Why Choose Us

There are other local options for interventional pain management services in the New Braunfels and Seguin area. Why should a patient consider care with Allies in Arthritis and Spine Care directed by Dr. Eric Miller?

While it is true that there are competent interventional pain providers in the area, Dr. Miller has been in practice for over 20 years compared to an average of less than 10 years for the other local providers. Dr. Miller lives in and contributes to this local community as opposed to residing in San Antonio or Austin. Most importantly, Dr. Miller offers a unique approach to patient care that maximizes successful alleviation of pain.

Why is our approach to patient care so unique?

The cornerstone of our treatment models is using highly individualized treatment regimens that are supported by the highest level of scientific, evidence-based medicine. We are only one of a few interventional pain management organizations in the entire country that utilizes traditional interventional pain management approaches alongside the newest, cutting-edge techniques such as extracorporeal shockwave therapy (ESWT), MLS laser treatments, and paravertebral ozone treatments. These are supported by the highest level of scientific research.

Why haven’t I heard of a lot of these treatments?

Even though these newer treatments are supported by the highest level of clinical scientific evidence, many of the trials have been conducted in Europe and are not as familiar to some US physicians. For example, ESWT has a very long history of usage in Europe, Asia, and South America and has only been offered at all in the US for about 20 years.

What have the controlled clinical trials shown for the treatments that you offer?

Note that all of the treatments listed below are supported by randomized controlled trials which demonstrate the highest level of scientific evidence:

• Epidural Steroid Injections and Facet injections: Offer good short-term relief during a 3-6 month period. Covered by insurance for common indications.
• Radiofrequency Ablation: Offers good longer-term relief for about a 6-12 month period. Covered by insurance for common indications.
• Spinal Cord Stimulation: Offers long term relief for a number of medical problems associated with pain. This modality does require a minor surgical procedure which does carry some risks. Covered by insurance for common indications.
• Paravertebral spinal ozone: Offers excellent long-term relief with evidence of healing from the underlying condition. This modality is supported by Level 1 evidence which is the most robust type of research available, however it tends not to be covered by insurance. Treatment is more expensive than some other listed, however, it is more likely to be effective after only a single treatment, especially for vertebral disk pathologies.
• Joint ozone: Offers excellent long-term relief with actual healing of tissues. Using joint ozone for knee osteoarthritis is especially supported by the most robust Level 1 evidence. This technique is not covered by insurance but is less expensive than paravertebral ozone.
• Extracorporeal Shockwave Treatment: Offers excellent relief for multiple disease pathologies including but not limited to plantar fasciitis, knee osteoarthritis, lumbar and cervical spine conditions, tailbone pain, and tendinopathies. This modality is not covered by insurance and is moderately expensive. It is minimally invasive with very low side effects. Clinical trials suggest healing and mobilization of stem cells.
• MLS Laser treatments: Excellent relief for multiple disease pathologies, especially conditions with a musculoskeletal components as well as neuropathy. MLS laser treatments are not covered by insurance but are only mildly expensive. This treatment technique is minimally invasive with very low side effects. Clinical trials suggest healing and mobilization of stem cells.

Are the only effective treatments those that are supported by randomized control trials?

Our approach is to look at scientific evidence and focus on therapies supported by randomized control trials. With that said, there are a lot of medical treatments that can be effective but do not have the backing of randomized control trials. There is evolving evidence in the field of interventional pain management for even newer techniques that have a lot of promise but have not yet been extensively studied. Randomized controlled trials can be costly and time-consuming to perform. In the US, many trials are conducted by the companies that make the medicines and devices that are being studied. I always suggest that my patients prioritize consideration of therapies that are supported by randomized control trials first. This is especially true if the non-supported or industry-sponsored trials involve invasive devices and treatments that could carry higher risks of side effects.

What about opioid pain medications?

Opioids have pain used for thousands of years for treatment of pain. Randomized controlled trials clearly suggest benefit in pain reduction (but not function) for up to 90 days of treatment but also clearly suggest serious risks which include abuse, addiction, and overdose death. There are few long term randomized controlled studies concerning opioid treatment for chronic non-cancer pain partially because of ethical dilemmas with randomizing patients to a treatment with limited known effectiveness and with a great chance of adverse effects. Observational studies have suggested that there is no long term (ie greater than 90 day) benefit from opioids and that there is a trend for the opioid treated patients to actually have worse pain and function long term than those who were never treated with opioids. The reason for this is a concept called hyperalgesia which is observed in opioid therapy. This simply means that the treatment actually causes more pain over time. In conclusion, available evidence does not support the usage of opioids for non-cancer pain for greater than 90 days and suggests that usage of 12 months or greater may actually worsen pain compared to those who never received opioids.

How do I make an appointment?

You can call us at 830-272-7746 or you can make an appointment at drericmillermd.com. We look forward to partnering with you to restore your best, pain-free life!