Learn More About Our Treatments
Advanced Wound Care Services for Chronic & Non-Healing Wounds
We provide comprehensive wound care treatment for patients dealing with chronic wounds, slow-healing wounds, and complex wound conditions. Our team treats venous ulcers, arterial ulcers, diabetic foot ulcers, surgical wounds, pressure injuries, and other non-healing wounds using advanced, evidence-based therapies.
If you or a loved one has a wound that is not improving, we focus on identifying the root cause and creating a personalized treatment plan designed to promote faster healing and prevent complications.
Types of Wounds We Treat
We specialize in the treatment of:
- Venous ulcers
- Arterial ulcers
- Diabetic foot ulcers
- Surgical wounds
- Pressure ulcers (bed sores)
- Chronic non-healing wounds
Advanced Wound Healing Treatments
We offer advanced therapies commonly used in modern wound management, including:
- Negative Pressure Wound Therapy (wound vac)
- Platelet-Rich Plasma (PRP) therapy
- Skin substitutes and graft applications
- Debridement (removal of damaged tissue to promote healing)
- Multilayer compression therapy for venous disease
- Infection control and wound bioburden management
- In-house lab testing for faster results
- Ordering wound care supplies for home use
These treatments help reduce infection risk, improve circulation, and stimulate natural healing.
Our treatment approach follows the widely recognized DIME framework, which focuses on:
- Debridement – Removing non-viable or damaged tissue to promote healthy healing
- Infection and Inflammation Control – Managing bacterial burden and reducing inflammatory barriers to healing
- Moisture Balance – Maintaining the optimal wound environment for tissue repair
- Edge Advancement – Encouraging healthy tissue growth and wound closure
Diagnostic Testing & Pre-Treatment Evaluation
Successful wound healing often depends on addressing underlying medical conditions. Prior to or alongside wound care treatment, patients may require evaluation for contributing factors such as vascular disease, diabetes, or nutritional deficiencies.
We recommend that patients complete appropriate diagnostic testing through their primary care provider or specialist before beginning advanced wound care. This may include:
- Vascular evaluations and referral to vascular specialists when needed
- Blood work such as Albumin and Hemoglobin A1c testing
- Diagnostic imaging including venous studies, arterial studies, and ABI testing
- Nutritional assessment to support tissue repair
By ensuring underlying conditions are properly evaluated and managed, we can improve healing outcomes and reduce the risk of recurrence.
Our Approach to Wound Care
We believe wound care should be thorough, compassionate, and personalized. Our goal is to:
- Promote faster healing
- Prevent infection and complications
- Reduce pain and discomfort
- Improve overall quality of life
If you are searching for expert wound care treatment for a chronic wound or non-healing ulcer, our team is here to help.
Palliative Care
Adult palliative care provides specialized support for people living with serious, chronic, or complex health conditions. The goal is to improve comfort and quality of life while helping patients navigate the physical and emotional challenges that can come with an ongoing illness. Palliative care can be provided alongside other medical treatments and is not limited to hospice or end-of-life care.
At Pain Relief Specialists, palliative care is centered around the individual needs and goals of each patient. Care may include pain and symptom management, medication support, care coordination, communication with family members and other healthcare providers, and conversations about treatment goals and priorities. By looking beyond a diagnosis and considering the whole person, our team helps patients feel more supported, informed, and comfortable throughout their care.
If you or a loved one is living with a serious or chronic condition, contact Pain Relief Specialists to learn how palliative care may provide additional support.
Pediatric Palliative Care
When a child is living with a serious or chronic illness, care needs to go beyond treating symptoms alone. Pediatric palliative care focuses on improving comfort, quality of life, and overall well-being for both the child and their family.
At our clinic, pediatric palliative care is specialized medical support designed to help children manage pain and other symptoms related to complex medical conditions. This care can be provided at any stage of illness and can be given alongside curative or life-prolonging treatments.
It is not hospice care. Palliative care supports children from the time of diagnosis forward, with the goal of helping them live as fully and comfortably as possible.
Who Pediatric Palliative Care is For:
Pediatric palliative care may benefit children with:
- Chronic or complex medical conditions
- Neurological disorders
- Genetic conditions
- Cancer or blood disorders
- Serious organ or metabolic diseases
- Ongoing pain or symptom burden
Eligibility is based on your child’s needs and symptoms, not on their prognosis.
Child + Family Approach
Children are not simply small adults. Their bodies, development, and emotional needs are constantly changing. Illness affects not only the child, but the entire family.
