Services

At Coastal Spine & Pain, we offer a comprehensive range of interventional pain management services delivered by dual board-certified physicians in both Anesthesiology and Pain Medicine. Our goal is to identify the source of your pain, offer evidence-based treatment, and restore your quality of life through the least invasive, most effective approach available.

Evaluation & Consultation Services

New Patient Comprehensive Evaluation — A thorough history, physical examination, and review of prior diagnostic studies to establish a precise diagnosis and individualized treatment plan tailored to your specific pain condition.
Follow-Up Pain Management Visits — Ongoing monitoring of your treatment response, adjustment of therapies, reassessment of functional goals, and coordination of care with your referring and primary care physicians.
Second Opinion Consultations — An independent, objective clinical review of your current diagnosis and treatment plan, particularly valuable before considering surgical intervention or major procedural therapies.
Pre-Procedural Evaluation & Clearance — Medical assessment and preparation prior to interventional procedures to ensure patient safety, optimize outcomes, and satisfy facility requirements.

Spinal Interventional Procedures

Lumbar Epidural Steroid Injections (Interlaminar & Transforaminal) — Fluoroscopically or ultrasound-guided delivery of corticosteroid and anesthetic into the epidural space to reduce inflammation and relieve pain radiating from lumbar disc herniations, stenosis, or nerve root irritation.
Cervical Epidural Steroid Injections — Targeted injection into the cervical epidural space to treat neck pain, cervicogenic headache, and upper extremity radiculopathy caused by disc herniations or foraminal stenosis.
Thoracic Epidural Steroid Injections — Epidural steroid delivery at the thoracic level for mid-back pain, intercostal neuralgia, and post-herpetic or post-surgical pain involving the thoracic spine.
Caudal Epidural Steroid Injections — Access to the lumbar epidural space through the sacral hiatus, particularly useful in patients with prior lumbar surgery or anatomical challenges to standard approaches.
Lumbar Transforaminal Epidural Steroid Injections (Selective Nerve Root Blocks) — Highly targeted injections delivering medication directly adjacent to a specific spinal nerve root, providing both diagnostic and therapeutic benefit for radiculopathy.
Lumbar Medial Branch Blocks (Diagnostic Facet Joint Injections) — Temporary anesthetic blocks of the medial branch nerves supplying the lumbar facet joints, used to confirm facetogenic low back pain as a precursor to radiofrequency ablation.
Cervical Medial Branch Blocks — Diagnostic nerve blocks targeting the cervical facet joints, commonly used to identify the source of axial neck pain and cervicogenic headache.
Thoracic Medial Branch Blocks — Diagnostic and therapeutic blocks of the thoracic facet joints for mid-back pain, rib pain, and thoracic spine-related discomfort.
Lumbar Facet Joint Injections (Intra-articular) — Direct injection into the facet joint capsule with corticosteroid and anesthetic to reduce joint inflammation and provide temporary relief of axial low back pain.
Cervical Facet Joint Injections (Intra-articular) — Intra-articular injection into the cervical facet joints to treat arthropathic neck pain and related symptoms including occipital headache.
Lumbar Radiofrequency Ablation (RFA) — A minimally invasive procedure using thermal energy to interrupt pain signals from the medial branch nerves supplying the facet joints, providing durable relief typically lasting 12 to 24 months or longer.
Cervical Radiofrequency Ablation (RFA) — Application of radiofrequency energy to cervical medial branch nerves, providing sustained relief from chronic axial neck pain and cervicogenic headache following confirmatory diagnostic blocks.
Thoracic Radiofrequency Ablation (RFA) — Denervation of thoracic medial branch nerves for long-term management of mid-back and thoracic facetogenic pain.
Intradiscal Procedures (Discogenic Pain Treatments) — Procedures targeting the intervertebral disc itself, including provocative discography for diagnostic purposes and intradiscal therapies for internal disc disruption and discogenic low back pain.
Vertebral Augmentation Consultation & Co-Management — Evaluation, treatment and referral coordination for vertebroplasty or kyphoplasty in patients with vertebral compression fractures related to osteoporosis or malignancy.

