Arthritis is diagnosed through consultation, physical exam, imaging — most often X-rays — and possibly blood testing. Dr. Varley always completes thorough exams to identify the cause of your arthritis symptoms and provides treatment as quickly as possible so you can get relief from your joint pain and discomfort right away.

Treatment for arthritis depends on your diagnosis and the severity of your symptoms. Conservative management of arthritis symptoms includes:
- Nonsteroidal anti-inflammatory medications.- Over-the-counter pain medications.- Physical therapy.- Changes to your diet, in cases of metabolic arthritis- Weight loss, if appropriate.
For more complicated arthritis cases, Dr. Varley also provides advanced forms of therapy, including:
- Nerve blocks.- Radiofrequency ablation (RFA).- Facet injections.- Viscosupplementation for chronic knee pain.- Sacroiliac joint injections.- Epidural steroid injections.

In addition to a comprehensive consultation and physical exam, Dr. Varley also provides advanced diagnostic procedures, such as:
- Discography.- Facet joint diagnostic injections.- Sacroiliac joint diagnostic injections.- Diagnostic selective nerve root blocks.- Diagnostic sympathetic nerve blocks.

Dr. Varley recommends different treatment options for back pain depending on your diagnosis and the severity of your symptoms. Conservative treatments for back pain include:
- Nonsteroidal anti-inflammatory medications.- Over-the-counter and prescription pain medications.- Physical therapy.- Bracing.
Dr. Varley may recommend an interventional pain management procedure if conservative therapies aren’t enough. Potential recommendations may include:
- Epidural steroid injections.- Facet injections.- Intradiscal electrothermal therapy (IDET).- Radiofrequency ablation (RFA).- Sacroiliac joint injections.- Vertebral augmentation (kyphoplasty)Spinal cord or nerve root electrical stimulation (SCS).

During the RFA procedure, Dr. Kenneth Varley inserts a thin, sterile needle into the affected area. He uses an X-ray to guide the needle to the precise location of your pain for exact, specific treatment. Dr. Varley then inserts a microelectrode through the needle, which may cause a tingling sensation in the area where you’ve been experiencing pain.
Dr. Varley then sends a small electric current through the microelectrode to heat the nerve in the treatment area. As nerve tissue is heated, the heat alters it slightly so it can’t send pain signals to your brain. The procedure is only performed on the affected nerve, so other nerves and tissues in the area remain unaffected. The procedure is considered low risk and has few side effects, such as mild soreness or discomfort at the site for 1-2 days afterward.

To determine if RFA is the right treatment for your nerve or joint pain, Dr. Varley first examines the injured area and performs a series of tests, such as X-rays, nerve studies, or diagnostic injections called nerve blocks, to determine which nerve is sending pain signals. In some cases, nerve blocks — injectable medication used to block pain signals — are enough to effectively relieve patient pain.

If Dr. Varley determines that a particular nerve is the source of your pain and other treatments, including nerve blocks, have been unsuccessful, he may recommend RFA or another procedure, depending on the severity of your pain and overall health.

Before getting RFA, Dr. Varley administers an anesthetic solution to the area via an injection, so the only discomfort you may feel is mild tingling during the procedure. Afterward, you can typically go home on the same day to recuperate. Dr. Varley follows up with you shortly after your visit to determine how effective the procedure was and if additional care is warranted.

Sciatica symptoms may vary depending on the cause of nerve irritation or compression, as well as your daily activities. Possible symptoms of sciatica include:
- Sharp, shooting pain down the back of your leg.- Numbness and tingling in the back of your leg or foot.- Buttock pain.- Weakness in the muscles of your legs and feet.- Pain that’s worse while coughing, sneezing, or having a bowel movement.- Pain that’s worse when you bend forward or stretch your hamstrings.- Movements that put tension on your sciatic nerve, such as bending forward to tie your shoes, can cause an increase in symptoms. Symptoms may resolve with rest or certain positions, such as lying flat on your back.

