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Below is additional information about conditions related to pain management. To learn more about where pain can commonly affect you, click on the terms below. Feel free to contact us with any questions.


Below are detailed descriptions of pain management procedures, grouped by the general region affected. Click on selected procedures below to learn more or use our glossary to look up common terms related to skeletal anatomy as well as pain. Feel free to contact us with any questions.

For Glossary click here

Dr. Mikhail Kogan, M.D.


Dr. Mikhail Kogan is an anesthesiologist and interventional pain management specialist with extensive experience in treating back and cancer pain. Since every patient is unique, Dr. Kogan believes in personalized treatment that maximally enhances quality of life and dramatically reduces pain with minimal surgery. In 2008, he founded Pain Solutions Medical PC to fulfill his vision for a patient-centered pain management practice that specializes in minimally invasive procedures and the use of up-to-date spinal interventions, such as percutaneous disc decompression, radio frequency neurolysis and spinal implantable devices.

After completing his anesthesiology residency at Saint Vincent's Medical Center, Dr. Kogan attended a fellowship at The State University of New York at Buffalo in pain management and was under the tutelage of prominent specialists, Dr. Mark Lema and Dr. Oscar DeLeon. During this time, a significant portion of his training took place at Roswell Park Cancer Institute.

Dr. Kogan is a member of the American Society of Anesthesiologists and the American Society of Regional Anesthesia and Pain Medicine. As his expertise and experience in anesthesiology grows, Dr. Kogan’s primary focus has remained unchanged: to be the compassionate, caring and effective physician his patients deserve

Academic Positions
Assistant Clinical Professor, Mount Sinai School of Medicine (Elmhurst Hospital Center), 1999-2004
Areas of Expertise
Cancer pain Hip and knee pain Neck and back pain Musculoskeletal pain
Joint pain Sciatica treatment Hand and wrist pain Thoracic pain
Lumbar facet joint injection Fibromyalgia Epidural steroid injection Sympathetic pain
Acute and chronic pain Platelet rich plasma injections Palliative care
Board Certifications

American Board of Anesthesiology, Pain Medicine, 1997

American Board of Anesthesiology, Anesthesiology, 1996

Clinical Certification, Acupuncture, 1995

Education and Training

Fellowship, The State University of New York at Buffalo, Pain Management, 1999

Residency, Saint Vincent’s Hospital and Medical Center, Anesthesiology, 1997

Residency, Brookdale Hospital and Medical Center, General Surgery, 1994

MD from Irkutsk Medical School, Siberia, 1979


Pain Solutions Medical PC believes that being informed is an important aspect of patient care. We are happy to provide supplemental information about services and conditions related to pain management. Feel free to contact us with any questions.

Information provided in this section is intended as an information resource only. It is not intended for diagnostic and treatment purposes and does not substitute for medical care provided by a qualified medical professional.

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Sciatica Treatment

Doctors of treatment medicine often treat sciatica. Sciatica is characterized by pain that originates within the low back or buttock that travels into one or each legs. Sciatic nerve pain varies in intensity and frequency; smallest, moderate, severe and occasional, intermittent, frequent or constant.

Pain is delineated as dull, achy, sharp, toothache-like, pins and needles or just like electric shocks. Different symptoms related to sciatica embrace burning, symptom and tingling sensations. Sciatica is additionally known as divergent or pain, neuropathy, or neuralgia. An idea is that sciatica may be a disorder - is a, sciatica is de facto a symptom of a disorder.

Caused by Nerve Compression

Sciatica is usually caused by sciatic nerve compression. Disorders best-known to cause sciatic nerve pain embody lumbar spine subluxations (misaligned os body/ies), herniated or bulging discs (slipped discs), pregnancy and birth, tumors, and non-spinal disorders like polygenic disease, constipation, or sitting on one's back pocket pocketbook.

One common explanation for sciatica is Piriformis Syndrome. Piriformis syndrome is called once the piriformis muscle. The piriformis muscle is found within the lower a part of the spine, connects to the femur, and assists in hip rotation. The nerve runs at a lower place the piriformis muscle. This muscle is liable to injury from a slip and fall, hip inflammatory disease, or a distinction in leg length. Such situations will cause cramping and spasm to develop within the piriformis muscle, thereby pinching the sciatic nerve and inflicting inflammation and pain.

Sciatic nerve compression might lead to the loss of feeling (sensory loss), paralysis of one limb or group of muscles (monoplegia), and sleep disorder.

Proper designation

Since there are a unit several disorders that cause sciatica, the chiropractor's start is to determine what's causing the patient's sciatica. Forming a designation involves a thoughtful review the patient's medical history, and a physical and neurological examination. Diagnostic testing includes associate degree x-ray, MRI, CT scan and/or electro diagnostic tests (nerve physical phenomenon speed, electromyography). These examinations and tests facilitate to observe possible contraindications to spinal changes and different treatment therapies.

Treatment Approach

The purpose of treatment is to assist the body's potential to heal itself. it's supported the scientific principle that restricted spinal movement results in pain and reduced operate and performance. Treatment care is non-invasive (non-surgical) and drug-free. the kind of treatment therapy provided depends on the reason behind the patient's sciatica. A sciatica treatment set up might embrace many completely different treatments like ice/cold therapies, ultrasound, TENS, and spinal changes - typically referred to as manipulation.

1. Ice/Cold medical care reduces inflammation and helps to manage sciatic pain.
2. Ultrasound is light heat created by sound waves that penetrates deep into tissues. Ultrasound will increase circulation and helps to cut back muscle spasms, cramping, swelling, stiffness, and pain.
3. TENS unit (transcutaneous electrical nerve stimulation) could be a little box-like, powered, moveable muscle stimulating machine. Variable intensities of electrical current management acute pain and cut back muscle spasms. Larger versions of the home-use TENS units area unit utilized by chiropractors, physical therapists and alternative rehab professionals.
4. Adjustments (Spinal Manipulation) At the core of treatment care area unit spinal changes. Manipulation frees restricted movement of the spine and helps to revive misaligned os bodies to their correct position within the spinal column. Spinal adjustment helps to cut back nerve irritability answerable for responsible for inflammation, muscle spasm, pain, and alternative symptoms associated with sciatica. Changes shouldn't be painful. Spinal manipulation is tested to be safe and effective.

In college and through their coaching, students of treatment learn many various adjustment techniques enabling them to treat many varieties of subluxations and disorders. Techniques vary from a swift high rate thrust to people who mix minimal force and mild pressure. Mastery of every technique is Associate in nursing art that needs nice ability and exactness. Spinal manipulation is that the treatment that differentiates treatment care from alternative medical disciplines. To prepare a patient for adjustment, the therapist might instruct the patient to take a seat up or lie. It’s not uncommon for the therapist to use a very completely different adjustment technique throughout the patient's ulterior visit. Treatment tables take issue too. Some area unit stationary, flat padded tables and others area unit elaborate with electrically or operated by hand head and foot rests.

Chiropractic's Limitations

Sciatica is caused by alternative disorders on the far side the scope of treatment practice. If the Doctor of treatment determines the patient's disorder needs treatment by another kind of doctor, then the patient is spoken another specialty. In some cases, the referring therapist might still treat the patient and co-manage the patient's care with the specialist.