Our approach addresses:
- Pain and physical symptoms
- Emotional and psychological support
- Developmental considerations
- Social and spiritual needs
- Guidance with medical decision-making
We work collaboratively with your child’s existing medical team to ensure coordinated, comprehensive care.
How Pediatric Palliative Care Works:
Referral: A child may be referred by a physician, specialist, or family member at any point during illness.
Comprehensive Assessment: We evaluate your child’s symptoms, treatment plan, and overall needs.
Personalized Care Plan: We create a tailored plan that evolves as your child grows and their needs change.
Ongoing Support: Care may be provided in clinic, hospital, or coordinated with other providers. Our goal is to reduce suffering, improve function, and support your family throughout the journey.
Supporting Parents & Caregivers:
Parents often carry enormous emotional and practical responsibilities. Pediatric palliative care also provides guidance, education, and support to caregivers navigating complex medical decisions.
You are not expected to manage this alone.
Skin Punch Biopsy for Small Fiber Neuropathy
When Pain is Real, Even if Other Tests Look Normal
Many patients live with burning, stabbing, or electric-like nerve pain for months or even years, only to be told that their nerve conduction studies or imaging look “normal.”
Small fiber neuropathy affects the smallest sensory nerves in the body. These nerves are responsible for pain and temperature sensation and can also influence certain automatic body functions. Because traditional nerve tests primarily evaluate larger nerve fibers, damage to these smaller nerves can go undetected.
This can leave patients with real symptoms but no clear explanation.
What is ENFD Testing
Epidermal Nerve Fiber Density (ENFD) testing is a minimally invasive 3 mm punch skin biopsy used to measure the number of small nerve fibers in the epidermis.
It is widely considered the gold standard diagnostic test for Small Fiber Neuropathy (SFN).
Unlike EMG or nerve conduction studies, ENFD testing can detect early small fiber nerve damage. This allows physicians to objectively confirm neuropathy even when traditional nerve tests appear normal.
Why This Test Matters
When symptoms don’t match previous test results, it can be frustrating and isolating.
ENFD testing provides measurable data that can help clarify what is happening beneath the surface.
This testing helps physicians:
- Confirm whether small fiber nerve damage is present
- Validate neuropathic pain symptoms
- Identify patterns consistent with small fiber neuropathy
- Guide more targeted treatment decisions
- Support further evaluation for potential underlying causes
Instead of relying on assumptions, ENFD testing provides objective information that helps move care from uncertainty to clarity.
Key Clinical Advantages
ENFD testing offers several important benefits:
- Detects small fiber neuropathy with approximately 80–90% sensitivity
- Identifies neuropathy earlier than EMG or nerve conduction testing
- Quick in-office procedure that typically takes about 5 minutes
- Minimally invasive with minimal discomfort and no sutures required
For many patients, this test provides something they have been missing: objective confirmation and a clearer direction for treatment.
Who May Benefit From Small Fiber Neuropathy Testing?
This evaluation may be appropriate for adults or pediatric patients experiencing:
- Burning, tingling, stabbing, or electric-like nerve pain
- Numbness or abnormal temperature sensation
- Persistent neuropathic pain despite normal EMG or nerve conduction studies
- Symptoms that began in the feet and progressed upward
- Neuropathic pain that remains unexplained by routine testing
Testing may also be considered in patients with conditions such as:
- Diabetes or prediabetes
- Chronic neuropathic pain syndromes
- Complex Regional Pain Syndrome (CRPS)
- Fibromyalgia with neuropathic features
- Idiopathic peripheral neuropathy
- Autoimmune or inflammatory-related neuropathies
Eligibility is determined through clinical evaluation and symptom patterns.
What to Expect During the Procedure
ENFD testing is performed in the office using a small skin punch biopsy.
The typical biopsy protocol includes:
- Identifying patients with neuropathic symptoms or metabolic risk factors
- Ordering the ENFD biopsy with the appropriate diagnostic coding
- Performing four small 3 mm punch biopsies from specific areas such as the distal leg, proximal leg, thigh, or a contralateral comparison site
- Sending the samples to a CLIA-certified laboratory for specialized nerve fiber staining and analysis
- Receiving a quantitative report within 5 to 7 days showing nerve fiber density measurements
During the procedure:
- A small area of skin is cleaned and numbed
- A tiny circular sample of skin is removed
- The biopsy site is covered with a bandage and simple aftercare instructions are provided
The procedure is brief and typically very well tolerated.
