Pain Management in Johns Creek: Conditions We Treat and What Your First Visit Looks Like

If you’ve been told you need pain management but aren’t quite sure what that actually means, or if you’ve been dealing with back or neck pain on your own for months and it’s no longer improving, this post is for you.

Pain management is one of the most misunderstood areas of medicine. Many patients come in with assumptions like “it’s mainly about prescribing opioids” or that “it’s the last step before surgery”, or “I’ll simply be referred back to physical therapy I’ve already tried”. At InterSpine, that’s not what we do.

I’m Dr. Sal Hemani — double board-certified in Anesthesiology and Interventional Pain Medicine, and founder of InterSpine. Let me walk you through what we actually do, who we help, and what you can expect when you come in.

What is interventional pain management — and how is it different?

Back pain is one of the most common reasons people seek medical care in the U.S. According to the CDC's National Health Interview Survey (NCHS Data Brief No. 415), 39% of US adults reported back pain in the past three months. Despite how widespread it is, many patients spend years cycling through treatments that only mask symptoms without addressing the root cause.

Interventional pain management focuses on identifying the exact structural or neurological source of pain and treating it directly with targeted, minimally invasive procedures. It fills an important gap between other types of care:

Primary care providers manage overall health and coordinate referrals but typically don’t perform spine-specific procedures
Spine surgeons specialize in structural repairs and are essential when surgery is necessary
Interventional pain specialists like me focus on the space between conservative care and surgery: image-guided injections, nerve blocks, ablation, and neuromodulation that can provide significant relief without an operating room

"Interventional" specifically means using minimally invasive techniques guided by real-time fluoroscopic X-ray or ultrasound to deliver treatment precisely where it's needed. This allows us to treat pain with precision, not guesswork. Every procedure is carefully targeted and image-confirmed.

My dual board certification in Anesthesiology and Interventional Pain Medicine means I've trained in both the physiology of pain pathways and the procedural techniques to address them. The American Board of Pain Medicine and the American Society of Interventional Pain Physicians (ASIPP) represent the national standards for this specialty — and the procedures I offer align with their evidence-based guidelines.

Conditions we treat at our Johns Creek office

Interventional pain management covers a wide range of conditions. The common thread is that these are conditions where pain has a diagnosable structural or neurological source that can be targeted precisely.

Back and spine

Lumbar radiculopathy (sciatica) — nerve root compression in the lower back causing shooting pain, numbness, or weakness down the leg; typically from a herniated disc or spinal stenosis
Herniated and bulging discs — disc material pressing on spinal nerves; one of the most common sources of both local and radiating back pain
Spinal stenosis — narrowing of the spinal canal that compresses nerve roots, often causing leg cramping or weakness with walking
Facet arthropathy — degeneration of the small joints that connect each vertebra; a frequent source of chronic, dull axial back pain
Osteoporotic compression fractures — vertebral collapse from bone loss, causing acute, severe back pain

Neck and cervical spine

Cervical radiculopathy — pinched nerve in the neck causing radiating pain, numbness, or weakness into the arm or hand; often described as an electric or burning sensation
Cervical facet arthropathy — degenerative joint disease in the neck producing chronic pain that may refer into the shoulder or upper back

Neuropathic pain

Complex Regional Pain Syndrome (CRPS) — severe, chronic limb pain occasionally following injury, often accompanied by swelling, diminished range of motion, and changes in skin temperature and color
Peripheral neuropathy — nerve damage causing burning, tingling, or numbness in the extremities; often seen in diabetic patients
Post-laminectomy syndrome — persistent pain following spinal surgery, sometimes called "failed back surgery syndrome"

Headaches

Chronic migraines are a condition many people don't associate with pain management — but it's one of the more treatable conditions in our practice. We offer Botox injections for chronic migraine treatment, which has strong clinical evidence and FDA approval for this indication

Other Conditions

Popliteal (Baker’s) cyst - fluid-filled lump behind the knee that may restrict movement, cause pain, or create stiffness
Carpal tunnel syndrome - compression of a nerve in the wrist that can lead to pain, weakness, numbness, and tingling in the hand and fingers
Fibromyalgia - chronic, centralized pain syndrome characterized by widespread musculoskeletal pain, disordered processing of painful stimuli, and associated symptoms including fatigue, sleep disturbances, and cognitive dysfunction

This is not a comprehensive list. Please call us at (404) 593-0090 to inquire if our office can provide care for your condition.

