Foot & Ankle Pain?

Dr Mike's interest in Foot and Ankle Pain goes back to an interest in Dance Mechanics and Dance Medicine.  Like most rehab doctors he has extensive training in electrophysiology and has done tens of thousands of nerve conduction studies.  Chronic ankle sprains are often due to weakness from spinal issues and ankle ligaments can be tightened up with sclerotherapy, sometimes called prolotherapy.  Uncommon pain syndromes like sesamoid bone pain and morton's neuromas can be treated.

Simple measures such as high top sneakers and the right stretches

Yes, we can use                      for excessive sweating (hyperhidrosis)


  • Did you know that there are nerves in the foot, that can get trapped like carpal tunnel in the hands?
  • No everyone has the same number of bones in their hands or feet?

Shoulder Pain?

Shoulder pain can come from the neck or thorax and can overlap with myofascial pain

Dr Mike often uses "Pulsed Radiofrequency" to treat the supra-scapular nerve" and control chronic shoulder pain.  Like the knee, the shoulder may undergo degenerative and arthritic changes.  Patients may be either unwilling or unable to undergo a shoulder replacement.  Pulsed-radiofrequency of the supra-scapular nerve takes just a few minutes and is done in a sitting position from the top of the shoulder.   Dr Mike also uses Phenol for the shoulder. 


  • Did you know that there are seven joints to your shoulder?
  • One major nerve can be put to sleep to stop pain


Dr Mike wrote 4 book chapters, for free, that were the first to address pulsed RF for the shoulder.  He quite literally "wrote the book"  His devotion to upper extremity rehabilitation goes back to his own arm having been paralyzed most of his first 2 years in medical school




















Most major insurance plans are accepted

​​We are a BWC, MediCare and limited Medicaid Provider. Patients are seen by appointment only.  Your insurance may require a referral from your primary care provider.  You need to know that your primary doctor may have a contract that pays them to refer you to another facility or to keep all their referrals "in house".  This is becoming much more common, but you do have a choice.  If you find this seems to be the case, please speak with us and we will do the best we can to find a way to render care.   


Yes, we now see some motor vehicle, car accident patients. 
We do not see personal injury claims or anyone involved in civil litigation.
We do not see patients looking for disability ratings
.


We are still accepting some new medicaid patients, but we are not a Buckeye, Unisyn or Molina Providers.

*Spine & Pain are

complex things. many people come to us desperate

No case is hopeless

No one is beyond help * Dr Mike is accustomed to patients who have had several surgeries and are told "here is nothing else that can be done"

* Even if you think you have had "shots" or "injections" elsewhere

Mansfield  -   Columbus - Shelby

Upper Sandusky Clinic is Closing March 11, 2015

 
 

Non-Operative Orthopedic Care


A whole host of options are available for shoulder, knee, hip, wrist ankle and elbow pain.  Dr Mike has written 10 book chapters on Ankle Pain, Shoulder Arthrtis, hand contractures among others and has a special personal interest in shoulder arm and hand rehabilitation.  We use  a whole host of options including basic injection techniques, manual medicine, manipulation, ultrasound, motor point blocks and pulsed radiofrequency.


Knee Pain?

Many patients with chronic knee pain and arthritis are at a point at which they cannot have a knee replacement.  Dr Stretanski is one of few physicians handling the chemical phenol.  Phenol is the active ingredient in throat sprays.  Dr Mike has used phenol extensively in his Honduran medical missions and uses it frequently for chronic knee and shoulder pain.  Treatment of chronic knee pain begins with a thorough exam.  It is not enough to say you have knee arthritis and or busitis ...

  • Did you know your  knee has 3 compartments and over 25 bursae?






​ORTHOVISC® (High Molecular Weight Hyaluronan) is the only FDA-approved treatment made from ultra-pure hyaluronan, a naturally occurring lubricant found in healthy knee joints. This knee pain injection provides up to six months of pain relief. Older knee injections were made from roosters and allergic reactions were rare but possible. ORTHOVISC is made from bacterial cells and does not come from avian (bird) sources. This means that ORTHOVISC® should not cause an allergic reaction if you suffer from bird, feather or egg allergies.


