Occupational and Sports Injuries

Our specialists evaluate injuries related to alterations of the skeletal structures as well as overuse and misuse of the area. Knowledge in physiology, anatomical characteristics of the individual and structural changes that have taken place as a result of overuse due to sport or occupational activities are applied for proper diagnosis and treatment. Prevention is always emphasized. Our pain specialist has extensive experience in the treatment and resolutions of these disorders. Some of these conditions include the following:

Tendinitis of the Wrist
Trigger Finger
Tendinitis and Bursitis of the Shoulder
Tennis Elbow
Runner’s Knee
Tendinitis of the Groin
Bursitis of the Hip
Tendon, Joint, and Ligament Injuries

Carpal Tunnel Syndrome (CTS)

Carpal Tunnel Syndrome (CTS) is the most common form of a class of syndromes or disorders known as repetitive strain injuries or cumulative trauma disorders. These syndromes afflict people who perform repetitive movements causing joint and muscle pain, which can eventually lead to inflammation, scarring, and possible nerve compression, as in the case of carpal tunnel syndrome.

CTS is most often caused by compression or pressure on the median nerve. The Carpal Tunnel is the name of the area of your wrist containing the 8 carpal bones, the transverse carpal ligament (connecting two outside carpals together), the median nerve and the tendons controlling finger and hand movement.

Pressure on the median nerve may occur due to trauma or injury (for example, a forced or sudden bending back of the wrist) or sustained pressure from activities such as typing/keypunching, hammering, chopping, pushing, or vibration from heavy equipment.

Proper diagnosis is determined by performing a thorough physical examination and a diagnostic test called an electromyogram (EMG).

Secondly, an individualized program including mobilization, myofascial release, physiotherapy, and therapeutic exercises and rehabilitation is developed for the patient. Patients often benefit from carpal tunnel injections. Prevention is always emphasized. Our pain specialist has extensive experience in the treatment and resolution of these disorders.

To read a brief CASE STUDY of this condition please click here.

Tarsal Tunnel Syndrome (TTS)

Tarsal Tunnel Syndrome (TTS) is the equivalent of carpal tunnel in the foot. In this case, the tibial nerve is compressed by ligaments as it winds behind the medial maleollus of the ankle. The condition causes a variety of symptoms that range from pain in the foot, discomfort in the heel, tingling, numbness, heaviness, or a combination of them. An electromyogram can detect it and an injection may resolve the symptoms. Some patients might respond only to surgery. A proper understanding of the underlying reason for the condition is critical and preventative measures are imperative to prevent recurrences.

Intractable Foot Pain & Other Local Pain Resistant to Treatment

Under this heading we include a number of conditions affecting a discrete area of an extremity, the foot being the most frequent, but it may also include the knee, hip, hand, scars, groin, shoulder, and elbow.

The condition requires a complete evaluation for it may be caused by nerve damage, inflammation, instability, dislocation, and other kinetic disorders of the area. It often follows surgical interventions of the area. A treatment customized for each patient is needed to successfully treat the problem.

For example in the case of foot pain, the treatment may include some of the following: foot nerve blocks, tarsal tunnel blocks, injections of the inflamed ligaments, tendons, and joints as well as appropriate inserts, arch supports, or other devices. If need be, we could coordinate the treatment with the patient’s podiatrist.

Arthritic and Rheumatic Pain Syndromes

Pain in the joints, shoulders, elbows, wrists, hands, hips, knees, ankles and feet are frequent complaints. The causes of these conditions can be complex and involve changes in the neuromusculoskeletal system. Our specialist has in-depth knowledge and extensive experience in the treatment and elimination of these disorders. The spectrum of treatment includes medication, specialized physical therapy, therapeutic injections, nerve blocks and, as a last resource, surgery. Based upon a thorough evaluation of the patient's medical history and test results, both near-term and long-term treatment programs are designed to eliminate pain and enhance the well-being of the patient.

"Pain is real. A person who reports having pain must be taken seriously. Persistent pain can cause anxiety depression, hostility, irritability, fatigue social withdrawal, and loss of productivity. Many times people are told, 'We can’t find anything wrong’ or ‘You are imagining the pain.’ “Such statements serve only to make the pain worse. We want to understand the person as whole and determine the impact pain has had upon that person’s total life. Our goal is to return every patient to meaningful daily function."

Dr. Jose L. Medina,
M.D., F.A.C.P.

Meet the Doctor

“ From the first visit and beyond, Dr. Medina listened intently and with care. He read all of the previous test results and he has never stated to me, ever, that “it was in my head” and not real. He is extremely knowledgeable about every test in relation to your illness, whether it affirms or negates your illness. He doesn’t have you take unnecessary tests. Dr. Medina has been my godsend. He knew not to rush the strength of my pain medication. Yes, I am so much better as a person and patient for seeing and knowing this man. If anyone comes to me or to someone in my family looking for a doctor, I always tell refer them to Dr. Medina at the NeuroCenter. This doctor has save my life several times. I shudder to think what my life would have been without him. I thank God for him.”.

L. Rooney