Joint Pain Specialist

What kind of joint pain do Dr. Enayati and Dr. Gruver treat?

Patients come to Beverly Hills Advanced Pain and Spine with all sorts of joint pain issues. Dr. Enayati and Dr. Gruver treats pain from any joint in the body. From sport injuries to auto collision injuries to arthritis and other chronic pain conditions, Dr. Enayati and Dr. Gruver are skilled at diagnosing the root cause of your pain and identifying the best treatment plan for you.

There are many treatment options for joint pain. Dr. Enayati and Dr. Gruver can identify the best treatment plan for your individual circumstances. Some excellent treatments include stem cell allograph, PRP injections, radiofrequency ablation (for certain knee pain), corticosteroid injections, and nerve blocks.

I have pain in my hip, or shoulder or small joint (finger, wrist, ankle, or foot). What options do I have other than surgery?

Understanding the reason you have the pain in the first place is essential to determining your treatment options, and this may require imaging (often an MRI), examination, and review of your medical history and lifestyle in order to properly diagnose the pain. Often osteoarthritis can be confused with tendinitis, tendon inflammation, or an immune reaction, among other things. Dr. Enayati and Dr. Gruver will thoroughly examine you to understand your pain and offer the best treatment options for you. This may include medications, medical foods, a corticosteroid injection, or a nerve block. Many patients qualify for regenerative medicine and stem cell therapies, and this is important because these advanced treatments not only treat the source the pain and help heal the joints at a microcellular level, but also can slow down and even reverse further degeneration of the joint. This is an excellent option for small joints, knees, hips and shoulders, all of which have cartilage that lines the surfaces of those bones, and muscles, ligaments, tendons that form the basis of movement at those joints.

I have elbow and forearm pain and was told I have tennis elbow or golfer’s elbow. How can this be treated?

Dr. Enayati and Dr. Gruver offer the most cutting-edge treatment for chronic elbow pain, called a percutaneous tenotomy. This procedure is much less invasive than a traditional tenotomy and allows you to use your elbow immediately afterward! The procedure is performed in the office, under local anesthesia, and there is virtually no recovery time! In this procedure, Dr. Enayati and Dr. Gruver view the inside of the elbow using live ultrasound imaging as he uses a special needle to break up scar tissue and calcium deposits in and around the tendon. Afterward, he can inject corticosteroids to reduce inflammation as the elbow heals. But as an alternative to steroids, Dr. Enayati prefers injecting Platelet Rich Plasma (PRP), and sometimes amnion stem cell allograft, into the tendon to promote cellular healing and tendon and tissue regeneration. There is no downtime after the procedure --in fact Dr. Enayati and Dr. Gruver will encourage you to be diligent with stretching and physical therapy exercises to promote recovery – we do not want the elbow immobilized.

“Minimally invasive percutaneous ultrasonic tenotomy provided sustained pain relief and functional improvement for recalcitrant tennis elbow at 3-year follow-up. It is one of the few procedures to demonstrate positive sonographic evidence of tissue-healing response and is an attractive alternative to surgical intervention for definitive treatment of recalcitrant elbow tendinopathy."

Ultrasonic Percutaneous Tenotomy for Recalcitrant Lateral Elbow Tendinopathy: Sustainability and Sonographic Progression at 3 Years. 
American Journal of Sports Medicine
2016 February; 44(2): pages 504-10

I have chronic knee pain, or, I had knee surgery and I still have pain. Do I have any options?

Acute knee trauma, and even osteoarthritis, can be often be successfully treated with minimally invasive regenerative medicine and stem cell options. For those who have already had knee surgery, but still have pain, FDA-approved radiofrequency ablation is another excellent option and can be performed on any knee, even if you have had a knee replacement!

The radiofrequency ablation procedure is performed under very light sedation, and there is essentially no recovery or down time. Four special needles are inserted around the knee in very specific locations and connected to an advanced FDA-approved radiofrequency generator. The needles then emit a radiofrequency signal to eliminate the nerve signals causing pain in your knee, and are then removed. The knee pain is no longer generated, and the results typically last between 6 months and 2 years.

Dr.Enayati and Dr.Gruver often combines radiofrequency ablation with regenerative medicine and stem cells treatments. This allows for immediate pain relief so that the patient can participate in more active physical therapy and knee muscle rebalancing, while the regenerative therapy helps the damaged knee cartilage regenerate on a cellular level over the course of the next 3-4 months.

Do I need to see a physical therapist, an orthopedist, or a pain doctor for my joint pain?

Your exact condition will determine who should be a part of your treatment team. But often you will benefit from having more than one provider involved in your care. For example, Dr.Enayati and Dr.Gruver can provide treatments that decrease joint inflammation so that a patient is able to participate in more physical therapy. Both physical therapists and orthopedic surgeons refer patients to Dr.Enayati and Dr.Gruver on a regular basis. Likewise, when appropriate Dr.Enayati and Dr.Gruver will send his patients to see a physical therapist or orthopedic surgeon. Above all else, if you are in pain you should seek treatment sooner than later – there are usually more options available to you if you address a problem without delay.