Genicular Nerve Block (G Block)
This outpatient procedure is an injection of anesthetic to the genicular nerves. These are the sensory nerves that transmit pain signals from the knee to the brain. Anesthetizing these nerves can disrupt the pain signals caused by degeneration of the knee.

A genicular nerve block can provide temporary pain relief. It may help determine if a patient is a candidate for nerve ablation, which can provide long-term pain relief.Dr Stretanski also performs Geniculate Nerve Radiofrequency - a short outpatient "buzzing" of the three nerves that go to the knee joint for permanent pain relief from knee joint pain.  This can be offered for patients who cannot have a knee replacement or have had their knee replaced and still have knee pain. 

  • Epidural Steroid Injection
  • Lysis of Epidural Adhesions
  • Facet Injection
  • Facet Radiofrequency
  • Cervical Epidural Injection
  • Thoracic facet Blocks
  • Lumbar sympathetic Blocks
  • Celiac Plexus Blocks/Lysis
  • Shoulder Radiofrequency
  • ​​Spinal Cord Stimulators
  • Implantable Pain Pumps
  • ​Kyhoplasty/Vertebroplasty
  • Botox®
  • Heachache / Migraine
  • Knee(Geniculate) RF ablation
  • Shoulder RF Ablation

Have you been told, you have a herniated disk, disk disruption, RSD, phantom limb pain, chronic pain syndrome, degenerative disks, and degenerative spine disease?

 

Do you feel pain in your neck or lower back that is shooting down your arm or leg?

 

Do you have chronic daily headaches, migraines or tension type headaches?

 

Dr Mike also takes care of patients  with knee pain, chronic chest, wrist, ankle, shoulder, joint pain, "fibromyalgia",  myofascial pain.  

As a Rehab Doctor he does still take care of

  • Stroke/Spasticity / Rehab
  • Traumatic Brain Injury / Rehab
  • Spinal Cord Injury / Rehab
  • Multiple Sclerosis
  • Cancer Pain/Caner Rehab
  • ​Osteoporosis


We care for many patients who have underlying medical conditions that make it impossible for them to have major surgeries such as major spine

surgery. Find out what alternative medication and other options are available to you.​
Controlled-Substance Prescribing
There is a time and place for controlled-substances and ISPROC, is a state registered pain clinic, but we do not see patients for "pain pills"  
We are House Bill 93 and Federation of State Medical Board Compliant and fulfill mandatory reporter status with Children's Services.

​All new patients undergo urine drug screening.
We have a zero-tolerance policy.
If you are seeking drugs like oxycodone, dilaudid, xanax, ritalin, percocet etc, have been discharged from a pain clinic, have been going to West Virginia, Florida, or Tennessee and coming back with medications, you have been taking someone else's medications, or you are using street drugs you are advised not to  schedule an appointment. Dr Mike is a certified Suboxone Provider, and runs a Suboxone Program, but does not prescribe Suboxone through ISPRoC, ltd the Interventional Pain Practice. 

​Suboxone Program 419 709 7709, BBF, ltd

Are You a Candidate?

The practice of Interventional Spine and Pain Management is one of the fastest growing areas of healthcare.  ISPRoC, ltd based out of Mansfield Ohio, provides state-of-the-art standard-of-care Interventional and comprehensive management to treat a variety of complaints including chronic pain, failed laminectomy syndrome, lower back and leg pain, neck and arm pain, as well as, compression fractures,  headache, post surgical pain, abdominal, chest and visceral pain.  We are a private independent practice and not part of any healthcare system.

 

We use a variety of treatments including very simple interventions where anti-inflammatory medication and local anesthetic medicine is placed in and around structures generating pain, as well as, thermal and chemical enhanced radiofrequency neruolysis and sympathetic blocks, which are done in the office with or without light sedation.  More involved treatments include Endoscopic Diskectomy (which often called Laser Spine Surgery), Facet Fusion Techniques,  and Implanting of Spinal Cord Stimulators or Implantable/Refillable Pain Pumps are used when appropriate.  There are patients who do end up a number of long term medications, few of which require long-term use of controlled drugs.  There is a time and place for open surgery, when and if things get to that point, we will get you to the right place.  We are able to see most cases but  all treatment options are not available under all insurances or networks.

