Our pain management experts help you find relief when you need it.

Pain can be a physically and emotionally draining experience. Whether your chronic pain is from accident, injury, cancer, arthritis or other ailment, it can impede your life and even erode your will to recover. At Health Quest, our Pain Management Program is committed to helping you improve the quality of your life by reducing your pain, restoring your strength and mobility and lessening your reliance on pain medication.

Utilizing a wide range of treatments, including rehabilitation, medically administered pain relief and alternative wellness treatments, our multidisciplinary team of experts brings the best and latest advancements in research and technology to ease your pain.

Pain Management

Pain can be a physically and emotionally draining experience. Whether your chronic pain is from accident, injury, cancer, arthritis or other ailment, it can impede your life and even erode your will to recover. At Health Quest, our Pain Management Program is committed to helping you improve the quality of your life by reducing your pain, restoring your strength and mobility and lessening your reliance on pain medication.

Our Pain Management Team

Our Pain Management Program is directed by board certified physicians with specialties in multiple areas, including anesthesiology, physical medicine and rehabilitation. Their combined expertise allows us to make a thorough assessment of your chronic pain condition in order to customize a solution that works for your needs. To take part in our Pain Management Program at Vassar Brothers Medical Center, Putnam Hospital, Northern Dutchess Hospital or Sharon Hospital, consult your physician for a referral or enroll without one.

Pain Conditions

We treat the following conditions:


Rehabilitative therapy is often prescribed as a first response for chronic pain to restore strength and mobility after surgery. Health Quest has a dedicated team of physical and occupational therapists who will work personally with you on a customized plan of exercise, massage and other restorative modalities. You might also be referred for nerve stimulation to help reduce your pain. See Rehabilitation for more information.

Physician-Administered Pain Relief

Health Quest pain management specialists offer a variety of physician- administered procedures to help relieve pain. Usually performed in the physician’s office, these procedures include nerve blocks that interrupt pain pathways, steroid injections that reduce swelling around nerves, trigger point injections, implants that distract pain sensation and other procedures that relieve pain in specific areas.

In many cases, your physician may provide you with some form of sedation before performing the procedure. Sedation can help you experience the procedure as pleasantly as possible and your physician will choose the right option for you, depending on your age, medical condition, pain tolerance and the type of procedure. Usually, sedation is administered intravenously (IV) by a registered nurse or anesthesiologist (in collaboration with your physician) minutes prior to the procedure. Check with your doctor ahead of time for all necessary preparation requirements. If you have sedation of any kind, it is usually required that you arrange a ride home after your procedure.

Nerve Blocks

  • Botox® is a FDA-approved treatment for the relief and prevention of migraine headaches. Injections are given to the brow area, above the ears and/or at the base or mid-area of the skull. Signs of improvement may not appear for 10 to 15 days.
  • Occipital nerve block, prescribed for occipital neuralgia, blocks the occipital nerves (located at the base of your skull), which are often the cause of migraines and other types of headaches. You’ll be asked to either lie on your stomach or sit with your arms leaning on a table. After your physician palpates the occipital area, medication is injected into the area through a small needle. Pain relief can be immediate or take a few hours.
  • Medial branch block is used both to diagnose and treat pain in the neck, shoulder, upper back and head by blocking the small pain-messaging nerves that feed out from the spine’s medial facet joints. Under local anesthesia or sedation, a thin needle is used to inject anesthetic near the medial branch nerve. If the block is effective (signifying that your pain did originate in the facet joints of the spine), your physician may suggest a long-term block. This relatively painless procedure takes about 15 to 30 minutes. Effects can be immediate but may take up to a week to manifest.
  • Celiac plexus block treats abdominal pain from chronic pancreatitis and cancer by blocking sensation from the pain-messaging nerves that run from the pancreas, liver, kidney, gall bladder, spleen and bowels. When agents such as alcohol or phenol are substituted for the local anesthetic, the results can last for months or years. A few days of light activity are suggested following the block.
  • Ganglion block is both a diagnostic tool and a pain-relief modality, involving an injection of local anesthetic into the sympathetic nerve tissue of the stellate (upper extremities and neck) or the lumbar (lower extremities). This five-minute procedure is usually given in a series of six. After each treatment, physical therapy will likely be recommended.
  • Sacroiliac joint block can help relieve a constant achiness in the sacroiliac that gets worse when you sit. (The sacroiliac is the joint in the pelvis that supports the spine.) During this one-minute procedure you’ll lie on your stomach. After the area is numbed, medication to block the pain pathways will be injected through a small needle. You may not notice relief for about a week.

