All Star Pain Management | Interventional Pain Management
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Interventional Pain Management

Interventional Pain Management in Annapolis and Glen Burnie MD



Ipain-procedurenterventional Pain Management at All Star Pain Management includes a set of procedures designed to provide relief for acute or chronic pain patients in the most minimally invasive fashion possible. Dr. Zamfirov, affectionately known as Dr. Zed, has helped thousands of patients achieve relief nonsurgically with interventional procedures.


Some of the procedures have existed for decades, while some of the more revolutionary ones have only been available for the last few years. Dr. Zed incorporates procedures that have an excellent safety profile and allow patients to return to work, play with their kids and get back to desired activities.


All of the procedures are performed as an outpatient, with low risk and generally take less than an hour. The procedures are either performed with local numbing or IV sedation, none of them require general anesthesia. Most of the injections are performed utilizing image guidance such as ultrasound or fluoroscopy, which is a real-time form of x-ray. This allows the Annapolis and Glen Burnie pain doctor to achieve extremely high accuracy and the best outcomes possible.


Epidural Steroid Injections


Epidural steroid injections are one of the more common types of procedures offered, having been invented over 50 years ago. They are excellent for conditions involving nerve compression such as sciatica or spinal stenosis. The procedure involves placing steroid medication around the area of nerve pinching. This can provide weeks to months of continuous pain relief in over 75% of patients. There are three different types of epidural steroid injection’s, and they each have a particular indication.


Should the procedure work well and then subsequently wear off, the Maryland pain management physician can repeat the procedure. Often times, it works very well the second series too.


Lumbar Transforaminal Epidural


Back or Neck Pain Procedures


When a person is suffering from neck or back pain due to arthritis, there are several procedures available.

Facet Joint Injection – in a Facet Injection, steroid medicine is placed into the thumbnail sized joints on either side of the spine. This can provide weeks to months of relief and may be repeated if necessary.


Medial Branch Block – this procedure involves placing numbing medicine and steroid around the facet joint and relieving pain while blocking the small sensory nerves. If pain relief from the procedure wears off, it can either be repeated or a radiofrequency ablation can be performed. A MBB procedure itself provides on average 3 months of relief!


Radiofrequency Ablation – The procedure, also known as radiofrequency lesioning, involves the application of thermal energy around the neck or back joints experiencing chronic pain. Studies show the pain relief lasts anywhere from 12 to 18 months and can be repeated easily. It has truly been a revolutionary addition to the management of chronic back and neck pain.


Sacroiliac Joint Injection – also known as SI joint injections, these procedures have been excellent for relieving pain emanating from these joints. Up to 25% of low back pain is a result of an SI joint issue! The Maryland pain doctor uses image guidance for SI joint injections to insure accurate placement of the steroid medication.


Medial Branch Blocks

Joint Injections


Joint injections for the hip, knee, shoulder, elbow and ankle may be exceptionally helpful for both acute and chronic extremity pain. The gold standard type of injection involves cortisone which may provide weeks to months of relief. The next option is Viscosupplementation, which involves hyaluronic acid injections. The tradename for this is Synvisc, and has been shown to help 80% of patients on average from 6 to 12 months.


These injections are generally covered by insurance. The newest options for extremity pain relief include platelet rich plasma therapy along with stem cell procedures. These are not covered by insurance, and have been shown to also be over 80% effective for longer-term relief. Most of these injections with cortisone, hyaluronic acid or regenerative medicine help patients delay or avoid the need for potentially risky surgery.


Occipital Nerve Block

Occipital Nerve BlockOne of the best procedures for those suffering from chronic migraines is an occipital nerve block. This is an outpatient procedure involving injection of numbing medicine and cortisone in the back of the neck around the area of the occipital nerves. The procedure helps to reduce both the frequency and severity of migraines nicely. For facial pain due to trigeminal neuralgia,  sphenopalatine ganglion block has been an excellent treatment option.


Plexus Blocks for Pelvic and Abdominal Pain


For those suffering from chronic abdominal or pelvic pain, there are various procedures that can be exceptionally helpful. Celiac plexus block’s or superior hypogastric plexus blocks can provide months of pain relief and reduce the need for opioid medication.




For a vertebral compression fracture due to osteoporosis or malignancy, a kyphoplasty procedure helps stabilize the fracture and provide relief in over 90% of patients immediately. The procedure takes less than an hour, and the bone cement acts as an “internal brace” once it hardens.


Spinal Cord Implants


For those patients suffering from chronic pain that has no surgical indication, there are two last resort procedures available with Dr. Zed at All Star Pain Management. These include spinal cord stimulator implants and also intrathecal morphine pain pumps. Each of these has specific indications, and both have been shown to be significantly effective over 75% for those suffering from chronic pain.