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Multiple modalities return patients to activities quickly.

One August day in 2005, while working as a corrections officer, Stephan Miller’s boot caught the edge of an uneven floor, and he went down. The fall injured his neck, lower back, shoulder and foot. Excruciating pain shot through his entire body. The pain intensified as time went on, and initial therapies failed to give him lasting relief.

Photo by Fred Bellet.

Stephan proudly serves
as a member of the
American Legion Honor Guard.

“My entire body was racked with pain,” confirms the New Jersey native. “I went to a sports medicine facility for treatment. They started with a couple of shots and physical therapy, but they couldn’t tell if the pain was coming from my shoulder or my neck. Everything was hurting.”
The sports medicine physician also tried epidural nerve blocks in Stephan’s neck, shoulder and lower back, but they weren’t as effective as he’d hoped.
“The pain was extreme. On a scale of one to ten, it was over a ten,” he declares. “I could walk, but I couldn’t stand for more than a few minutes. I had to lie down.”
A curvature of Stephan’s spine complicated his back condition, and he was told he required surgery. During two separate procedures he underwent while still living in New Jersey, he had five metal rods placed in his spine. Even after surgery, however, he had severe pain and was forced to retire because he could no longer function at his job.
In January 2013, Stephan relocated to Florida for a more comfortable retirement, but he needed to find a physician to manage his ongoing pain. His workers’ compensation case worker recommended Maulik Bhalani, MD, founder and CEO of Florida Pain Medicine. Stephan was anxious to see what Dr. Bhalani suggested to control his pain.
“Stephan presented with pain in his low back and neck related to a work injury,” reports Dr. Bhalani. “He had a cervical disc herniation compressing a nerve root in his neck, which radiated pain signals down his arm. He also had degenerative disc disease with arthritic changes in both his neck and lower back.
“He was looking for effective treatment for his pain, and he wanted to avoid any additional surgery. My main goal was to get him back to a functional status using conservative treatment modalities.”
“My pain was persistent. It would come and go, but it always came back,” relates Stephan. “One day, I’d be walking normally, then the next day, I’d be walking really slowly in agony.
“Dr. Bhalani performed two nerve ablations in my lower back, and nerve blocks in my neck, which helped. I’m also on pain medication, and the doctor gave me a muscle relaxant for when the pain is bad enough to take it. That helps as well. I was very pleased with what Dr. Bhalani and Florida Pain Medicine offered me.”

Multimodal Approach

Dr. Bhalani stresses that the approach at Florida Pain Medicine is complete, compassionate and comprehensive care based on the most up-to-date
knowledge of pain and how to alleviate it. Florida Pain Medicine’s physicians go beyond relying on one or two methods to treat patients. Instead, they’re able to use multiple therapies in the appropriate combinations to help their patients restore function and relive life.
“When people come to us with disabling pain that leaves them dysfunctional and unable to work, we take a multimodal, multidisciplinary approach to their care,” verifies Dr. Bhalani. “We focus on what we can do to reduce their pain and get them back on their feet or back to work quickly.
“I often start with medications, but I specifically avoid narcotic-based medications, or opioids. Rather, I consider non-narcotic, non-sedating pain medications, but add other analgesics to the regimen. These include nerve pain medicines, muscle relaxants and anti-inflammatories.”

“I like Dr. Bhalani and his staff. They’re very nice, friendly and professional. I’d rate them as excellent.” – Stephan

Physicians at Florida Pain Medicine choose among the available modalities for their patients on a case-by-case basis. In Stephan’s case, he responded well to the medications, but Dr. Bhalani added several other therapies to his treatment plan in order to achieve the best possible results.
“For Stephan, I included interventional pain procedures, specifically lumbar radiofrequency ablation and cervical epidural steroid injections,” describes
Dr. Bhalani. “Those were followed up with physical therapy to maintain his improvement. The aim was to get him to and keep him at a functional status where he is able to do the things he enjoys.”
Radiofrequency ablation is a needle-based, minimally invasive procedure. It uses thermal energy to damage the sensory nerve endings in the areas where pain originates. Destroying these nerves provides long-term pain relief.
“Relief from a radiofrequency ablation lasts anywhere from six months to a year or even longer,” notes Dr. Bhalani. “Eventually, the nerves grow back, but they tend to grow very slowly, especially in older adults. The ablation can be repeated if necessary.”
Cervical epidural steroid injections are injections of pain-relieving, anti-inflammatory steroid medications into the epidural space at the base of the neck. They are used to help relieve pain in the neck, shoulders and arms caused by pinched or inflamed nerves in the cervical spine. These can result from conditions such as herniated discs, spinal stenosis and arthritis.

Giving Back

The damage done by Stephan’s work injury has left him with nearly constant pain. He knows he will always have some pain, but his treatment at Florida Pain Medicine made it manageable. With Dr. Bhalani’s help, Stephan’s function has been restored, and he’s back to reliving his life.
“Pain is an ongoing thing for me, but now it’s only about a five, and I can tolerate that,” states Stephan. “Before I went to Florida Pain Medicine, my pain level was anywhere from a seven to a ten.
“Right now, I’m comfortable. I’m able to walk and function, and I help out wherever I can. I’m retired from work, but I volunteer with the American Legion Honor Guard.”
Even though he still has some pain to manage, Stephan is very pleased with the results of his treatment at Florida Pain Medicine. “I consider my treatment successful. I was in the United States Air Force for seven years and was a volunteer firefighter for more than twenty-five years. I’m so happy I’m capable of giving back to the veterans through the American Legion!
“I like Dr. Bhalani and his staff,” adds Stephan. “They’re very nice, friendly and professional. I’d rate them as excellent. I definitely recommend Dr. Bhalani and Florida Pain Medicine.”

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    • Florida Pain Medicine

      At Florida Pain Medicine, your interventional pain and diagnoses experts, their mission is to help you “RESTORE FUNCTION & RELIVE LIFE.” Florida Pain Medicine offers complete, compassionate, and comprehensive pain care. They provide the la... Read More

    • Maulik Bhalani, MD

      Maulik Bhalani, MD, is the founder and CEO of Florida Pain Medicine. He earned a Bachelor’s degree at Creighton University in Omaha, NE, and medical degree at Creighton University School of Medicine. Dr. Bhalani completed a residency in anesthe... Read More