Interventional Pain Management at Back To Mind Chiropractic
Epidural steroid injections and trigger point injections, performed by a licensed medical provider and combined with chiropractic care and rehabilitation, for accident-related pain that has not settled with conservative treatment alone.
After a car accident, most neck and back injuries improve with chiropractic care, decompression, and rehabilitation. Some do not. Nerve pain that shoots down a leg or an arm, or a muscle knot that keeps returning no matter how often it is treated, can stall recovery and make rehabilitation too painful to tolerate. Interventional pain management is designed for exactly those cases. At Back To Mind, the injections and the hands-on care happen under one roof, with one team following one plan.
Dr. Gady Abramson, DC · Founder
- Florida PIP accepted
- $0 out-of-pocket for eligible PIP patients*
- Letters of Protection accepted
- Direct insurance billing
- Complimentary injury evaluation
- Complimentary initial examination
- Same-day appointments
- Emergency appointments
- Free door-to-door transportation
- Experienced accident chiropractors
*Coverage depends on your policy and eligibility.
What Is Interventional Pain Management?
Interventional pain management is a medical approach that treats pain with targeted procedures rather than oral medication or surgery. Most of these procedures are injections that deliver medication directly to the structure causing the pain, such as an inflamed nerve root in the spine or a tight band of muscle. Because the medication is placed precisely where it is needed, a small dose can do more than a much larger dose taken by mouth.
The procedures are performed by licensed medical providers. In Florida, chiropractors do not perform injections, which is why many patients have historically been sent from a chiropractic office to a separate pain clinic, then to an imaging center, with little coordination between them. Back To Mind brings interventional procedures into the same clinics where patients receive their chiropractic care and rehabilitation.
Interventional pain management is not a cure on its own. An injection can calm inflammation or release a stubborn muscle for weeks or months. The lasting result depends on what happens during that window: the decompression, mobility work, and strengthening that address the reason the pain developed in the first place.
Who Is Interventional Pain Management For?
These procedures are most helpful for patients whose pain has a clear, specific source that conservative care has not fully resolved. After a car accident, that usually means one of two problems.
Nerve pain from a disc injury
When a disc is injured in a crash, its soft center can push outward against the nerve root leaving the spine. This is a herniation. The disc material also releases inflammatory chemicals that irritate the nerve even when the pressure is mild. The result is radicular pain: pain that follows the path of the nerve rather than staying at the site of injury.
In the low back, this appears as sciatica: pain, burning, numbness, or tingling through the buttock and down the leg, sometimes into the foot. In the neck, it appears as cervical radiculopathy: pain or pins-and-needles into the shoulder blade, arm, or fingers. Some patients also notice weakness, such as a foot that slaps when walking or a grip that drops objects. Drivers with pre-existing spinal stenosis often find that a crash turns a quiet narrowing into a painful one. This is the type of pain an epidural steroid injection is designed to treat.
Muscle pain from trigger points
Whiplash does more than strain muscles. It can leave behind trigger points: small, hard knots within a taut band of muscle that remain contracted long after the original injury. Pressing on a trigger point hurts more than it should, and the pain often spreads to a predictable spot elsewhere. A trigger point in the upper trapezius can send pain into the back of the head. One in the gluteal muscles can send pain down the leg and mimic sciatica, which is one reason a careful examination comes before any treatment decision.
Trigger points are common in the upper trapezius, levator scapulae, and the muscles alongside the spine after a rear-end collision, and in the gluteal and low-back muscles after a side impact. Many release with soft-tissue work and stretching. Some settle for a day or two and tighten again. Those are the trigger points a trigger point injection is designed to treat.
- Leg or arm pain that follows a nerve path (sciatica, cervical radiculopathy)
- Disc herniation confirmed by examination and MRI
- Spinal stenosis aggravated by a crash
- Muscle knots that keep returning despite manual therapy and stretching
- Tension-type headaches driven by neck and shoulder trigger points
- Pain severe enough to prevent participation in rehabilitation
- Pain that has not been examined. An injection should never be a guess.
- Nerve pain treated with a trigger point injection, or muscle pain treated with an epidural. The right procedure depends on the source.
- Widespread pain without a specific nerve or muscle generator
- Pain that is already improving steadily with conservative care
★★★★★ “I have been suffering from disc issues, leading to sciatic pain since last October… My mobility is improving, and my pain level has decreased from strong pain to discomfort.”
What We Offer
Two interventional procedures are performed in-house at Back To Mind by a licensed medical provider who works alongside the chiropractic team. Both are available at all nine Florida locations.