There are a number of factors that must be ruled out before diagnosing your condition. Common causes of back and leg pain which may cause or mimic sciatica include:
- Piriformis syndrome.- Sacroiliac joint dysfunction.- Lumbar radiculopathy.- Spinal stenosis.- Facet joint dysfunction.- Arthritis.

To diagnose sciatica, Dr. Varley begins with a physical exam and diagnostic testing. He may recommend imaging, such as X-rays, magnetic resonance imaging (MRI), or a CAT scan. Advanced diagnostic testing like diagnostic nerve blocks or joint injections may help confirm the diagnosis. These tests help Dr. Varley determine where your nerve pain is coming from and what conditions or anatomical structures are compressing or irritating your sciatic nerve.

Based on your diagnosis and the severity of your condition, Dr. Varley discusses which treatment options are best for you. He may recommend one or more of the following options, depending on your specific case:
- Nonsteroidal anti-inflammatory medications.- Over-the-counter or prescription pain medications.- Physical therapy.- Epidural steroid injections.- Intradiscal electrothermal therapy (IDET).- Radiofrequency ablation (RFA).- Spinal cord or nerve root electrical stimulation (SCS).

Vertebral compression fractures typically cause severe back pain when they occur. Other symptoms include:
- Sudden onset of back pain.- Increased pain when standing or walking.- Decreased pain while lying flat on your back.- Decreased spinal mobility.- Eventual loss of height.- Eventual deformity and disability.
It’s possible to have more than one compression fracture at a time, especially in cases of trauma or severe osteoporosis. Not all compression fractures are painful, and other conditions can mimic fracture pain. Dr. Varley rules out other causes of back pain and confirms that the vertebra should be treated with diagnostic nerve blocks before proceeding with kyphoplasty. Multiple compression fractures can cause an obvious change to your posture called kyphosis, in addition to other symptoms.

The most common cause of vertebral compression fractures is osteoporosis. Compression fractures are most likely to occur in the thoracic spine — or middle back — especially the lower half of the thoracic spine where your rib cage ends, although they can occur anywhere in your spine.

Other potential causes are trauma or metastatic cancer. Types of trauma that can cause compression fractures are car accidents, sports injuries, and falls. If you’ve experienced any trauma and have back pain, it’s best to be evaluated by Dr. Kenneth Varley to determine if you have a vertebral compression fracture.

Dr. Varley performs a procedure called kyphoplasty to repair vertebral compression fractures. During this procedure, he makes two small incisions in your skin and uses a drill to make space on the sides of the vertebrae to insert two deflated surgical balloons. The balloons are filled with a contrast medium until they expand to the desired size, which restores height to the vertebrae. Dr. Varley then injects surgical cement into the vertebrae to fill the space that has been compressed. The cement dries and restores strength and height to your spine and protects the nerves and soft tissues in the area from further damage.

As soon as the nerve block is injected into the epidural space — the fluid-filled space around your spinal cord — the anesthetic medication takes effect. It is quickly absorbed by your nerves in the area to block pain signals that are sent from your nerves to your brain. Since nerve blocks are placed at the nerve roots where they attach to your spinal cord, you get relief from the root to the end of your nerves, which may continue all the way to your fingers or toes, depending on which nerves are being treated.

Dr. Varley recommends nerve blocks for patients suffering from chronic joint or nerve pain that hasn’t responded to other conservative treatments, like anti-inflammatory medications or physical therapy. Conditions that can benefit from nerve blocks include:
- Low back pain.- Sciatica.- Neck pain.- Arthritic pain in the spine.- Sacroiliac joint pain.- Facet joint pain.
To determine if a nerve block is right for you, Dr. Varley discusses your symptoms and previous treatments you’ve tried before performing a physical exam and ordering additional tests, like X-rays or a CT scan.

