PROCEDURES: OVERVIEW

​CURRENTLY AVAILABLE PROCEDURES:

• Botulinum toxins (Botox, Dysport, Xeomin, etc...) *

• Bursa injections

• Dry needling

• Extracorporeal Shock Wave Therapy (ESWT) Ω

• Joint injections

• Ligament injections

• ​Muscle injections

• Nerve blocks and hydrodissection

• Nerve stimulator insertion †

• Osteopathic Manipulative Therapy (OMT)

• Plexus blocks

• Prolotherapy Ω

• Tendon injections

• Tunnel injections

• Trigger point injections

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* Preferred botulinum toxin agent varies by insurance plan. Typically, we work with your drug insurance coverage to order the medication then do the procedure when it arrives. We work with a few companies that assist with coverage. 

Ω Rarely covered by insurance and typically cash pay. ESWT is covered by some payors for certain conditions. For a price inquiries, please call our office.

† We work with a company that works with your insurance on this

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CURRENTLY AVAILABLE MEDICAL EQUIPMENT:

•  Electromyographic (EMG) guidance 

  • to confirm Botox is injected into the most spastic muscle(s)

•  Ultrasound (US) guidance 

  • to confirm that injectate is placed in the correct location

• NEW: Extracorporeal Shock Wave Therapy (ESWT) ​

  • anticipate arrival 3/7/2025​

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POTENTIALLY AVAILABLE AND FUTURE PROCEDURES:

• Acupuncture

  • requires more training by Dr Spears​

• Amniotic membrane allografts

  • Dr Spears is trained to perform

  • these can be injected if available 

    • AmnioFix

    • EpiFix​

• Lumbar epidural steroid injections (LESI)

  • both interlaminar and transforaminal lumbar epidural steroid injections (LESI) have recently demonstrated to be safely performed under ultrasound guidance

    • requires more training by Dr Spears​

• Lumbar facet joint injections

  • recently demonstrated to be safe to perform under ultrasound guidance

    • requires more training by Dr Spears​​

• Nerve ablations

  • Dr Spears is trained to perform

  • pending equipment required to perform

    • cryoablation​

    • radiofrequency ablation

• Platelet Rich Plasma (PRP)​

  • Dr Spears is trained to perform

  • pending equipment required to perform​

  • this can be injected if available 

• Stem Cells​

  • Dr Spears is trained to perform

  • these can be injected if available 

• Sympathetic and parasympathetic nerve blocks​

  • Requires more training by Dr Spears​

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NOT AVAILABLE 

• Cervical, thoracic, & lumbar spine ablations

• Cervical and thoracic spine facet joint blocks

• Cervical and thoracic spine epidural injections

  • These procedures require fluoroscopy (a portable "c-arm" x-ray) to confirm needle placement

    • No fluoroscopy available at this time​

• Collagenase (Xiaflex)​ injections

  • Poor experience with outcomes in the past​ in treating Dupuytren's contractures