Epidural Steroid Injections
Anti-inflammatory medication is placed in the epidural space next to the irritated nerve root. Used for sciatica-type leg pain or arm pain caused by a herniated disc or spinal stenosis. The goal is to reduce inflammation enough that pain drops and rehabilitation becomes possible.
Trigger Point Injections
A small injection, usually of local anesthetic, placed directly into a tight, tender knot in a muscle. Used for trigger points in the neck, shoulders, and low back that have not released with soft-tissue work and stretching. The goal is to deactivate the knot so the muscle can be retrained.
When a case calls for a different procedure, such as a facet joint block, radiofrequency ablation, or a joint injection, Back To Mind refers the patient to a trusted specialist and continues to coordinate the chiropractic and rehabilitation side of care.
How It Works: From Evaluation to Injection
No one is scheduled for an injection on a first visit, and no one is scheduled because an MRI report looks dramatic. Many people have disc bulges on imaging and no pain at all. An injection is recommended only when three things line up: the symptoms, the examination findings, and the imaging. Here is the process.
History and physical examination
The chiropractor reviews how the accident happened, since the direction of impact and head position indicate which tissues took the load. Orthopedic tests such as a straight-leg raise or a neck compression test help separate nerve pain from muscle pain. Neurological testing checks reflexes, strength, and sensation side to side. Palpation identifies trigger points: a taut band, a knot that twitches when pressed, and pain that spreads to a predictable spot.Imaging when indicated
Digital X-rays are taken when appropriate, and an MRI is ordered if the examination suggests disc or nerve involvement. The imaging has to agree with the examination. If it does not, the team keeps looking rather than treating the picture.Conservative care first
In most cases, treatment begins with chiropractic care, spinal decompression, flexion-distraction, soft-tissue work, and home exercises. Many patients improve over a few weeks and never need an injection.Referral to the medical provider
If pain is not easing after a fair trial of conservative care, or is so severe that rehabilitation cannot be tolerated, the medical provider performs a separate evaluation using the same history, examination, and imaging. The provider decides which injection is appropriate, where, and whether one is appropriate at all.The procedure
The injection is performed in the clinic. Details for each procedure are below.Rehabilitation during the relief window
Chiropractic care and rehabilitation resume within days, while inflammation is down or the muscle is released, so the underlying mechanical problem can be corrected.
★★★★★ “…aside from taking 9 x-rays and looking at an MRI I had done he had asked me many questions to better understand my situation and where the pain was originating.”
Epidural Steroid Injections: What to Expect
The word “epidural” makes some patients think of spinal surgery. It is not surgery. The epidural space is the fat-filled area surrounding the nerve roots as they exit the spine. The medication is placed there, not into the spinal cord.
Preparation
The provider reviews current medications. Blood thinners usually need to be paused with the prescriber’s approval, and patients with diabetes receive instructions for managing blood sugar afterward. Allergies, recent infections, and any chance of pregnancy should be disclosed. A ride home is required.
The procedure
The patient lies face down. The skin is numbed. The provider guides a thin needle to the epidural space near the affected nerve root, with image guidance when indicated, and injects a corticosteroid, often with a small amount of anesthetic. The patient stays awake, and most describe pressure rather than pain. The injection takes roughly 15 to 30 minutes, followed by a short rest.
The first few days
The rest of the day should be kept easy. The anesthetic may provide a few hours of relief that then wears off, which is normal. Soreness at the site, or a brief flare of the usual pain for a day or two, is also common. The steroid typically begins working within one to three days, sometimes up to a week.
Repeat injections
If the first injection helps meaningfully, a repeat may be considered when symptoms return. If it does not help at all, repeating it rarely does, and the plan is reassessed. Most providers limit epidural injections to about three or four per spinal region per year because steroids have cumulative effects.
What the research says
A 2020 Cochrane review pooled 25 placebo-controlled trials and found that epidural steroid injections probably reduce leg pain and disability in the short term. The average effect is modest, and the benefit is measured in weeks to a few months rather than years. The injection reduces inflammation; it does not repair the disc. Some patients experience dramatic relief and others very little. This is why Back To Mind pairs the injection with rehabilitation rather than treating it as the finish line.
Side effects and risks
Common and minor: soreness at the site, facial flushing, headache, a restless night or two, and a temporary rise in blood sugar. Rare but real: infection, bleeding, a spinal-fluid leak causing a headache, and nerve irritation. The FDA requires a warning on injectable corticosteroids about rare but serious neurological complications after epidural use. The provider reviews these risks with every patient before consent.