When you arrive for your nerve block procedure, Dr. Varley first cleans your skin and injects a numbing solution to minimize discomfort.
Mild sedation is administered before Dr. Varley inserts the needle for the nerve block using the appropriate imaging technology. He injects the nerve block solution and then removes the needle. This occurs in about 5-10 minutes. Nerve blocks typically take 15-20 minutes to work.
After your procedure is complete, Dr. Varley cleans your skin and applies a bandage. He provides after-care instructions and follows up within a few days to determine how you’re doing.

Bone is constantly being broken down and rebuilt as a normal part of aging. When bone is broken down — called resorption — bone cells dissolve and are replaced by new, healthy ones in a process called formation. Osteoporosis occurs when the amount of bone being broken down outpaces the formation of new bone.

This leads to the development of microscopic holes in your bones that make it weaker. This can happen in any bone in your body, so if left untreated, osteoporosis can cause fractures in your spine and limbs.

Since bone changes are a normal part of the aging process, being over the age of 50 increases your risk of developing osteoporosis, which increases even more as you get older. Other risk factors for developing osteoporosis include:
- Being female.- Family history of osteoporosis.- Previous fracture.- Menopause or having a hysterectomy.- Long-term glucocorticoid therapy.- Rheumatoid arthritis.- Primary or secondary hypogonadism in men.
Certain medications, including those used for breast cancer treatment, may also cause an increase in bone loss.

Dr. Kenneth Varley performs bone densitometry scans in the office to determine the amount of bone loss in your body. This is a simple and painless type of X-ray that detects osteoporosis and osteopenia. Once the test is complete — which takes 5-10 minutes — Dr. Varley analyzes the data collected from the test to determine the density of your bones.

There are many ways to manage osteoporosis and reduce your risk of developing osteoporosis-related fractures, including vertebral compression fractures. Most treatments involve medications that help build more bone. Other treatments include hormone replacement therapy and lifestyle recommendations, like increasing your daily activity level, which may help strengthen your bones.

Common signs of peripheral neuropathy include:
- Numbness or tingling in your arms, hands, legs, or feet.- Weakness in your limbs.- Difficulty gripping objects.- Poor coordination.- Difficulty walking.- Loss of sensation in your hands or feet.
Peripheral neuropathy can become dangerous if it prevents you from feeling sensations in your hands and feet that may lead to burns, trips, or falls. Peripheral neuropathy is also a progressive condition that can get worse over time and cause permanent damage to your nerves.

The leading cause of peripheral neuropathy in your legs and feet is diabetes, while the leading cause in your hands is carpal tunnel syndrome. With diabetes, high blood sugar irritates nerves throughout your body — although the symptoms are most notable in the legs and feet.

With carpal tunnel syndrome, the median nerve in the inner part of your wrist that controls sensation and movement in your hand becomes compressed. The median nerve can be compressed by muscles in your forearm or wrist or the tendons in your carpal tunnel if they swell due to overuse. If left untreated, carpal tunnel syndrome can become chronic and permanently damage your nerves.

Different tests are available to examine your nerves and isolate the cause of your symptoms. Nerve-specific tests include nerve conduction velocity (NCV) and electromyogram (EMG) tests, which check how quickly your nerves can send impulses to and from your brain and the muscles in your hand and wrist.
Dr. Kenneth Varley may also recommend an X-ray or diagnostic ultrasound to rule out other potential causes of your symptoms, like bony abnormalities or muscle tears.

Treatment for peripheral neuropathy depends on your diagnosis and the location and severity of your symptoms. Possible treatments include:
- Dietary supplements, including magnesium and B vitamins..- Nonsteroidal anti-inflammatory medications.- Activity changes.- Nerve gliding exercises.- Spinal cord or nerve root electrical stimulation.- For peripheral neuropathy caused by diabetes, Dr. Varley works with your primary care provider or internal medicine specialist to manage your diabetes and control your blood sugar.