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JORDAN PYSZ / iFoundMyDoctor.com
From left: Drs. Troncale, Cordner and Fernandez-Silva bring more than 80 years of combined clinical experience to Florida Pain Management Associates.
Thirty years ago, Harold J. Cordner, MD, a board-certified pain management physician, arrived in Sebastian with a vision to bring a world-class pain management practice to the Indian River County-Treasure Coast area.
The physician’s plan soon came to fruition with the opening of Florida Pain Management Associates.
“I came to Sebastian in 1993 and opened the practice in 1994, providing anesthesia at the hospital,” Dr. Cordner recounts. “I started doing pain management shortly thereafter. At the time, I was the only pain management physician between Sebastian and Jupiter.
“I currently have privileges at Sebastian River Medical Center, Holmes Regional Medical Center in Melbourne and Cleveland Clinic Indian River Hospital in Vero Beach. I provide pain management expertise and patient care to communities in two counties: Brevard and Indian River.”
Beyond his practice, which has offices in Sebastian and Vero Beach, Dr. Cordner shares his expertise as a leader in his specialty and as an educator.
“I am a founder and past president of the Florida Society of Interventional Pain Physicians and a past president of the American Society of Interventional Pain Physicians,” the doctor notes. “For more than 25 years, I have gone around the globe lecturing and teaching pain management procedures to physicians.
“I’ve given thousands of lectures and presentations. and I’ve taught thousands of physicians who are now helping to bring the science of pain management to people around the world, particularly those in Third World countries, where few physicians are trained in the specialty.
“Some of those physicians come to Florida to train with us. Sometimes, I travel to other countries to provide training to physicians who don’t have access to leading-edge pain management facilities.”
Approaches for Back Pain
The staff at Florida Pain Management Associates also includes Jorge Fernandez-Silva, MD, and Joseph Troncale, MD. With more than 80 years of combined clinical experience, the colleagues provide the full scope of advanced therapies for the management of pain.
“What I enjoy most is the procedural side of the specialty as well as the long-term engagement with patients that the practice affords,” Dr. Fernandez-Silva says. “I’m driven by the positive impact we can have on patients’ lives.”
One way he improves his patients’ lives is by treating their back pain.
“The most common procedures for low back pain are epidural steroid injections and radiofrequency ablation, which uses heat to destroy the nerves responsible for pain,” Dr. Fernandez-Silva reports. “There are other, more advanced treatments such as spinal cord stimulation, which is like a pacemaker for the spine, and newer procedures for treating spinal stenosis, which is a narrowing of the spinal canal.”
One of the newer treatments for spinal stenosis is minimally invasive lumbar decompression, or MILD.
“We use MILD when the spinal stenosis occurs due to an overgrowth of a ligament or arthritis,” Dr. Fernandez-Silva notes. “During MILD, we go in and scoop out some of that excess tissue to make more room for the nerves to pass through.
-Dr. Fernandez-Silva
“There’s also a procedure where we place a spacer between the bones on the backside of the spine that lifts the bones apart to create more room for the nerves.
“Lifting the bones apart sounds dramatic, but we’re talking only millimeters of movement. Still, that can make a significant improvement in a patient’s pain – and life.”
Medical Management
Dr. Cordner and Dr. Fernandez-Silva are anesthesiologists, so they perform procedural treatments for pain management.
Dr. Troncale concentrates on the medical management of pain. For that, he explains, it is important to understand that pain is complex, with psychological and physiological aspects.
“I’m here to take care of whatever it is that ails patients but mostly to help them manage their pain,” Dr. Troncale points out. “There are medical and interventional techniques for easing pain, and I walk our patients through those.”
“I also perform assessments to determine if patients would benefit from a procedure done by Dr. Cordner and Dr. Fernandez-Silva. If they’re not candidates for those procedures, then we must treat their pain with medicines. Some are nonopioids, and some are adjunct medicines that help with certain pain syndromes.”
Dr. Troncale is also a specialist in addiction medicine and offers counseling for patients with addiction problems. This is an aspect of pain management not provided by most practices.
“Some patients come to us because they really need help with their addictions,” says Dr. Troncale, who has more than 25 years of experience in addiction medicine. “We have effective techniques to help them overcome their addictions as well as treat their pain.”
Like Dr. Fernandez-Silva, Dr. Troncale enjoys creating long-term relationships with his patients.
“I find working with families inspiring,” Dr. Troncale says. “Many people bring their family members to our practice. They bring their spouses and elderly relatives that are suffering from pain. We take care of them and their caregivers.”
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