Pain Management

Find Pain Relief at Our Offices

Pain management is a branch of medicine that applies the latest in treatment methods to reduce or control pain. Our doctors specialize in a variety of solutions including pharmacological, interventional and alternatives to reduce or control pain. At Blue Ridge Orthopaedic & Spine Center, our pain management group offers a variety of options tailored to address all of our patients' pain management needs. We offer inpatient, outpatient, surgical and non-surgical services, as well as innovative, minimally invasive pain management treatment for patients with acute or chronic pain. 


No matter what you're dealing with, our pain management group works closely with the surgeons and therapists at Blue Ridge in a multidisciplinary approach to develop a unique treatment plan that best suits each of our patient's needs. 




Managing Pain

Managing pain, such as acute and chronic spine pain management, neck pain management, or back pain management, requires a number of interventions, some of which are handled on an inpatient manner and some of which can be done at home through outpatient care. Our physicians work with patients to determine the best course of pain management for their unique diagnosis and needs.

Many of our pain relief treatment options, including medication, injection therapies, and blocks, can be performed on an outpatient basis, allowing our patients to enjoy their normal daily activities while still achieving excellent pain relief.

When pain is not responding well to outpatient treatments, we may perform a series of treatments, including more invasive options, while the patient is admitted to our facility. Inpatient treatment allows our medical team to perform multiple procedures while monitoring response and controlling medication in order to achieve better pain management. The goal of inpatient treatment is to find a solution that allows the patient to continue to manage pain when released from our facility.

Surgical and Non-Surgical Options

Surgery is often considered a last resort for pain conditions, but sometimes surgery is the best solution. When there is significant damage to a joint or nerve, or when non-invasive options have not created a true solution to the pain, surgery may offer relief. For instance, surgically implanting a stimulator or pain pump into the affected area of the back or neck can create true relief when other methods have failed. In other instances, we can perform a similar procedure without the need for surgery using our state-of-the-art technology to inject the same pain relieving medications directly into the nerves or use radiofrequency ablation to stop pain signals from nerve tissue and create reduced pain.


Some of the surgical and non-surgical solutions we offer include:

  • Spinal Cord Stimulation Trials and Surgical Implants

  • Radiofrequency Ablation

  • Intra-Discal Electrothermal Therapy

  • Percutaneous Discectomy

  • Vertebroplasty/Kyphoplasty


Each of these is minimally invasive with little required downtime. If you are ready to pursue one of these for your pain, we will help you weigh the pros and cons of all of your options to come up with a solution that truly works for your needs, with the ultimate goal of providing true pain relief.

Minimally Invasive Cutting Edge Pain Management Solutions

At Blue Ridge Orthopaedic & Spine Center, in Warrenton and Gainesville, VA, our goal is to provide patients with the least invasive treatments possible. Many times we are able to achieve exceptional pain management with minimal intervention with treatments such as:


Physical Therapy

Exercise to strengthen the area where pain is occurring to reduce pain and reduce the chance of re-injury. Physical therapy in addition to aerobics, swimming, cycling, yoga and other non-weight-bearing exercises are highly beneficial.

Behavioral modification

Lifestyle changes can sometimes make a huge difference in pain levels, and our team will help you discover those areas where you can make changes to your behavior to improve your pain levels.

Injection therapy

Some injections are designed for temporary pain relief, while others provide a long-term solution without surgery or ongoing medical care.

If you do not wish to go through the trauma of surgery, wish to avoid dependence on medication, or find that you are not a good candidate for more invasive procedures, talk to our team about minimally invasive pain management solutions.

Diagnostic and Therapeutic Spinal Interventions

  • Cervical, Thoracic, and Lumbosacral Transforaminal, Interlaminar, and Caudal Epidural Steroid injections and Spinal Interventions

  • Chronic Pain Management

  • Diagnostic Provocation Discography

  • Selective Nerve Root Blocks

  • Diagnostic Facet and Sacroiliac Joint Blocks and Radiofrequency Ablation

  • Sympathetic and Stellate Ganglion Blocks

  • Occipital Nerve Blocks

  • Peripheral Nerve Blocks

  • Fluoroscopically guided Diagnostic and Therapeutic Peripheral Joint injections

  • Cervical, Thoracic and Lumbosacral facet joint blocks and injections

  • Neurolytic Blocks

  • Intercostal Nerve Blocks

Minimally Invasive Surgical and Non-Surgical Interventions

  • Spinal Cord Stimulation Trials and Surgical Implants

  • Radiofrequency Ablation

  • Intra-Discal Electrothermal Therapy

  • Percutaneous Discectomy

  • Vertebroplasty/Kyphoplasty

We Provide Cutting Edge Care

Dr. Daniel Heller becomes one of the first Pain Management Physicians in Virginia to use Nevro’s HF10 therapy.

The Senza SCS system, which delivers Nevro’s proprietary HF10™ therapy (Nevro Corporation, Menlo Park, CA), is a recently FDA-approved spinal cord stimulator that has demonstrated superior results compared to traditional SCS for the treatment of back and leg pain in a large multicenter study in the United States. With the current therapy, 46.5% of patients complained of uncomfortable stimulation1 after three months. With the Nevro HF10 therapy, that number was zero.

“I’m honored to be one of the first pain management physicians in Virginia to offer this promising technology to patients with chronic low back and leg pain,” said Dr. Heller. “The results have shown that this therapy offers more pain relief, without many of the side effects of the current therapy, and I’m confident we will be able to provide similar outcomes as we begin to utilize the HF10™ therapy here at Blue Ridge Orthopaedic and Spine Center.”

Spinal cord stimulation (SCS) represents another option to treat chronic pain. It involves the delivery of electrical signals to the spinal cord in order to alter pain signals to the brain. The electrical pulses are delivered by small electrodes on leads that are placed near the spinal cord and are connected to a compact, battery-powered generator implanted under the skin. SCS is a reversible therapy that has helped hundreds of thousands of people experience relief from chronic pain.

HF10 therapy, Nevro’s high-frequency therapy at 10,000 Hz, represents a significant advance in spinal cord stimulation. FDA approval for HF10 therapy included superiority labeling over traditional SCS therapy (HF10 therapy is the only SCS therapy with this distinction), validating that HF10 therapy reduces pain more effectively in more patients.

Additionally, HF10 therapy is also the only SCS therapy indicated to deliver pain relief without paresthesia (a stimulation-induced sensation, such as tingling, burning, or pricking, which is the basis of traditional SCS) and is also the only SCS system approved by FDA to be used without patient restrictions on driving while receiving therapy.

Dr. Heller has been my go to guy for pain management for over 2 year. He is very professional and knowledgable. Dr. Seal has performed one surgery I needed 2 years ago and is about to perform another on my lower back. He's great and I could not ask for a better doctor. He answers all my question and makes me feel at ease with any surgery I may need. Everyone at blue ridge is courteous and helpful.

– Michelle S.

Patients Say