Trigger Point Injections: What to Expect
A trigger point injection is a much smaller procedure than an epidural. The provider locates the knot by hand, cleans the skin, and inserts a small needle directly into the trigger point. A small amount of local anesthetic, sometimes with a corticosteroid and sometimes with no medication at all, is injected, and the needle may be moved gently in and out to deactivate the point. Patients often feel the muscle twitch once as the knot releases.
A few minutes per point
Several trigger points can be treated in one visit. No sedation is used, and most patients drive themselves home.
Sore, then looser
A bruised, achy feeling for a day or two is normal. Relief from the anesthetic is often immediate. The lasting change comes as the muscle stays relaxed and is kept moving.
A short series
Stubborn points may need a few sessions spaced a week or more apart. If a point does not respond after a reasonable trial, the team looks for what is driving it rather than injecting it again.
Why it works best inside a rehabilitation plan
A trigger point injection releases the knot. It does not fix why the knot formed. After a crash, that reason is usually a joint that is not moving well, a protective posture the neck adopted, or a muscle doing a job it was never meant to do. Soft-tissue work, stretching, and strengthening are scheduled in the same week as the injection, while the muscle is quiet enough to retrain. Research on trigger point injections suggests the needling itself does much of the work regardless of what is injected, and that results hold up best when the injection is paired with movement rather than used alone.
Side effects and risks
Common and minor: soreness, a small bruise, and light-headedness for a few minutes. Uncommon: a flare of pain for a day or two, or temporary numbness from the anesthetic. Rare: infection, or, for points over the upper back and chest wall, a punctured lung. This is why technique and needle depth matter, and why the procedure is performed by a trained medical provider. If a corticosteroid is used, the same steroid cautions described above apply.
If an injection has been offered elsewhere without an examination, it is worth getting a second opinion first. The procedure is only as good as the diagnosis behind it.
Benefits of Interventional Pain Management at Back To Mind
Targeted relief
Medication goes directly to the inflamed nerve root or the contracted muscle, so a small dose can accomplish what oral medication often cannot.
A window for rehabilitation
Lower pain for several weeks makes decompression, mobility work, and strengthening tolerable, which is where lasting recovery actually happens.
One team, one plan
The chiropractor and the medical provider work from the same examination, the same imaging, and the same record. No lost referrals, no repeated workups, no conflicting advice.
Less reliance on medication
For many patients, controlling the pain at its source reduces the need for ongoing oral pain medication and the side effects that come with it.
Clear documentation
Every examination, imaging report, and procedure note is recorded in plain, objective language for the patient’s records, insurer, and, when applicable, attorney.
Easy access
Nine Florida locations, same-day and emergency appointments, and free door-to-door transportation for patients who cannot comfortably drive.
Why Injections and Chiropractic Care Work Better Together
An epidural quiets the inflammation around a nerve root. A trigger point injection releases a muscle that has been locked for weeks. Either one opens a window in which movement that was unbearable becomes tolerable. Back To Mind uses that window deliberately:
- Spinal decompression to reduce load on the injured disc
- Cox Flexion-Distraction, a gentle, table-assisted technique used for disc herniations and stenosis
- Soft-tissue work and stretching for muscles that have been guarding, especially in the days after a trigger point injection
- Progressive stabilization exercises that rebuild strength and control around the spine
- A home program patients can realistically continue after discharge
The plan changes as the patient does. Re-examinations happen at regular intervals. If leg pain is gone but the back is still stiff, the plan shifts toward mobility and strength. If an injection did not help, the team returns to the imaging and discusses whether a specialist, such as orthopedics, neurosurgery, or a different interventional procedure, is the right next step.
Not everyone who has been told they need injections actually does. Some patients arrive with an injection already scheduled elsewhere, and their examination points to a mechanical problem that responds to hands-on care. The right answer depends on the examination, not on what is available.
★★★★★ “I was on my way to get my third set of epidural shots when I learned of Dr. A… after only 4 short visits, I have more mobility and less pain.”
The Team Behind Your Care
Dr. Gady Abramson, DC, PA
Dr. Abramson earned his Doctor of Chiropractic from Life University in 1997 and has spent more than 22 years in South Florida focused on auto-accident injuries: whiplash, disc herniations, sciatica, and the joint and soft-tissue damage that accompanies them. He founded Back To Mind on one principle: treat the cause, not just the symptom, with a plan based on each patient’s specific injuries rather than a standard protocol. Interventional pain management is an extension of that principle.
