of the right treatment and your commitment to strengthening and restoring your body. We’re here to guide you every step of the way so you can reach your goals and get back to living the life you want.

Author

Evan Chung, MD Dr. Chung is double board certified in Pain Medicine and Physical Medicine and Rehabilitation. He's trained at a top 5 program in the country : Kessler Rehab in New Jersey and comes with several years of world class experience in PM&R, MSK, and Interventions. His passion is to preserve form and function.