Peripheral Neuropathy

Peripheral Neuropathy Pain Management Specialist in Tampa, FL

Peripheral Neuropathy can negatively impact a patient’s everyday quality of life- physically, socially, and psychologically. Neuropathic pain can have a variety of causes such as traumatic injuries, infections, metabolic problems, or inherited causes. Typically, the damaged nerves are peripheral nerves (those located outside of the brain and spinal cord), often causing weakness, numbness, and pain in the hands and feet. It can also affect other areas of the body.

What are some signs and symptoms?

  • sharp, jabbing, throbbing or burning pain
  • muscle weakness
  • gradual onset of numbness, prickling or tingling in feet or hands
  • pain during activities that shouldn’t result in pain
  • extreme sensitivity to touch

What is the step-wise approach for treatment?

A comprehensive step-wise approach is used for the management of neuropathic pain with the best practices and treatment guidelines. Dr. Kalava can determine the best plan tailored to your needs and guide you through this effective treatment process at any stage in the step-wise process.


STEP 1

Approximately 4 to 6 Weeks

  • TCAS (Tricyclic Anti- Depressants)
  • SNRIs (Seratonin – Norepinephrine Reuptake Inhibitors)
  • Gabapentanoids (Gabapentin, Pregabalin)
  • Topicals (Focal NP) ~ Cream or Patch

If Patient’s Response is inadequate move to STEP 2

STEP 2

Approximately 4 to 6 Weeks

  • Tramodol
  • Combination with Treatment 01 Therapies

If Patient’s Response is inadequate move to STEP 3

STEP 3

Approximately 4 to 6 Weeks

  • SSRIs (Selective Serotonin Reuptake Inhibitors)
  • Anticonvulsants/ NMDA Antagonists (IV Ketamine; IV Lidocaine)
  • Interventional therapies (Nerve Blocks/Sympatholytic Blocks, Cryoanalgesia, LASER Therapy)

If Patient’s Response is inadequate move to STEP 4


STEP 4

In Office Trial

  • Neuromodulation ~ Peripheral Nerve Stimulation (Learn More)
    • Greater than 50% pain relief during trial prior to implant

If Patient’s Response is inadequate move to STEP 5

STEP 5

Approximately 4 to 6 weeks

Low-Dose Opioids

Regular 3-Month Review

If Patient’s Response is inadequate move to STEP 6

STEP 6

  • Targeted Drug Therapy
  • Greater than 50% pain relief prior to implant

Contact Us  Accepted Insurances  Professional Fees

Frequently Asked Questions

  • sharp, jabbing, throbbing or burning pain
  • muscle weakness
  • gradual onset of numbness, prickling or tingling in feet or hands
  • pain during activities that shouldn’t result in pain
  • extreme sensitivity to touch

A comprehensive step-wise approach is used for the management of neuropathic pain with the best practices and treatment guidelines. Dr. Kalava can determine the best plan tailored to your needs and guide you through this effective treatment process at any stage in the step-wise process.

Ketamine is an anesthetic medication. It is a schedule 3 dissociative anesthetic, which has shown promising antidepressant effects that are both rapid and robust. It has been safely used for years as the ideal anesthetic in hospital and medical settings. When used under medical supervision, studies have shown ketamine infusions to have significant effects in healing treatment-resistant depression. It is on the World Health Organization’s List of Essential Medicines because of its safety and efficacy for anesthesia.

More recently, ketamine has been discovered as a safe and effective treatment for depression, and randomized controlled trials have shown rapid improvement in mood as well as reduction in suicidality compared to people who receive a placebo or another drug. Ketamine has the ability to go to work right away, unlike most antidepressants, which take weeks, sometimes months, to provide relief.

Ketamine infusion therapy is an IV procedure performed in-office by Dr. Kalava. Dr. Kalava & his associates will monitor your response and level of consciousness throughout the infusion.

Please contact our office to discuss Ketamine Infusion Therapy, and see if it is right for you.

The most important factors when choosing a ketamine provider are the doctor’s experience and commitment to providing safe, compassionate care. Dr. Kalava is the nation’s leading practitioner of ketamine infusion therapy and is a recognized expert in the field of anesthesiology.

[Scientific articles on Ketamine published by Dr. Kalava: Article 1 & Article 2 ]

Every patient is unique and deserves special care. Whether determining dose, infusion duration, the number of initial infusions, or the interval between return visits, we make individual assessments and structure ketamine treatments to match each patient’s response and unique needs.

Low dose ketamine is administered by Dr. Kalava, who is a Double Board Certified, Mayo Clinic fellowship trained Anesthesiologist. Ketamine, as we know, is an anesthetic and is best administered under the constant vigilance of a qualified anesthesiologist.

Depending on the medical condition being treated, IV ketamine can be administered over 1 minute, 40 minutes, one hour, or 4 hours. The actual type of treatment will be discussed with you during your initial consultation. The number of infusions and duration of ketamine therapy varies and is individualized. An average of 6-8 treatments are required for a good clinical response.

There are a handful of studies since 2014 that show promising results in managing symptoms from PTSD after ketamine infusion. (Study 1) (Study 2)(Study 3).

Mild psychotomimetic (confusion, hallucinations) effects, increase in heart rate, blood pressure, mild headache, and nausea are possible in some patients and are usually well tolerated.

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