The interventions we perform and  not trying to simply "cover up" what is wrong.  Patients often ask  "How long will this last?"  

Treatments such as implants and facet fusion techniques and endoscopic diskectomy may last decades, but you will still have the same ongoing degenerative process as any other person continuing to have birthdays.  Many spinal pain syndromes are chronic problems, like diabetes or high blood pressure.  Our goal is to actually fix the underlying problem.  This may require effort on your part, as well as ourselves.  Managing these issues often requires periodic treatment as part of  long term management.


Interventional Options


   Interventional Spine &Pain     

     Rehabilitation Center


https://books.google.com/books?id=FiMoQ-OtbB0C&pg=PA389&lpg=PA389&dq=Essentials+of+Physical+Medicine+and+Rehabilitation+stretanski&source=bl&ots=GeSFDwnMgf&sig=C6dvjvE7vX-0unrEOHFk2YTHIyo&hl=en&sa=X&ei=PJTGVLSgIMejNqWPgqgN&ved=0CDEQ6AEwAw#v=onepage&q=Essentials%20of%20Physical%20Medicine%20and%20Rehabilitation%20stretanski&f=false


Supra-Scapular Nerve, above, can be "buzzed" with an RF probe in about 3 minutes. This can result in prolonged relief of shoulder pain.  A similar procedure can be done for knee or hip

Scheduling  419 522 1100  Fax 419 522 4118

Interventional Spine  uses only Brand-Name Depo-Medrol® steroid

There has been an obvious media frenzy regarding the safety of epidural steroids in this country.  This has been found due to contamination from poorly performing compounding pharmacies.  We do not and have never used compounding pharmacies.  


Dr Mike uses only Brand-Name, Non-Generic Depo-Medrol®.  DEPO-MEDROL® is an anti-inflammatory glucocorticoid used widely throughout the world for intramuscular, intra-articular, soft tissue or intralesional injection.  You may have had DepoMedrol before for something like Poison Ivy, allergies or an insect sting.  DepoMedrol® it's similar substances and/or generic equivalents have never been FDA-Approved for epidural use.   The use of DepoMedrol® or Dexamethasone in the epidural space is "Off-Label" and "non-FDA approved"  The consent form declares and indicates this off-label use in the epidural space.  DepoMedrol® is safe and effective when accurately placed in the epidural space under fluoroscopic-guidance with radiopaque contrast-confirmation by an adequately trained physician.  It is the prevailing standard-of-care both in the United States and Worldwide.  We mix our Depo-Medrol® with preservative-free Lidocaine/Marcaine and preservative-free saline.   The commercially available Depo-Medrol® does come mixed with a preservative (Benzyl Alcohol).  Bad things can happen if any amount of preservative gets anywhere it is not supposed to be placed.  Several studies have indicated that preservative-free agents are not necessary, but Dr Mike still uses preservative free agents whenever possible and does not let injections get to places they are not intended.  The use in Facet Blocks is considered FDA approved, but your consent form still indicates the potential for interpretation as "off-label"   Rarely, Depo-Medrol® can also has it's own side effects that have nothing to do with where it is placed or how it is administered , such a water retention, moodiness and a spike in your blood sugars. 


People often refer to DepoMedrol, Dexamethasone or other glucocorticoids as "Cortisone" but it is not quite the same thing.  

Dr Mike trusts DepoMedrol to the point he has used it on his mother, his father, his little brother (the day of his wedding), his GodMother and had it placed in his own spine.  Because there is the same amount of preservative in 1ml of the 80 mg as the 20 mg, we only use the 80 mg/ml so there is never more than 1 ml (instead of 2-4 ml)of anything that has a preservative.

The reality is that anything bad can happen any time a doctor is doing something to try and help a patient.  ISPROC is very well-equipped with emergency equipment that we have never needed, but check daily,  and Dr Mike holds a valid ATLS, not just ACLS certification - none of which he has ever needed in the course of his interventional pain practice.