When you should come in — and when it's okay to wait

Not every bout of back pain needs specialist attention. A new episode of low back pain without neurological symptoms can often improve with conservative care within 6 weeks. Here's when I'd encourage you to see someone sooner rather than later.

See a specialist promptly if you have:

Pain radiating down the leg or arm, especially with numbness or tingling
Weakness in a leg or arm that's new or worsening
Pain severe enough to disrupt sleep or prevent normal daily activity
Back pain following a fall, accident, or trauma
Any changes in bladder or bowel control — this is a red flag and warrants urgent evaluation

Procedures available in Johns Creek

Every treatment at InterSpine is tailored to the individual and based on what the evidence actually supports for your specific diagnosis. We don't run patients through a fixed protocol. Here's an overview of what we offer:

Injection-based treatments:

Epidural steroid injections — corticosteroid delivered to the epidural space to reduce nerve inflammation; a common interventional treatment for radiculopathy and disc herniation
Facet injections — targeted injections into or around the facet joints to reduce pain from arthropathy
Nerve injections and diagnostic nerve blocks — both therapeutic and diagnostic, to identify and treat certain neuropathic conditions and specific pain generators
Sacroiliac joint injections — for SI joint dysfunction, a commonly overlooked source of low back and buttock pain
Stellate ganglion injections and Lumbar sympathetic blocks — sympathetic nerve blocks used for complex regional pain syndrome and other sympathetic-mediated conditions

Longer-duration relief:

Radiofrequency ablation (rhizotomy) — uses heat to interrupt pain signals from specific nerve branches; effective for facet-mediated pain with relief lasting 6–12 months or even longer
Spinal cord stimulation — implantable device that modulates pain signals in the spinal cord; appropriate for patients with complex chronic pain who haven't responded to other treatments

Specialty procedures:

Botox for chronic migraines and cervical dystonia — FDA-approved; delivered as a series of injections every 12 weeks
Ketamine infusion therapy — for treatment-resistant depression and certain refractory chronic pain conditions
Platelet-rich plasma (PRP) therapy - promotes healing at injected site; can treat musculoskeletal injuries to tendons, joints, muscles, and ligaments

The procedures I recommend always reflect the best available evidence. The ASIPP's comprehensive epidural intervention guidelines — covering 47 systematic reviews and 43 randomized controlled trials — assign Level I evidence with a strong recommendation for epidural injections in disc herniation and radiculopathy.

Reference: ASIPP Comprehensive Evidence-Based Guidelines for Epidural Interventions (2021)

What your first visit looks like

I want to demystify this because patient anxiety about first appointments is real — and usually based on imagining something more dramatic or rushed than what actually happens.

Before you arrive

Download and complete your new patient forms before your appointment to save time. Please bring:

Any imaging you have (MRI, CT, X-rays) on disc or accessible digitally
Records from prior treatments — physical therapy notes, surgical records, prior injection history
A complete list of your current medications and dosages
Your insurance card and a photo ID

The consultation

Your first visit is a conversation and an examination — not a procedure. I'll take a detailed history of your pain: when it started, what makes it better or worse, what you've already tried, and how it's affecting your daily life. I'll perform a focused neurological and musculoskeletal exam and review any imaging you've brought.

I don't rush patients into procedures on visit one. If I think an injection or other treatment is appropriate, I'll explain exactly why, what the expected outcome is, what the alternatives are, and what happens if we wait.

Treatment planning

If an intervention makes sense for your case, we'll schedule it and walk you through preparation instructions. If it doesn't — if I think a different referral, further imaging, or a different approach would serve you better — I'll tell you that plainly and explain why.

Insurance and logistics

We accept most major insurance plans. To confirm your coverage before your visit, call our office at (404) 593-0090. For referring physicians, our fax is (833) 973-4752.

Ready to take the first step?

Our Johns Creek office is located at 10680 Medlock Bridge Road, Suite 102, Johns Creek, GA 30097 and is open Monday through Friday, 7:30am to 4pm.

We also see patients by appointment only at our Braselton location: 5670 Old Winder Highway, Suite 200, Braselton, GA 30517.

If you've been told you need pain management, or if you're simply tired of managing pain that isn't getting better, we'd like to help you figure out what's actually going on — and what we can do about it.

Call us at (404) 593-0090 to schedule your consultation, or reach out through our website.

Dr. Sal Hemani is a double board-certified Anesthesiologist and Interventional Pain Specialist at InterSpine, serving patients in Johns Creek, Braselton, and the surrounding Atlanta metro area.