Procedures We Perform
Here are all the procedures Dr. Richard A. Gasalberti, M.D. conduct in his daily practice:
Electromyography (EMG) and Nerve Conduction Studies (NCS)

Nerve conduction study (NCS)
NCS test (also called nerve conduction velocity – NCV)
Measures the speed of conduction of an electrical impulse through a nerve. It is done to find damage to the peripheral nervous system, which includes all the nerves.
Nerve Conduction Studies (NCS)
Can determine nerve damage and destruction.
Electromyography (EMG)
Measures the electrical activity in muscles. It is done to find diseases that damage muscle tissue and nerves.
EMG is often performed at the same time as NCS.
Both NCS and EMG procedures:
Help to detect the presence, location, and extent of diseases that damage the nerves and muscles.
Digital Pulsewave Analysis (DPA)
Digital Pulsewave Analysis (DPA)
DPA is a test that provides valuable data about the health of your arteries.
The DPA measurement method (medically known as Plethysmogram - PTG)
Uses infrared light on the fingertip in order to obtains pulse wave information.
DPA screening:
- Takes a snapshot of arterial elasticity
- Tests heart rate, artery flexibility, hydration levels and overall cardiovascular health
- Is quick, affordable, painless and reliable
DPA performs the following checks:
- Electrocardiogram
- Echocardiogram
- Duplex Doppler
- Pulse Oximeter
- CV Profiler
- Heart Rate Variability
- Augmentation Index
- MRI

Epidural Block

Epidural Nerve Block
Is a corticosteroid injection into the epidural space of the spinal column
To treat:
Pain (decrease it) and inflammation
Caused by:
Spinal stenosis, sciatica or herniated disc
Epidural nerve block treatments
Offer substantial pain relief without surgery.
Facet Blocks
Facet joints are small joints at each segment of the spine.
These joints provide stability and help guide motion.
Painful due to:
Arthritis of the spine, mechanical stress to the back or a back injury.
Facet joint injections
Have two goals:
Diagnostic goals - To help diagnose the cause and location of pain.
Pain relief goals - To provide pain relief.
The injection procedure may also be called a facet block, as its purpose is to block the pain.
Cervical, Thoracic and Lumbar Facet Joint Injections
What is the purpose of Cervical, thoracic or lumbar facet joint injections?
To anesthetize the facet joints and block the pain. It help a patient better tolerate a physical therapy routine.
How it’s done:
Local anesthetic or steroid medication.

Joint Drainage (Arthrocentesis)

Arthrocentesis (also known as joint drainage or joint aspiration)
Is a common procedure of removing synovial fluid (that lubricates your joints), to diagnose and treat a variety of joint diseases and conditions
Why Is Arthrocentesis Performed?
Your doctor may recommend arthrocentesis for:
- Autoimmune disorders, such as lupus, which can lead to joint pain and swelling
- Joint infection
- Joint injury
- Unexplained buildup of synovial fluid with swelling of the joint
- Arthritis or inflammation of the joint including gout
- Cysts filled with synovial fluid
- Bleeding into the joint (hemarthrosis)
Spinal Nerve Block
Nerve Blocks: Medication Injections
Blocks
Are injections of medications (local anesthetics, steroids, and opioids) that are injected onto or near nerves.
Injections into joints are also referred to as blocks.
Spinal Injections
Lumbar epidural steroid injection
Is the most common spinal injection.
To treat:
Pain that radiates from the lower back into a leg.
Pain caused by:
Disc herniation or spinal stenosis

Viscosupplementation with Hyaluronate

Hyaluronan Injections for Knee Osteoarthritis
Hyaluronan injections (also called viscosupplementation), are used to treat kneeosteoarthritis.
They are injected directly into the joint.
To treat:
Pain in a knee affected by osteoarthritis.
Rehabilitation
What is rehabilitation?
Rehabilitation
Is a treatment designed to facilitate the process of recovery from injury, illness, or disease to as normal a condition as possible.
Rehabilitation helps restore an individual to optimal health, achieve the highest level of function, independence and well-being.
The Purpose of Rehabilitation
Is to restore a patien’s mental, physical and sensory capabilities.
That were lost due to injury, illness, or disease.
Including:
- Amputations
- Arthritis
- Cancer
- Cardiac disease
- Neurological problems
- Orthopedic injuries
- Spinal cord injuries
- Stroke
- Traumatic brain injuries

Pain Management

What is Pain Management?
Pain management
Is the treatment of all types of pain.
To treat:
Musculoskeletal, spinal and neuropathic pain disorders.
After getting a pain assessment, your doctor can prescribe:
Pain medicine, other pain treatments, or psychotherapy to help with pain relief.
Physical Therapy
What is physical therapy?
Physical therapy (Type of treatment)
A person may require physical therapy when health problems make it hard do everyday tasks and activities.
It helps a person to move better and may relieve pain.
The goal of physical therapy is to help improve or restore your physical function and your fitness level.
Physical therapy can help with recovery after some surgeries.
