Early in my practice, I was confronted with the lack of training offered family doctors and emergency medicine doctors in orthopedic non-surgical conditions. It was this inability to address significant human suffering that motivated me to develop this expertise which is much self-trained/self-taught with the help of many preceptorships.

  • Chronic musculoskeletal pain is most often of mixed multiple origin.
  • A primary lesion often creates secondary lesions.
  • A chronic MSK pain often develops a neuropathic central and peripheral component.
  • My protocols permit me to relieve 50-80% of the pain in 50-80% of my patients for the great majority of anatomical pain sites. Many are indefinitely pain free. Officially pain clinics are known to relieve 30% of pain in 30% of their patients.
  • I will usually attempt at least two cortisone infiltrations before declaring failure with cortisone. If success is partial or negative, I will propose 2-3 PRP infiltrations.
  • A significant percentage of elders prefer staying on cortisone and have their 50-80% success rate for at least 3 months.
  • I will use cortisone or PRP infiltrations on painful tendons, ligaments and joints.
  • I will do Xylocaine with or without cortisone or a botulinic agent on myofascial and enthesis.
  • I may use Hyaluronic Acid on joints not responding sufficiently to cortisone.
  • I do cortisone or PRP epidurals for lombo-sciatica from degenerative disc disease, discal hernias or pinal stenosis.
  • I do perifacettal blocks for facettal OA(osteoarthritis).
  • I always encourage combining my infiltrations with the manual therapies (physiotherapy, chiropractics, kinesiology, osteopathy, massotherapy…) when a myofascial or capsular component is present.
  • Psychotherapy is encouraged when a strong emotional component influences the pain and its management.
  • Reconditioning is always part of a global/systemic approach.