Steroid Injections

  • Transforaminal nerve block is a steroid injected into your back while you lie on your stomach. It’s used to treat pain from such conditions as spinal stenosis, herniated disc or degenerative disc disease. Generally completed in a series of three, spaced two to three weeks apart, the procedure lasts about 10 to 20 minutes.
  • Epidural nerve block is a steroid injected into the cervical, thoracic or lumbar area for pain resulting from spinal stenosis, herniated discs or degenerative disc disease. During the procedure you’ll be required to lie on your stomach for 10 to 20 minutes. It is usually completed in a series of three treatments spaced two to three weeks apart.

Trigger Point Injections

Trigger point injections are used to “break up” clumps of muscles that have gone into spasm and hurt when palpated. After injecting numbing anesthetic, your physician will massage the area to stop the spasm. If this proves successful, Botox® or Myobloc® (both forms of botulinum toxin) can provide extended relief for approximately three months. No more than five areas are injected per visit and usually the injections have to be repeated at two- to four-week intervals. You can return to your normal activity immediately afterwards.

Implant Device

A dorsal column stimulator is an implanted electronic device that delivers a low-level electrical current through wires placed near your spinal cord. The electrical current distracts you from your perception of pain and allows you to focus on more soothing sensations. It’s usually performed as same-day surgery and takes about three hours. A minimally invasive trial run is sometimes performed first to see if the full procedure will work for you.

Complementary Therapies

We also offer a variety of alternative wellness therapies, such as acupuncture, massage and reiki, that can help you relax, reduce pain and manage your stress levels more successfully.

Other Pain Relief Procedures

  • Epidural blood patch therapy is used to relieve severe spinal headaches that can sometimes occur after certain procedures — caused by the puncturing of the fluid-filled sac that surrounds the brain, spinal cord and its branches. Blood is first withdrawn from a vein in your forearm or hand then injected through a sterile needle into the epidural space (the area in the spine between the dura mater, a membrane, and the vertebral wall). The blood then clots and acts as a “patch” against further leakage of spinal fluid.
  • Lumbar discography is used to determine the exact cause of pain in patients with a bulging disc or back and lumbar radicular pain when traditional diagnostic modalities (MRI, CT) have been unsuccessful. Under conscious sedation you’ll be positioned on your stomach while a needle is injected into various discs to determine the level of discomfort. Recovery time varies; you may be required to take additional days off from work.
  • Lumbar facet rhizotomy neurotomy can relieve pain in the facet joints of the lower spine for six months to two years. Following intravenous sedation, radio frequency waves are generated through a special coated needle inserted into designated areas in the lower back. The tip of the needle heats up the nerve, stopping the pathways of pain messaging and thus lessening your pain sensations. Percutaneous discectomy (nucleoplasty) is a treatment for patients with bulging discs whose pain has not been relieved by other treatment. A small amount of disc tissue is removed from the disc nucleus with a special probe that then transmits thermal energy or heat to the disc. This decreases pressure inside the disc wall, which causes the disc to bulge or protrude less, thus lessening pain.
  • Infusion therapy, the intravenous application of pain medication, is also an option for cancer patients and others in pain. For more information, see Infusion Therapy.


Insurance or worker’s compensation may cover part or all of the cost of your pain management program.


Northern Dutchess Hospital
6511 Springbrook Avenue
Rhinebeck, NY 12572
(845) 871-3665

Putnam Hospital
670 Stoneleigh Avenue
Carmel, NY 10512
(845) 278-PAIN (278-7246)

Vassar Brothers Medical Center
45 Reade Place
Poughkeepsie, NY 12601
(845) 214-1300