Pain Management Physician | Anesthesiologist | Addiction Medicine Physician



Ryan Peterson, MD




Dr. Ryan Peterson



What is Pain Management?



A pain management specialist is a physician with special training in evaluation, diagnosis, and treatment of all different types of pain. Pain is actually a wide spectrum of disorders including acute pain, chronic pain and cancer pain and sometimes a combination of these. Pain can also arise for many different reasons such as surgery, injury, nerve damage, and metabolic problems such as diabetes. Occasionally, pain can even be the problem all by itself, without any obvious cause at all.

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What types of pain does Dr. Ryan Peterson treat?


UPPER BODY PAIN
Radiculopathy - Cervical
Migraines - Common and Classic
Tension Headaches
Occipital Neuralgia
Cervicogenic Headaches
Medication Overuse Headaches
Post Dural Puncture Headache "Spinal Fluid Headache"
Cervical Radiculopathy
Cervical Degenerative Disk
Chest Wall Pain
Intercostal Neuralgia
Scapula Pain
Shoulder Pain
Abdominal Pain
Facet Syndrome - Cervical
Herneated Disc - Cervical, Thoracic
Spondylolisthesis
Elbow Pain

LOWER BODY PAIN
Low Back Pain or Sciatica
Radiculopathy - Lumbar
Pelvic Pain
Rectal and Anal Pain
Peripheral Neuropathy
Facet Syndrome - Lumbar
Coccydynia / Tailbone Pain
Herneated Disc - Lumbar
Post Laminectomy Syndrome / Failed Back Surgery Syndrome
Spondylolisthesis
Phantom Limb Pain
Piriformis Syndrome
Sacroiliitis / Sacroiliac Pain
Spinal Stenosis
Scoliosis
Hip Pain
Knee Pain

OTHER PAIN
Opioid Dependence Pain
Fibromyalgia
Multiple Sclerosis Pain/Central Pain
Cancer Pain
Myofascial Pain
Muscle Spasm Pain
Post Surgery Pain
Complex Regional Pain Syndrome or Reflex Sympathetic Dystrophy
Causalgia
Motor Vehicle Accidents - Personal Injury
Whiplash Pain
Thoracic Outlet Syndrome
Neuropathic Pain



How does Dr. Ryan Peterson treat pain?


Dr. Ryan Peterson likes to sit down with each patient and evaluate them and look at the whole situation and evaluate the injury but also with the knowledge that pain is "biopsychosocial" and a good pain management doctor takes into consideration all aspects of a patient's life: the physical injury, the patient's function, coping skills, medication use, history with substance use, daily functions, mental health, support systems, and life events.

Once Dr. Ryan Peterson has evaluated you, he will likely either make recommendations to your current physician as a consultant, or keep you on with a care plan. The care plan may involve trials of medications or interventional procedures. Please note that if it is necessary to use any kind of controlled substance or opioid medication, it will likely and usually be very short term and closely monitored with frequent visits, medication contract, and urine drug screens. Dr. Ryan Peterson recognizes the current opioid crisis in California and knows that while some individuals require these medications for severe debilitating pain conditions or cancer, that they are easily abused. Dr. Ryan Peterson uses his skills as an addiction medicine physician to monitor and treat any substance issues.

If you need a procedure to help fix the pain condition, then Dr. Ryan Peterson will go over that with you in the office. In general these procedures are non-surgical and involve needles to fix the pain. Usually these procedures are performed in a surgery center using "twilight" anesthesia delivered by an anesthesiologist or certified registered nurse anesthetist. You always go home the same day, and Dr. Peterson will go over with you at what point you can expect to feel the pain get better (some procedures "kick in" right away; others take days). Some procedures are performed as a part of a "series" of stepwise injections intended to maximize pain relief. There is a science to this, and Dr. Ryan Peterson loves to describe it to you in a clear, understandable way. He knows that when it comes to pain management, EXPECTATIONS ARE EVERYTHING!