Sacroiliac Joint & Pelvic Pain

Sacroiliac (SI) Joint Injections — Image-guided intra-articular injection of the sacroiliac joint with corticosteroid and local anesthetic to treat SI joint dysfunction, a commonly under-recognized source of low back and buttock pain.
Sacroiliac Joint Radiofrequency Ablation (Lateral Branch Neurotomy) — Radiofrequency denervation of the lateral branch nerves supplying the sacroiliac joint for patients who have experienced sustained relief from diagnostic SI joint blocks.
Genicular Nerve Blocks — Diagnostic and therapeutic nerve blocks targeting the genicular nerves of the knee joint, used to confirm knee joint pain origin and as a precursor to radiofrequency ablation.
Genicular Radiofrequency Ablation — Radiofrequency ablation of the genicular nerves supplying the knee joint, offering long-lasting pain relief for patients with chronic knee osteoarthritis who are not surgical candidates or wish to avoid surgery.
Piriformis Muscle Injections — Targeted injection into the piriformis muscle to treat piriformis syndrome, a condition that can mimic or coexist with sciatic nerve pain.
Coccydynia Injections (Ganglion Impar Block) — Treatment of tailbone pain through targeted injections at the ganglion impar, a sympathetic ganglion at the sacrococcygeal junction.

Peripheral Nerve Blocks & Neuraxial Procedures

Stellate Ganglion Block — Sympathetic nerve block targeting the cervical stellate ganglion, used in the treatment of complex regional pain syndrome (CRPS), post-traumatic stress-related pain, and sympathetically maintained pain of the head, neck, and upper extremity.
Celiac Plexus Block / Neurolysis — Sympathetic plexus block or neurolytic procedure targeting the celiac plexus for intractable abdominal pain related to chronic pancreatitis or intra-abdominal malignancy.
Lumbar Sympathetic Block — Sympathetic nerve block targeting the lumbar sympathetic chain for treatment of CRPS of the lower extremity, peripheral vascular pain, and hyperhidrosis.
Superior Hypogastric Plexus Block — Targeted block of the superior hypogastric plexus for pelvic pain related to endometriosis, interstitial cystitis, pelvic malignancy, or other visceral pelvic pain syndromes.
Intercostal Nerve Blocks — Injections targeting the intercostal nerves for rib fracture pain, post-thoracotomy pain syndrome, post-herpetic neuralgia, and other sources of chest wall pain.
Occipital Nerve Blocks (Greater & Lesser) — Targeted nerve blocks at the base of the skull for the treatment of occipital neuralgia, cervicogenic headache, and refractory migraine.
Supraorbital & Supratrochlear Nerve Blocks — Targeted blocks of the frontal nerve branches for frontal headache and supraorbital neuralgia.
Suprascapular Nerve Block — Injection targeting the suprascapular nerve for shoulder pain related to rotator cuff pathology, glenohumeral arthritis, and post-surgical shoulder pain.
Ilioinguinal / Iliohypogastric Nerve Block — Targeted injection for chronic groin pain, post-herniorrhaphy pain syndrome, and post-surgical lower abdominal neuralgia.
Lateral Femoral Cutaneous Nerve Block — Treatment of meralgia paresthetica (outer thigh burning pain) through targeted block of the lateral femoral cutaneous nerve.
Median, Ulnar & Radial Nerve Blocks — Peripheral nerve blocks of the upper extremity for carpal tunnel syndrome, cubital tunnel syndrome, and other entrapment neuropathies.
Pudendal Nerve Block — Targeted block of the pudendal nerve for perineal pain, pudendal neuralgia, and post-surgical pelvic pain syndromes.

Neuromodulation & Advanced Interventional Therapies

Spinal Cord Stimulation (SCS) Trial — A minimally invasive trial period using temporary electrodes placed in the epidural space to determine whether neuromodulation therapy will effectively reduce a patient’s chronic pain before proceeding to permanent implantation.
Spinal Cord Stimulation — Permanent Implantation — Surgical placement of a permanent pulse generator and leads for long-term neuromodulation therapy, indicated for failed back surgery syndrome, CRPS, refractory neuropathic pain, and other chronic pain conditions unresponsive to conventional therapies.
Dorsal Root Ganglion (DRG) Stimulation — Advanced neuromodulation targeting the dorsal root ganglion for highly focal chronic pain conditions, particularly CRPS Type I and II and post-surgical neuropathic pain.
Intrathecal Drug Delivery Systems (Pain Pumps) — Consultation & Management — Evaluation for and ongoing management of implanted intrathecal pump systems delivering opioids or baclofen directly into the cerebrospinal fluid for refractory cancer pain or spasticity.
Platelet-Rich Plasma (PRP) Injections — Autologous biologic therapy using concentrated growth factors from the patient’s own blood to promote tissue healing in tendons, ligaments, joints, and other musculoskeletal structures.
Regenerative Medicine / Orthobiologic Consultations — Evaluation and patient selection for advanced regenerative therapies targeting degenerative joint disease and soft tissue injuries, including emerging biologics.