Understanding Your Results
If reduced nerve fiber density is identified, the findings can support a diagnosis of small fiber neuropathy. This information allows physicians to:
- Refine treatment plans
- Investigate potential underlying causes
- Adjust medication strategies when appropriate
- Document objective findings for ongoing care
If results are normal, that information is also valuable. It helps narrow the list of possible causes and guides the next steps in evaluation.
A Step Toward Answers
Living with chronic nerve pain can feel invisible. When other tests fail to explain what you are experiencing, it does not mean your symptoms are not real.
ENFD testing offers another layer of insight. For many patients, it provides the first measurable confirmation of what they have been feeling.
If you have been searching for answers about persistent nerve pain, this evaluation may be an important step toward clarity and effective treatment.
CBAT Diagnostic Testing
Understanding your health starts with having the right information.
At Pain Relief Specialists, CBAT diagnostic testing provides valuable insight into your cardiovascular and autonomic nervous system health. This non-invasive testing allows our providers to evaluate important measurements that may help identify potential risk factors and provide a more complete picture of your overall health.
Rather than looking at symptoms alone, this testing provides objective information that can be considered alongside your medical history, current symptoms, diagnoses, medications, and treatment plan.
What Is CBAT Testing?
CBAT testing combines several assessments designed to evaluate different aspects of cardiovascular and autonomic function.
The testing includes:
Heart Rate Variability (HRV)
Heart rate variability measures changes in the amount of time between heartbeats. This information can provide insight into autonomic nervous system balance and how the body regulates certain automatic functions.
Pulse Wave Velocity (PWV)
Pulse wave velocity evaluates arterial stiffness, an important measurement related to cardiovascular health. Assessing arterial function can help identify potential cardiovascular risk factors that may deserve additional attention.
Sudomotor Function Testing
Sudomotor testing evaluates sweat gland activity and small nerve function. Changes in sudomotor function may provide information about possible autonomic nervous system dysfunction or peripheral autonomic neuropathy.
Together, these assessments give your provider additional objective information about how your cardiovascular and autonomic systems are functioning.
Why Might Your Provider Recommend CBAT Testing?
Some health concerns aren't always apparent from symptoms alone. CBAT testing can help providers evaluate measurements associated with cardiovascular and autonomic health and identify findings that may warrant closer attention.
Your provider may recommend this type of testing when additional information could help them better understand your health, symptoms, or potential risk factors.
Testing may provide insight into areas such as:
- Autonomic nervous system function
- Cardiovascular health
- Arterial stiffness
- Heart rate variability
- Peripheral vascular function
- Sudomotor and small nerve function
- Potential cardiovascular or autonomic risk factors
The goal is not to evaluate one number in isolation. Your results become another piece of information your healthcare provider can consider when evaluating your overall health and determining appropriate next steps.
What Does CBAT Testing Involve?
CBAT testing is designed to collect several measurements during a single in-office assessment.
Sensors and specialized equipment are used to evaluate cardiovascular and autonomic responses. Depending on the assessment, measurements may be taken while you are resting, breathing in a controlled manner, or changing position.
The testing is non-invasive and does not require surgery or injections.
Once testing is complete, your provider can review the results in the context of your symptoms, medical history, current medications, diagnoses, and existing treatment plan.
How Can CBAT Testing Help?
Having more objective information can help your healthcare team make more informed decisions about your care.
CBAT testing may help identify measurements or patterns that could otherwise be difficult to recognize based on symptoms alone. When potential concerns are identified, your provider can determine whether additional evaluation, monitoring, treatment considerations, or referral to another specialist may be appropriate.
At Pain Relief Specialists, we believe effective care begins with understanding the bigger picture. Diagnostic testing is one tool that can help us gather that information and create a more informed, individualized approach to your care.
Schedule CBAT Testing at Pain Relief Specialists
If your provider has recommended CBAT testing, or you want to learn whether this type of evaluation may be appropriate for you, our team is here to help.
Contact Pain Relief Specialists today to schedule an evaluation and learn more about CBAT diagnostic testing.
Pain Management
At our medical center, our highly trained medical staff specializes in providing comprehensive pain management services to help our patients manage and alleviate their pain. Our team consists of experienced pain management specialists who are dedicated to developing personalized treatment plans that address each patient's unique needs and concerns. Whether it's chronic pain, acute pain, or pain related to a specific condition or injury, our team has the expertise to offer medication management. We offer a range of medications to help manage back pain, including nonsteroidal anti-inflammatory drugs (NSAIDs), muscle relaxants, and opioids (when appropriate and in accordance with safe prescribing practices). Our goal is to help our patients achieve optimal pain relief and improve their quality of life.