Here are some things you need to remember for procedure:
  1. Talk with your primary care doctor before having any procedure. If they suggest having a conference call with Dr. Peterson about this, please let him know. That is never a problem.
  2. Unless Dr. Ryan Peterson or your pain management referring physician tells you differently, you do NOT need to come off aspirin or anti-inflammatory (NSAID) drugs (ibuprofen, naproxen, diclofenac, meloxicam, etc) before the procedure. Acetaminophen should be continued as normal.
  3. BLOOD THINNERS: Stop clopidogrel (Plavix) or prasugrel (Effient) 7 days before procedure. Stop warfarin (Coumadin) 5 days before procedure and get blood drawn the day before procedure to reach an INR below 1.5. Stop apixiban (Eliquis) and rivaroxaban (Xarelto) 3 days before procedure. Stop dabigatran (Pradaxa) 5 days before procedure.
  4. FOOD AND DRINK: Most procedures are performed with anesthesia, so do not eat anything for EIGHT HOURS or drink anything at least SIX HOURS prior to the procedure. If you have to take important cardiac/blood pressure/thyroid meds, you may take them in the morning before the procedure with a VERY SMALL SIP of water (no blood thinners-see above).
  5. You must have an adult drive you home after the procedure (no taxi, Uber, etc).
  6. Notify Dr. Ryan Peterson of any infections, fevers, or antibiotics taken in the week prior to the procedure.
  7. If you are diabetic, you can usually have the procedure, assuming the benefit of pain relief outweighs the risk of the transient increase in blood sugar.


Dr. Peterson's Interventional Procedures to Treat Pain


ADVANCED PROCEDURES FOR PAIN MANAGEMENT
Spinal Cord Stimulator Placement, Intrathecal Morphine Pump Placement, Regular Refills of Intrathecal Pump

UPPER BODY PAIN
Cervical Epidural Injection
Thoracic Epidural Injection
Cervical Facet Joint Injection and Median Branch Block
Cervical Radiofrequency Ablation
Celiac Plexus Block
Splanchnic Nerve Block
Hypogastric Plexus Block
Trigger Point Injections
Suprascapular Nerve Block
Epicondyle Injections of the Elbow
Botox Injection of the Scalene Muscles
Prolotherapy
Intercostal Nerve Blocks
Epidural Blood Patch for Spinal Headache
Stellate Ganglion Block
Occipital Nerve Block

LOWER BODY PAIN
Sacroiliac Joint Injection
Lumbar Epidural Injection
Lumbar Facet Joint Injection and Median Branch Block
Lumbar Radiofrequency Ablation
Caudal Epidural Injection
Ganglion Impar Block
Coccyx Injection
Piriformis Injection
Botox Injection of the Piriformis Muscle
Lumbar Sympathetic Block
Radiofrequency Strip Lesion of the Sacroiliac Joint
Hip Injection and Hip Nerve Block
Trochanteric Bursa Injections
Trigger Point Injections
Hyalgan Injections of the Knee
Cortisone Injections of the Knee
Platelet-Rich Plasma Injections




Pain Management Locations



Advanced Spine Institute

As of Oct. 1, we've moved
to our new Encino location:

16030 Ventura Blvd. Ste 150
Encino, CA 91436
Phone: (818) 501-2001
Fax: (818) 484-4111




Advanced Spine Institute

42051 10th St West, Ste 109
Lancaster CA 93534
Phone: (818) 501-2001
Fax: (818) 484-4111




Encino Plaza Surgery Center

5400 Balboa Blvd, Ste 111
Encino CA 91316
Phone: (818) 784-8975
Fax: (818) 784-2035
encinoplazasurgery.com




Avanguard Surgery Center

5620 Wilbur Ave, Ste 207
Tarzana, CA 91356
Phone: (818) 344-0070
Fax: (818) 344-0079
avanguardsurgerycenter.com