Joint & Musculoskeletal Injections

Intra-articular Corticosteroid Injections — Image-guided or landmark-based injections into peripheral joints (shoulder, hip, knee, ankle, elbow, wrist) to reduce inflammation and provide relief from osteoarthritis, rheumatoid arthritis, and post-traumatic joint pain.
Hyaluronic Acid (Viscosupplementation) Injections — Injection of hyaluronic acid into the knee or other joints to supplement the natural lubricating properties of synovial fluid, indicated for osteoarthritis.
Joint Aspiration (Arthrocentesis) — Removal of excess fluid from swollen joints for diagnostic evaluation and therapeutic decompression, alleviating pain and improving mobility.
Shoulder Joint Injections — Targeted corticosteroid or biologic injections into the glenohumeral joint, acromioclavicular joint, or subacromial bursa for rotator cuff disease, impingement syndrome, frozen shoulder (adhesive capsulitis), and shoulder arthritis.
Hip Joint Injections — Image-guided injection into the hip joint for osteoarthritis, labral pathology, iliopsoas bursitis, and other sources of hip pain.
Knee Joint Injections — Targeted therapeutic injections for knee osteoarthritis, meniscal pathology, and post-traumatic or post-surgical knee pain.
Ankle & Foot Joint Injections — Therapeutic injections targeting the ankle, subtalar, or other small foot joints for osteoarthritis, plantar fasciitis, and post-traumatic pain.
Bursal Injections (Trochanteric, Subacromial, Olecranon, Prepatellar) — Corticosteroid injections targeting inflamed bursae throughout the body to reduce localized bursal inflammation causing focal pain and functional limitation.
Trigger Point Injections — Injections of local anesthetic (with or without corticosteroid) into myofascial trigger points — hyperirritable knots within muscle tissue — to relieve referred pain, reduce muscle spasm, and restore range of motion.
Tendon Sheath Injections (Tenosynovitis Treatment) — Targeted injections into inflamed tendon sheaths for conditions such as de Quervain’s tenosynovitis, trigger finger, and bicipital tendinitis.

Headache & Facial Pain

Occipital Nerve Blocks for Migraine & Occipital Neuralgia — Targeted injection at the greater and lesser occipital nerves providing relief from intractable migraine, cervicogenic headache, and occipital neuralgia.
Sphenopalatine Ganglion Block — Minimally invasive block of the sphenopalatine ganglion for cluster headache, migraine, and facial pain syndromes, performed via a transnasal approach without needles.
Botulinum Toxin (Botox) Injections for Chronic Migraine — FDA-approved injection therapy using onabotulinumtoxinA into pericranial and cervical muscles to prevent chronic migraine (≥15 headache days per month), administered every 12 weeks.
Trigeminal Nerve Branch Blocks — Targeted blocks of the supraorbital, infraorbital, or mental nerve branches for trigeminal neuralgia, post-herpetic facial neuralgia, and atypical facial pain.

Medication Management

Non-Opioid Analgesic Management — Prescription and oversight of non-opioid pharmacologic therapies including NSAIDs, SNRIs, anticonvulsants (gabapentin, pregabalin), topical agents, muscle relaxants and emerging non-opioid analgesic medications.

