SPECIALTIES

Spinal Interventions

Epidural Steroid Injections

Epidural steroid injections (ESIs) are a common treatment option for many forms of low back pain and leg pain. They have been used for low back problems since 1952 and are still an integral part of the non-surgical management of sciatica and low back pain. The goal of the injection is pain relief; at times the injection alone is sufficient to provide relief, but commonly an epidural steroid injection is used in combination with a comprehensive rehabilitation program to provide additional benefit.

Facet Block/Medial Branch Block

The medial branch block is often used as part of a 2-step diagnostic and treatment approach. A medial branch nerve block is a procedure in which an anesthetic is injected near small medial nerves connected to a specific facet joint. Typically several levels of the spine are injected in one procedure. If the patient experiences marked pain relief immediately after the injection, then the facet joint is determined to be the source of the patient’s pain. The procedure is primarily diagnostic, meaning that if the patient has the appropriate duration of pain relief after the medial branch nerve block, then he or she may be a candidate for a subsequent procedure – called a medial branch radiofrequency neurotomy (or ablation) – for longer term pain relief. In cases where a medial branch nerve block has confirmed that a patient’s pain originates from a facet joint, a radiofrequency neurotomy can be considered for longer term pain relief. A radiofrequency neurotomy is a type of injection procedure in which a heat lesion is created on the nerve that transmits the pain signal to the brain. The goal of a radiofrequency neurotomy is to interrupt the pain signal to the brain, while preserving other functions, such as normal sensation and muscle strength.

Disc Fx

In the past, patients with contained disc herniations have been treated with conservative care including rest, medications, injections and/or physical therapy. Unfortunately, this does not always provide relief. In the past, people who did not respond to conservative care were forced to live with the symptoms or consider major spine surgery. If they underwent surgery, it could take weeks or months to recover, causing a major disruption in their daily lives. With Disc-FX®, this is not the case. Disc-FX® provides an option for those people who have failed conservative care, and are not yet ready for major surgery. It is a minimal access procedure performed on an out-patient basis whereby the patient will go home the same day of the procedure with only a small bandage on their back. Disc-FX® is performed using x-ray guidance to accurately place the Disc-FX® System into the disc. The patented Disc-FX® device is then inserted into the center of the disc where tissue is precisely treated and/or removed. As a result, disc pressure is reduced, which eases symptoms.

Regenerative Medicine

Regenerative medicine holds the promise of definitive, affordable health care solutions that heal the body from within.

Though great progress has been made in medicine, current evidence-based and palliative treatments are increasingly unable to keep pace with patients’ needs, especially given our aging population. There are few effective ways to treat the root causes of many diseases, injuries and congenital conditions. In many cases, clinicians can only manage patients’ symptoms using medications or devices.

Regenerative medicine is a game-changing area of medicine with the potential to fully heal damaged tissues and organs, offering solutions and hope for people who have conditions that today are beyond repair.

Regenerative medicine itself isn’t new — the first bone marrow and solid-organ transplants were done decades ago. But advances in developmental and cell biology, immunology, and other fields have unlocked new opportunities to refine existing regenerative therapies and develop novel ones.

Regenerative medicine is an advanced branch of translational research enabling the management of acute or chronic pain conditions. The research in tissue engineering and molecular biology creates an environment in which the regeneration of human cells is achieved to restore or establish normal physiological functioning. The science applies findings from tissue engineering that dates back to 1962 with the first synthetic skin used in grafting procedures. Regenerative medicine for pain is rapidly growing, offering benefits to individuals who suffer from a number of different medical conditions.

Bone Marrow Concentrate (BMC)

Bone Marrow Concentrate (BMC) Therapy, also known as Bone Marrow Aspirate Concentrate (BMAC) Therapy, is a promising cutting-edge regenerative therapy to help accelerate healing in moderate to severe osteoarthritis and tendon injuries.

While similar to Platelet Rich Plasma (PRP) in its ability to harness the body’s ability to heal itself through the aid of growth factors, BMC also utilizes regenerative cells that are contained within a patient’s own bone marrow. The marrow contains a rich reservoir of “pluripotent” stem cells that can be withdrawn from the patient’s hip bone and used for the procedure. Unlike other cells of the body, stem cells are “undifferentiated”, meaning they are able to replicate themselves into various types of tissue.

BMC therapy is a promising non-surgical regenerative treatment used to treat various orthopedic injuries, including moderate to severe osteoarthritis and tendon injures. BMC is a concentrate of regenerative stem cells obtained from a patient’s own bone marrow. The physician removes a small amount of the patient’s bone marrow and spins it in a centrifuge in order to generate a powerful concentrate that is injected into the injured area. In the past, these types of cells were often very difficult and expensive to obtain from the body. With recent medical advancements, the cells can be easily obtained and the procedure can be done with minimal discomfort by a simple office procedure.

Platelet-Rich Plasma (PRP)

During the past several years, much has been written about a preparation called platelet-rich plasma (PRP) and its potential effectiveness in the treatment of injuries.

