Physical Medicine

& Pain Management

Conservative Knee Treatments

There are a number of non-surgical treatment options for knee pain caused by arthritis and other conditions like tendonitis or bursitis, including steroid injections and viscosupplementation. Corticosteroid injections provide anti-inflammatory effects which can ease joint pain significantly. Viscosupplementation can be helpful in restoring a joint’s lower-than-normal hyaluronic acid, which tends to occur in joints affected by arthritis. The process of viscosupplementation involves injecting a solution of hyaluronic acid into the knee joint, multiple times over several weeks.

Electromyogram (EMG)

An electromyogram (EMG) measures the electrical activity of muscles when they are relaxed and contracted. Your muscles move when they receive signals from the brain, and an electromyogram measures how well your muscles respond to those signals. During an EMG, a needle electrode is put to a muscle and also attached to a recording machine. Once the electrodes are in place, the electrical activity in that muscle is recorded while the muscle is at rest. Your doctor will ask you to contract the muscle slowly, and that electrical activity is recorded as well. Throughout the test, the electrode may be moved a number of times to assess the activity in different parts of the muscle or in different muscles altogether. This test helps to diagnose neuromuscular disorders. Your doctor may order an EMG if you have signs or symptoms of a nerve or muscle disorder, which may include tingling, numbness, muscle weakness, muscle pain, or cramping. 

Epidural Injections

Following a damaged disc, sciatic pain, or spinal stenosis, nerve irritation may cause inflammation and pain in your lower back, hip, or legs. An epidural injection puts anti-inflammatory medicine into the epidural space, which surrounds the nerve, to reduce this nerve inflammation, reducing pain and improving symptoms.

Facet Joint Injections

The facet joints are located on the cervical, thoracic, and lumbar levels of the spine, one on each side at each level. Facet joint injections puts an anti-inflammatory solution into the facet joint to decrease inflammation and irritation. Facet joint irritation is a common cause of neck, back, arm, and leg pain. Facet joint injections can be an important part of a treatment plan for conditions like degenerative disc disease or arthritis. The goal of the procedure is two-fold: to define that the joint is in fact the source of the pain, and to provide pain relief with the injection of the steroid.

Genicular Nerve Block

Genicular refers to the various arteries and nerves that feed into the knee. For those suffering from arthritis and other knee conditions, the pain signals delivered from these nerves can be unbearable. A genicular nerve block temporarily blocks the nerve signals in the knee through an injection of a local anesthetic, alleviating pain and restoring function to the knee.

Major Joint Injections

Joint injections can pinpoint and alleviate pain accused by irritation or injury to the affected joint(s). Causes of joint pain can include arthritis, injury, or degeneration. Our pain specialists at Hudson Orthopedic Pain & Spine are able to inject a corticosteroid medication into the affected joint, which is a long-lasting medicine that reduces inflammation and provides pain relief over an extended period. The goal of this injection is two-fold: to determine which joint is causing pain, and to relieve the pain by injecting the steroid medication. Joint injections are used in the shoulders, elbows, wrists, hips, knees, ankles, hands, feet, and more.

Nerve Conduction Studies

A nerve conduction study will measure how well and how quickly the nerves can send electrical signals, or impulses, to your muscles, and can tell if a nerve has been damaged. Problems will the electrical activity in your nerves can cause pain, tingling, or weakness in your muscles. A nerve conduction study can also help your doctor see how well you’re recovering from a nerve injury.


Radiofrequency can be used to treat back pain stemming from degenerative disc disease and other spinal or nerve conditions. Radiofrequency pulses interrupt the sensory nerve supply to the affected joint through the use of thermal denervation. Radiofrequency needles are placed alongside nerves affected by the inflamed joint using fluoroscopic guidance, and thermal energy is applied to deaden the nerve.

PRP Therapy

Platelet rich plasma (PRP) therapy utilizes platelets taken from a patient’s own blood to rebuild damaged tendons or cartilage. Blood is drawn from the patient and the platelets are harvested. Those platelets are re-injected into the affected site. As a result, the damaged tissue begins to heal. PRP therapy is successful in not only relieving pain, but in jump-starting the healing process.

Sacroiliac (SI) Joint Injections

The sacroiliac joints connect the pelvic bones and spine, and absorb the force of the upper body before transferring the weight to the hips and legs. When the cartilage that covers these joints is damaged or wears out with age, the bones can rub against each other, resulting in lower back pain and sciatica symptoms. Sacroiliac joint injections can pinpoint and alleviate pain and discomfort that can stem from the joint becoming injured or irritated. Inflammation of these joints often results in pain in the back, hip, buttocks, or groin. The purpose of the procedure is two-fold: to diagnose the source of the pain, and to provide pain relief with the injection of the steroid.

Spinal Cord Stimulator

The spinal cord stimulator is used for the management of chronic back pain. The stimulator sends electrical impulses to the areas of the spinal cord causing the pain and interferes with the transmission of pain signals to the brain, thus blocking the brain’s ability to sense pain in the stimulated areas. During the procedure, a device is implanted in the back. Using an external device, electrical impulses can be adjusted in order to regulate pain. A trial procedure, in which a temporary stimulator is implanted, is often done to monitor the treatment’s success for a patient’s symptoms.

Trigger Point Injections

When a muscle becomes stiff, torn, or bruised, the point of origin of the injury is known as the trigger point. We also refer to trigger points as knots. Treating pain at its trigger point is one of the most effective pain management techniques. A trigger point injection contains a combination anesthetic and steroid that helps the muscle relax and reduce inflammation. As the medication begins to work, blood flow improves and helps to alleviate the pain.


Viscosupplementation can be helpful in treating various types of joint pain. During this procedure, a fluid called hyaluronate is injected into the affected joint. Hyaluronate will improve the lubricating properties of the synovial fluid that already exists in the joint, reducing the joint pain and improving mobility.