Comprehensive Opioid Management — Evidence-based management of opioid therapy for chronic non-cancer and cancer pain, including initiation, titration, rotation, and tapering protocols in full compliance with internal Coastal Spine & Pain prescriptive guidelines, Alabama Prescription Monitoring Program (PDMP) requirements, DEA regulations and CDC prescribing guidelines. In addition, to further maximize the safe utilization of these medications, we will often bring in third party experts in psychiatry and psychology to give an independent evaluation on the patient and the appropriateness of the treatment plan in regards to these medications.
Controlled Substance Monitoring & Compliance — Structured monitoring protocols including prescription drug monitoring program (PDMP) checks, treatment agreements, periodic urine drug screening, and pill counts to ensure safe and compliant controlled substance prescribing. Unique to Coastal Spine and Pain, we utilize a fully state and federal regulatory compliant, propriety software algorithm developed by Dr. Webb to help ensure maximum compliance while diminishing bias in our monitoring program to hopefully ensure maximum safe prescribing for the patient.
Medication-Assisted Treatment (MAT) Consultations — Evaluation and referral coordination for patients who or currently on opioids who their referring provider wishes to have an evaluation for addiction or opioid use disorder that may require buprenorphine or other MAT, ultimately in collaboration with addiction medicine specialists who will be prescribing and treating the patient if needed. We do not prescribe these medications, as we feel pharmacologic treatment for addiction or opioid overuse needs specialized training in addiction. Likewise, if a patient is already on these medications, the patient will need to remain with the prescribing provider of those medications, regardless of their desire to change medications or providers, as changing medications or providers can be detrimental to the patient in these situations.
Low-Dose Naltrexone (LDN) Therapy — Off-label use of low-dose naltrexone as an anti-inflammatory and immunomodulatory treatment for fibromyalgia, complex regional pain syndrome, and autoimmune-related pain conditions.
Compounded Topical Analgesic Prescribing — Customized topical medication formulations (combining lidocaine, ketamine, gabapentin, or other agents) delivered transdermally for localized pain with minimal systemic exposure.

Ancillary Diagnostic Services

In-Office Digital Radiography (X-Ray) — On-site plain film imaging providing immediate evaluation of bony anatomy, joint alignment, hardware integrity, and fracture assessment without the need for an outside referral.
Point-of-Care Urine Drug Screening (Immunoassay) — Immediate in-office urine drug testing used for controlled substance monitoring compliance, providing rapid qualitative results during the visit with confirmatory send-out laboratory testing as indicated.
Confirmatory Urine Drug Testing (LC-MS/MS) — Definitive outside laboratory-based urine drug confirmation testing using liquid chromatography-mass spectrometry to accurately identify and quantify specific drugs and metabolites in controlled substance monitoring programs.
Electromyography (EMG) & Nerve Conduction Studies (NCS) — Referral & Co-management — Coordination of electrodiagnostic testing to evaluate peripheral nerve and muscle function, assisting in the diagnosis of radiculopathy, plexopathy, peripheral neuropathy, and nerve entrapment syndromes.
Psychological Evaluation Referral & Coordination — Referral for psychological assessment required prior to neuromodulation implantation, intrathecal pump placement, or in patients with significant psychosocial contributors to chronic pain.

