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Putting the pieces back together after injury or disease—without surgery
The Department of Physical Medicine and Rehabilitation at Lenox Health Greenwich Village focuses on nonsurgical treatments for a wide variety of spine and musculoskeletal conditions, as well as rehabilitation and prevention of sports-related injuries.


Our physicians at Lenox Health Greenwich Village (LHGV) have specialty training in:

  • Sports medicine
  • Interventional spine care, including nonoperative management of a wide variety of spine and musculoskeletal conditions
  • Rehabilitation and prevention of sports-related injuries

Spine and musculoskeletal care revolves around the concept of improving your body's mobility, alleviating discomfort, and maximizing your quality of life.

Spine treatments

Interventional spine procedures aren’t cures for underlying conditions, but rather stepping stones in the overall treatment process. When pain and discomfort become barriers to your everyday life, these treatments can help control pain and inflammation.​ You can then progress through a proper rehabilitation and prevention program—the foundation of long-term spine care.

​Interventional spine procedures are performed in a dedicated procedure room using fluoroscopy, or low-dose X-ray, to ensure accuracy, precision and safety.

All procedures are outpatient procedures, which means you go home the same day. The following are some of the spine treatments we offer:

  • Epidural injections
    • An epidural injection delivers medication around spinal discs and nerve roots. The steroid used in the epidural injection reduces the inflammation of irritated nerves and/or discs, which are often the source of the pain. This procedure may target the cervical spine to relieve neck and/or arm pain, or the lumbar spine to relieve low back and/or leg pain. It is important to note that an epidural steroid injection should not be considered a cure.
  • Facet injections
    • Facet injections place a small amount of local anesthetic and steroid medication into the facet joint, which are small joints located on either side of each segment of the spine. Facet joints can become painful due to arthritis of the spine, injuries or excessive mechanical stress. Pain caused by facet joints in the cervical spine is usually felt in the head, neck, shoulder and/or arm. Pain caused by lumbar facet joints is typically felt in the lower back, hip, buttock and/or leg.
  • Medial branch blocks
    • Medial branch blocks are small nerves that transmit pain signals from the facet joints in the spine. Medial branch blocks are part of a two-step diagnostic and treatment approach. During a medial branch block, anesthetic is injected near the small medial nerves connected to a specific facet joint.
  • Radiofrequency ablation
    • A radiofrequency ablation, or neurotomy, is a type of injection procedure used to treat facet joint pain caused by arthritis or other degenerative changes. In this procedure, heat is used to interrupt pain signals being transmitted from medial branch nerves. The medial branch block acts as a test run before the radiofrequency procedure.
  • Sacroiliac joint injections
    • A sacroiliac joint injection is used to treat low back or hip pain, with or without sciatica symptoms, that is associated with sacroiliac joint dysfunction. The sacroiliac joints connect the lowest part of the spine, called the sacrum, with the hip on each side.
  • Trigger point injections
    • Trigger point injections may be an option for treating pain in some patients. This is a procedure used to treat painful areas of muscle that contain trigger points, or knots of muscle that form when muscles do not relax. These injections of lidocaine, bupivacaine or other medications treat these tight muscles and help them loosen. As the muscle relaxes, your pain should decrease either immediately or gradually. This outpatient treatment has limited side effects and has been used successfully for many years.

Musculoskeletal treatments

Like interventional spine procedures, musculoskeletal procedures are short-term solutions for pain relief. They’re designed to help control pain and inflammation so you can progress to a rehabilitation program for musculoskeletal and sports care.

​Interventional musculoskeletal procedures are performed using ultrasound imaging. All procedures are on an outpatient basis and you can go home the same day.

  • Ultrasound-guided injections
    • Ultrasound enables physicians to visualize soft tissue structures including muscles, tendons, ligaments, blood vessels and nerves in real time. It also helps to identify any pathologic changes within these structures. The use of ultrasound then extends to intervention, where visualization and identification of structures can be used to guide a needle safely and accurately through soft tissue to deliver the appropriate treatment.
  • Viscosupplementation
    • Hyaluronic acid (HA) is a natural substance found in human joints. It is a thick, slippery fluid that helps cushion, lubricate and protect bones and joints. With arthritis, HA gets thinner over time and loses the ability to provide protection. Viscosupplementation is a series of HA injections directly into the joint to help replenish some of the natural HA that has been lost. This can help provide relief of arthritis symptoms in patients who do not get enough relief from therapeutic exercise, physical therapy and anti-inflammatory medications.
  • Platelet rich plasma
    • Blood is made up of plasma, red cells, white cells and platelets. Platelets, which are responsible for clotting blood, also contain proteins—called growth factors—that are essential in tissue healing. Platelet rich plasma (PRP) is a higher concentration of platelets and growth factors above normal levels. This is created by drawing a patient’s own blood, then isolating and concentrating the platelets and growth factors. The PRP is then injected into abnormal tissue to promote and speed up the healing process.
  • Stem cell therapy
    • Stem cells are naturally present inside all of us in a variety of tissues. They are cells from your own body that have the ability to renew themselves and turn into other cells. As we age or get injured, we may not be able to recruit enough of these cells to the site to fully repair the area. Stem cell procedures help facilitate the process by extracting stem cells from an area of the body, then concentrating the cells and re-injecting them into the damaged area to help the body heal naturally.


Michael Robert Nicoletti, MD

Specialties: Physical / Rehab Medicine, Sports Medicine

Additional location

130 East 77th Street, 11th Floor
New York, NY 10075

Wednesday: 9am - 5pm

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