Modern Approaches to Pain Management: A Conversation with Dr. Edward Alexeev
Q: What typically brings patients to seek treatment for neck pain, and when should they consult a specialist?
A: Neck pain is incredibly common in our practice, and I often see patients who’ve been trying to manage their discomfort on their own for too long. While some neck pain can result from simple causes like poor sleeping positions or posture, I encourage patients to seek evaluation when the pain is continuing to worsen, especially if it’s accompanied by headaches or shooting pains down the arms. These symptoms can indicate more serious conditions like cervical disc herniation, spinal stenosis, or cervical spondylosis. What many patients don’t realize is that early intervention can prevent the condition from progressing to a point where it significantly impacts their daily activities or work life. In our practice, we can usually perform necessary imaging right in the office to get to the root cause quickly.
Q: Why is back pain often so challenging to diagnose and treat effectively?
A: Back pain is particularly complex because the back is essentially a sophisticated mechanical system with multiple potential pain sources. In our practice, we look at the entire structure – from the vertebrae and facet joints to the discs, spinal cord, ligaments, tendons, and surrounding muscles. Each of these components can contribute to pain in different ways. For instance, a patient might come in thinking they have a muscle problem, but after proper diagnostic work, we discover it’s actually related to facet joint arthritis or nerve compression from a herniated disc. This is why we take a comprehensive diagnostic approach, using state-of-the-art imaging and diagnostic techniques to pinpoint the exact cause before developing a treatment plan.
Q: How do you approach pain management without relying heavily on medication?
A: My philosophy is to utilize multiple procedural approaches that address pain at its source rather than masking it with medications that can lose effectiveness over time. For example, we might use nerve blocks that target pain directly at its origin, or joint injections that provide focused relief without systemic effects. I often combine these interventional techniques with physical medicine and rehabilitation approaches. We might incorporate bracing for proper support, specific stretching and strengthening exercises, and even alternative therapies like acupuncture, which has shown excellent results for acute pain management with minimal side effects. The goal is to create a comprehensive treatment plan that provides both immediate relief and long-term management without creating medication dependency.
Q: Can you explain how radiofrequency ablation works for treating chronic pain conditions?
A: Radiofrequency ablation is one of our most effective minimally invasive treatments, particularly for patients with chronic neck or back pain caused by degenerative conditions like arthritis. The procedure works by temporarily deactivating the sensory nerves that transmit pain signals from specific regions of the neck or back to the brain. What makes this treatment particularly valuable is its targeted nature – we can precisely identify and treat the exact nerves causing pain. This is especially effective for patients with localized pain patterns from conditions like facet joint arthritis. The procedure can provide extended pain relief, allowing patients to participate more fully in physical therapy and rehabilitation programs, which are crucial for long-term improvement.
Q: What role does arthritis play in spine and joint pain, and how do you approach treatment?
A: Arthritis is one of the most common causes of chronic pain we treat at our center. Whether it’s osteoarthritis from wear-and-tear, rheumatoid arthritis affecting multiple joints, or facet joint arthritis in the spine, each type requires a specialized approach. In treating arthritis, we focus on three main goals: relieving pain, preventing further joint damage, and stimulating the body’s natural healing abilities. We often use a combination of treatments, including steroid injections for immediate relief, regenerative medicine approaches like platelet-rich plasma (PRP) to promote healing, and physical medicine techniques to maintain joint function. What’s particularly exciting is how we can now combine traditional treatments with newer technologies like radiofrequency ablation for longer-lasting pain relief.
Q: How do you incorporate integrative care into your treatment plans?
A: I’m a strong believer in comprehensive care that combines various therapeutic approaches. When patients come to us with spine or joint issues, we often develop treatment plans that include both interventional procedures and conservative therapies. Physical therapy, for instance, is crucial for strengthening muscles and improving joint stability. We might combine this with chiropractic care for proper alignment and acupuncture for pain management. The key is that these therapies work synergistically – while the interventional procedures provide immediate pain relief, the integrative therapies help build a foundation for long-term improvement and prevention of future issues. Each patient receives a customized combination of treatments based on their specific condition, lifestyle, and goals.
Dr. Alexeev continues to provide cutting-edge pain management solutions at Atlantic Spine and Joint Pain Center LLC in Manalapan, New Jersey, where he specializes in treating complex spine, joint, and chronic pain conditions using the latest minimally invasive techniques and integrative approaches.