Dr. David Ledwitz, DC
Licensed for more than 30 years, with a master’s degree in sports medicine and extensive experience in disc herniations, spinal stenosis, and extremity injuries. His Cox Flexion-Distraction work is often the first treatment scheduled after an injection. English and Spanish.
Dr. Thomas Gyorfi, DC
Bachelor’s and master’s degrees in exercise science, more than 11 years in injury treatment and pain management, and a strength-and-conditioning background that includes collegiate athletes and the Florida Marlins. He designs the stabilization and return-to-activity phase so that relief from an injection becomes lasting function.
Injections are performed by a licensed medical provider on the Back To Mind team, working from the same examination findings and imaging as the treating chiropractor. Across the practice’s eight licensed chiropractors, patients are served in English, Spanish, Hebrew, Haitian Creole, and Hindi.
★★★★★ “From my initial consultation, I was highly impressed by their professionalism and clinical expertise.”
Available at All Nine Back To Mind Locations
Interventional pain management is scheduled through every Back To Mind clinic. Whether you commute along I-95 through Broward, the Turnpike into Palm Beach County, the Palmetto around Miami, or I-4 across Orlando, there is an office near your route. For patients who cannot comfortably drive, free door-to-door transportation is available.
- Hollywood3990 Sheridan St., Suite #201, Hollywood, FL 33021(954) 919-2555
- Coral Springs2825 N University Dr., Suite #100, Coral Springs, FL 33065(954) 919-2555
- Fort Lauderdale6450 NW 5th Way, Fort Lauderdale, FL 33309(954) 620-6833
- Tamarac7431 N University Dr., Suite #206, Tamarac, FL 33321(954) 620-7666
- West Palm Beach4700 N Congress Ave., Suite 202, West Palm Beach, FL 33407(561) 821-5525
- Kendall (Miami)13501 SW 136th St., Suite 207, Miami, FL 33186(786) 786-7945
- North Miami1125 NE 125th St., Unit 303, North Miami, FL 33161(786) 796-8707
- Doral (Miami)2794 NW 79th Ave., Miami, FL 33122(954) 919-2555
- Orlando6342 W Colonial Dr., Building 1, Orlando, FL 32818(407) 890-5463
The Hollywood office alone carries a 4.9★ rating across 733 Google reviews, and Coral Springs holds 5.0★ across 324. Group-wide, more than 36,000 patients have trusted Back To Mind with their recovery, and the practice holds an A+ rating with the Better Business Bureau. See all locations and hours.
For injuries from a car accident, Florida PIP, MedPay, health insurance, or a Letter of Protection may apply. The billing team verifies coverage before anything is scheduled, and every examination, imaging report, and procedure note is documented in plain, objective language for the patient’s records, insurer, and, when applicable, attorney. More than 100 Florida personal-injury attorneys refer their clients to Back To Mind for that reason. Learn how we handle personal injury cases.
★★★★★ “I went in for a bulging/herniated disc, the front desk employees and the Dr. took great care of me.”
What Recovery Looks Like
Realistic expectations matter, because unrealistic ones are how patients lose confidence halfway through treatment. Nerve-root injuries heal slowly. Even after a successful injection, an irritated nerve may keep sending occasional signals for weeks. Muscles that have been locked for months do not relearn normal tension in a single visit. Progress is rarely a straight line: good days, then a flare after a long drive or a poor night’s sleep. That is not failure. It is how injured tissue behaves.
What the team watches is the trend. Is the pain centralizing, moving out of the leg and back toward the spine? Is the numbness shrinking? Are the knots staying soft between visits? Is more of the exercise program being tolerated? Those markers show the plan is working. If they stall, the plan changes. If they go backward, imaging is repeated and the appropriate specialist is brought in. No patient is kept on a treatment that is not earning its place.
Frequently Asked Questions
Do I need to try chiropractic care before getting an injection?
What is the difference between a trigger point injection and an epidural?
Who performs the injections?
Will insurance cover the injections?
How soon after an injection can chiropractic treatment and rehab resume?
How many injections can a patient have?
Does the injection fix the herniated disc or cure the muscle problem?
Will the injection hurt, and can I drive afterward?
Find Out What Is Actually Causing Your Pain
If pain is traveling down an arm or a leg, or a knot in the neck or back keeps coming back, it should not have to become unbearable before someone examines it properly. A thorough evaluation shows whether hands-on care alone will get you there, or whether an injection can open the door that rehabilitation walks through. Either way, you will leave the first visit understanding the injury and the options, and no one will pressure you into a procedure.
Same-day and emergency appointments are available at all nine locations, and free door-to-door transportation is available if driving is painful right now.