Many famous athletes — Tiger Woods, tennis star Rafael Nadal, and several others — have received PRP for various problems, such as sprained knees and chronic tendon injuries. These types of conditions have typically been treated with medications, physical therapy, or even surgery. Some athletes have credited PRP with their being able to return more quickly to competition.

Although blood is mainly a liquid (called plasma), it also contains small solid components (red cells, white cells, and platelets.) The platelets are best known for their importance in clotting blood. However, platelets also contain hundreds of proteins called growth factors which are very important in the healing of injuries.

PRP is plasma with many more platelets than what is typically found in blood. The concentration of platelets — and, thereby, the concentration of growth factors — can be 5 to 10 times greater (or richer) than usual.

To develop a PRP preparation, blood must first be drawn from a patient. The platelets are separated from other blood cells and their concentration is increased during a process called centrifugation. Then the increased concentration of platelets is combined with the remaining blood.

Sports injuries

Exercising is good for you, but sometimes you can injure yourself when you play sports or exercise. Accidents, poor training practices, or improper gear can cause them. Some people get hurt because they are not in shape. Not warming up or stretching enough can also lead to injuries.
Dr. Robert Farhat DO - Sports injuries Expert
If you get hurt, stop playing. Continuing to play or exercise can cause more harm. Treatment often begins with the RICE (Rest, Ice, Compression, and Elevation) method to relieve pain, reduce swelling, and speed healing. Other possible treatments include pain relievers, keeping the injured area from moving, rehabilitation, and sometimes surgery.

Dr.Robert P. Farhat is an expert of these kind of sports injuries. You can find here the best treatment of your sports injuries. most common type of sports injuries are Sprains and strains,Knee injuries,Swollen muscles, Achilles tendon injuries, Pain along the shin bone , Rotator cuff injuries, Fractures,Dislocations are treated with a great excellence.

EMG evaluation

An electromyogram (EMG) is a test that measures the electrical activity of a muscle. It detects any signs of blocking or slowing down of responses to nerve stimulation. The test provides information about the muscle itself and shows how well it receives stimulation from the nerve. A nerve conduction velocity (NCV) test is often done at the same time as an EMG.Dr. Robert Farhat DO - EMG Evaluation Test

An EMG is often used to evaluate unexplained muscle weakness, twitching or paralysis, and to find the causes of numbness, tingling and pain. EMG testing can differentiate between true weakness and reduced use because of pain or lack of motivation. It can also determine whether a muscle disorder begins in the muscle itself or is caused by a nerve disorder.

In an EMG, a physician or technician inserts a very fine needle, which serves as an electrode, through the skin into the muscle. With the electrode in place, the patient is asked to slowly contract the muscle—for example, by bending the arm—with gradually increasing force, while the electrical activity is being recorded. The activity can be displayed visually on an oscilloscope or screen, or played audibly through a speaker. The results can provide information about the ability of the muscle to respond to nerve stimulation.

 

Injuries from auto accidents

In a car accident, one of the most common injuries suffered by drivers and passengers is a closed head injury, which can range from a mild concussion to a traumatic brain injury (TBI). Even when there is no physical sign of trauma (i.e. cuts or bruises), the brain is at risk of being jostled inside the skull because of the impact of a car crash, so that bruising and other injuries can result.Dr. Robert Farhat DO – Specializes in Pain Management
Neck Injuries – Another common form of injury from a car accident is neck injuries, which can occur in more mild forms such as whiplash and neck strain, but also as more serious injuries like cervical radiculopathy and disc injury.
Back Injuries – The impact of a car accident and the resulting torque on the bodies of drivers and passengers can cause back injuries such as a sprain, strain, fracture, disc injury, thoracic spine injury, lumbar radiculopathy, and lumbar spine injury. Like neck injuries, sometimes the symptoms of even the most serious back injuries can take some time to show up after an accident, and just as often a back injury can cause longlasting pain and discomfort.
Face Injuries – In a car accident, injuries to the face can be caused by almost anything — including a steering wheel, dashboard, airbag, windshield, side window, car seats or shattered glass. These injuries range in severity from scrapes and bruises, to laceration and fractures, even Temporomandibular disorders of the jaw (TMJ) and serious dental injuries.
Psychological Injuries – Injuries caused by car accidents aren’t limited to the physical. Especially after serious car accidents involving severe injuries and even loss of life, drivers and passengers may suffer short or long-term psychological injuries such as emotional distress, and may even develop conditions that closely resemble post traumatic stress disorder, or PTSD after a car accident.

 

Treating pain without opioids

Dr. Robert Farhat DO – Best Treatments for Your Chronic PainThe management of acute and chronic pain often includes opioid therapy. In both the acute and chronic pain settings, however, opioids have several disadvantages including risk of nausea and vomiting, somnolence, constipation, respiratory depression, androgen deficiency, physical dependence, and tolerance. Opioid medications also carry a risk of abuse or addiction by either the patient or non-medical users. For these reasons, consideration of non-opioid strategies for pain management is beneficial. While opioids will certainly continue to have a place in pain management despite their disadvantages, the use of non-opioid medication options may limit the amount of opioid necessary or even result in improved pain control.
In fact, given that the majority of both acute and chronic pain is thought to be complex and multifactorial, a multimodal analgesic approach is ideal for management