[00:00:00] Welcome and Introductions
Lawrence LeBrocq, managing partner of Garces, Grabler & LeBrocq and host of Victim to Victory, introduces Dr. Wael Elkholy, pain management specialist, director of Precision Pain and Spine Institute, and former pain management director at Yale and JFK Hospital in New Jersey. LeBrocq sets the stage by framing pain management as a specialty many injury victims encounter without fully understanding.

[00:01:09] What Is a Pain Management Doctor Today
Dr. Elkholy traces how pain management has shifted since his fellowship at Albert Einstein College of Medicine and his time teaching at Yale, moving away from medication toward a comprehensive, procedure driven model. He describes his philosophy that chiropractors, physical therapists, rehabilitation doctors, and spine surgeons must all work together for the best patient outcome.

[00:02:57] The Treatment Ladder: Conservative Care First
Dr. Elkholy explains why 50 percent of his patients resolve their pain with conservative care alone and never need to see him for procedures. He outlines the role of nonsteroidal anti-inflammatory medications and the firm shift away from narcotic prescribing, grounded in the clinical reality of addiction risk.

[00:04:45] Diagnosis as the Foundation of Treatment
Dr. Elkholy argues that accurate diagnosis drives every treatment decision that follows, and explains how MRI review and EMG nerve testing work together to identify which disc or nerve is generating the pain. He notes that 60 percent of his practice involves personal injury patients who sustained trauma in car accidents or other incidents.

[00:06:50] How Epidurals Work and What They Can and Cannot Do
Using an accessible analogy of sunburn and cortisone cream, Dr. Elkholy explains what an epidural injection actually does to an inflamed nerve root. He is candid that the goal of an epidural is to calm the nerve and buy time, not to cure the underlying structural problem, and that roughly one third of patients get long term relief, one third short term, and one third none.

[00:10:46] Cervical Discectomy: A Revolution in Pain Management
Dr. Elkholy describes cervical discectomy as a procedure performed by only about 20 to 30 interventional pain specialists in the country. He details the surgical approach, the nucleoplasty and annuloplasty steps, and the clinical results: 80 to 90 percent radicular pain relief and 70 to 80 percent axial neck pain relief. He references seven published studies from Precision Pain and Spine Institute supporting these outcomes.

[00:12:45] Cervical Rhizotomy: Cutting the Pain Signal at the Source
Dr. Elkholy explains the difference between disc pain and facet joint pain, and how cervical rhizotomy addresses the latter by cauterizing the medial branch nerve under scope visualization. He describes the procedure as producing 80 to 90 percent pain relief for two to three years and notes that only 10 to 15 interventional pain specialists nationwide perform it.

[00:15:50] Fusion Surgery and Disc Replacement
Dr. Elkholy walks through when fusion becomes necessary and contrasts it with artificial disc replacement, which preserves range of motion and is particularly appropriate for younger patients. He notes that single level fusion now typically occurs in a surgery center with a same day discharge, a significant shift from the multi day hospital stays required two decades ago.

[00:18:49] Fighting Insurance Denials: A Real Case
Dr. Elkholy describes a 32 year old patient on fentanyl patches and gabapentin whose cervical discectomy was denied by insurance. After clinical communication explaining the procedure’s necessity and long term cost benefit, the insurer approved the surgery. The patient went home the same day with complete radicular pain relief and was successfully weaned off narcotics.

[00:20:39] Why Dr. Elkholy Videos His Procedures
Dr. Elkholy explains that recording surgeries serves two purposes: training other pain management specialists to expand access to these rare procedures, and educating patients on exactly what was done and why. He argues that thorough explanation builds trust and improves patient acceptance of necessary treatment.

[00:22:31] Why Precision Pain and Spine Institute
Dr. Elkholy describes the comprehensive care model at Precision Pain and Spine Institute, with nearly 100 staff members across multiple New Jersey locations spanning Hamilton, North Brunswick, Edison, Jersey City, Elizabeth, Clifton, Passaic, Somerset, and a new Newark office, with Philadelphia and additional New Jersey locations in development.

[00:23:35] Locations and How to Reach Precision Pain and Spine Institute
Dr. Elkholy lists all current and upcoming office locations across New Jersey and the Philadelphia area, giving injured patients a clear sense of how accessible the practice has become. LeBrocq closes by thanking Dr. Elkholy and reaffirming his value to the Victim to Victory audience.