Specialized Pain Syndromes & Conditions Treated

Complex Regional Pain Syndrome (CRPS Type I & II) — Multidisciplinary and interventional management of this debilitating chronic pain disorder characterized by allodynia, hyperalgesia, autonomic dysfunction, and trophic changes, using desensitization therapy, sympathetic blocks, spinal cord stimulation, and pharmacologic therapy.
Post-Herpetic Neuralgia (Shingles-Related Pain) — Treatment of persistent neuropathic pain following shingles outbreaks through nerve blocks, neuromodulation, and pharmacologic management.
Phantom Limb Pain — Interventional and pharmacologic strategies for management of pain perceived in an amputated or absent limb, including mirror therapy coordination and neuromodulation.
Cancer Pain Management — Comprehensive interventional and pharmacologic pain management for cancer patients, including neuraxial procedures, sympathetic blocks, and intrathecal drug delivery to optimize pain control and quality of life.
Post-Surgical Pain Syndromes — Evaluation and treatment of chronic pain following spinal surgery (failed back surgery syndrome), joint replacement, thoracotomy, mastectomy, radiation and other procedures where persistent neuropathic or structural pain remains.
Peripheral Neuropathy — Evaluation and treatment of painful peripheral neuropathy from diabetic, chemotherapy-induced, idiopathic, and other etiologies, using pharmacologic and interventional strategies.
Neuropathic Pain — Management of neuropathic pain conditions including postherpetic neuralgia, diabetic neuropathy, trigeminal neuralgia, and post-traumatic nerve injury through pharmacologic, procedural, and neuromodulation therapies.
Vertebral Compression Fractures — Evaluation and management of osteoporotic and malignant vertebral compression fractures, including pain management, augmentation procedures, and osteoporosis co-management coordination.
Spinal Stenosis — Non-surgical management of lumbar and cervical spinal stenosis through epidural therapy, physical therapy coordination, minimally invasive decompression surgery and activity modification, with orthopedic or neurosurgical referral when appropriate.
Herniated Disc / Disc Disease — Interventional treatment of cervical, thoracic, and lumbar disc herniations causing radiculopathy or myelopathy, utilizing epidural steroid injections, selective nerve root blocks, and other evidence-based treatments.
Degenerative Joint Disease / Osteoarthritis — Comprehensive management of spinal and peripheral joint osteoarthritis through intra-articular injections, radiofrequency ablation, biologic therapies, and functional restoration strategies.
Sacroiliac Joint Dysfunction — Diagnosis and treatment of SI joint pain, a frequently overlooked cause of low back and buttock pain, through image-guided injections, radiofrequency ablation and if indicated, SI joint fusion for refractory cases.
Myofascial Pain Syndrome — Treatment of muscle-based pain conditions characterized by trigger points and referred pain patterns through trigger point injections, dry needling coordination, and pharmacologic therapy.
Piriformis Syndrome — Diagnosis and treatment of deep buttock pain caused by piriformis muscle irritation or spasm of the sciatic nerve through targeted injections and physical therapy coordination.
Occipital Neuralgia — Diagnosis and treatment of unilateral or bilateral occipital nerve pain through nerve blocks, radiofrequency ablation, and peripheral nerve stimulation.
Pelvic Pain — Evaluation and interventional treatment of chronic pelvic pain through superior hypogastric plexus blocks, pudendal nerve blocks, ganglion impar blocks, and coordinated gynecologic or urologic co-management.
Discogenic Low Back Pain — Treatment of axial low back pain originating from the intervertebral disc itself, evaluated through provocative discography and managed with intradiscal therapies and conservative modalities.
Whiplash & Cervical Acceleration-Deceleration Injuries — Comprehensive evaluation and treatment of cervical soft tissue and facet joint injury following motor vehicle accidents, including nerve blocks, radiofrequency ablation, and physical therapy coordination.

Patient Support & Care Coordination

Multidisciplinary Pain Care Coordination — Collaboration with primary care physicians, surgeons, physical therapists, psychologists, and other specialists to ensure a comprehensive, coordinated approach to each patient’s pain management.
Physical & Occupational Therapy Referrals — Referral to and co-management with licensed physical and occupational therapists to address functional deficits, improve mobility, and support long-term pain reduction through rehabilitation.
Pain Psychology & Behavioral Health Referrals — Coordination with pain psychologists for cognitive behavioral therapy (CBT), acceptance and commitment therapy (ACT), biofeedback, and other psychological interventions that improve coping, function, and quality of life.
Patient Education & Shared Decision-Making — Comprehensive education regarding diagnosis, treatment options, risks and benefits, realistic expectations, and self-management strategies, empowering patients to actively participate in their own care.
Disability & Functional Capacity Documentation — Preparation of thorough, medically accurate documentation to support if appropriate, disability claims, injury cases and workers’ compensation cases.
Workers’ Compensation Case Management — Specialized evaluation and treatment of work-related injuries, including detailed reporting and coordination with case managers and employers.
Prior Authorization Assistance — Dedicated staff support to obtain insurance prior authorizations for procedures, medications, and durable medical equipment, minimizing patient burden and avoiding delays in care.
Medication Assistance Program Navigation — Assistance connecting patients with pharmaceutical manufacturer programs, patient assistance programs, and copay reduction strategies for high-cost medications.

Coastal Spine & Pain serves patients throughout Baldwin County, Mobile County, and the Florida Panhandle from our Foley, Alabama location at 150 W. Peachtree Avenue. Our team of dual board-certified physicians is committed to delivering evidence-based, compassionate care for every patient we serve.