National Pain Centers isn’t a bigger version of the practice down the street. It’s a fundamentally different one, led by a physician who was right early, right often, while the rest of medicine wasn’t paying attention.
We Didn't Follow The Field. We Were a Decade Ahead Of It — Repeatedly.
Anyone can call themselves a pain specialist. Almost no one can back it up all the way down.
Each credential below eliminates most of the field. Stack them together, and the number left standing is one.
Board Certified
Certification is voluntary and not every provider treating pain actually holds it. Dr. Joshi does. It’s the floor, not the ceiling.
Anesthesiology-Trained
Pain medicine is practiced by physicians from many backgrounds. Comparatively few completed a full anesthesiology residency, the training most directly rooted in neuraxial precision, procedural safety, and the sedation many practices simply cannot offer. Dr. Joshi did.
Accredited Fellowship Trained
Fewer still completed an ACGME-accredited pain medicine fellowship as opposed to a weekend certificate or a self-appointed title. Dr. Joshi did.
A Published Innovator
Almost no physician contributes a single first to their field. Dr. Joshi has consistently pioneered procedural techniques, mechanistic discoveries, and technological advances the field is still catching up to.
Opioid-Free by Conviction
Three decades of practice without a single OxyContin or oxycodone prescription, because he predicted the epidemic before it began.
Independent
Nearly four out of five U.S. physicians now have their loyalty to a corporate owner, like a hospital system, insurer, or private-equity group, instead of the patient. Only about one in five remains independent. Dr. Joshi and everyone at National Pain Centers are among them.
Dr. Jay Joshi
Filter the field through every one of those standards and you don’t arrive at a short list. You arrive at a category of one.
Right early, and right often
Not a list of credentials, it is a pattern. For thirty years, Dr. Joshi has seen what was coming before the rest of medicine did, and built the alternative first.
First U.S. Pain Physician at the World Health Organization
In 1999, Dr. Joshi became the first U.S. pain physician to work with the WHO’s Department of Substance Abuse in Geneva, Switzerland helping shape international substance-abuse policy years before the topic reached the American conversation. It’s the vantage point that let him see the opioid crisis forming while it was still invisible to everyone else.
Predicted the OxyContin Epidemic
While OxyContin was being marketed to physicians as safe and non-addictive, Dr. Joshi was already warning of the epidemic it would unleash, more than a decade before the CDC, federal agencies, or organized medicine would acknowledge the crisis. He didn’t just avoid the field’s biggest mistake. He called it before it happened.
Never Prescribed OxyContin or Oxycodone
In over three decades of practice, Dr. Joshi has never once prescribed OxyContin or oxycodone. This is not as a marketing stance. It is clinical conviction held since before the crisis began. Every patient is treated with a philosophy built around resolution, not dependency.
Remote and Cloud-Based Before the World Was
National Pain Centers was hybrid-remote in 2010, before the iPad, when every other practice was tethered to in-office, server-based systems. We were cloud-based before “the cloud” was common language. When the world was forced remote in 2020, we didn’t scramble to adapt. We’d already been doing it for a decade and simply went fully remote without missing a step.
First Wearable-Free, Fully Remote Movement Exam
Our proprietary MSK movement assessment measures how your body actually moves, objectively, remotely, and without a single wearable or sensor. It’s the first fully remote musculoskeletal examination of its kind: a blood test for how you move, turning movement into data instead of guesswork.
Co-Architect of the SGB Unifying Theory
Dr. Joshi is a co-author and co-architect of the landmark 2009 unifying theory, published in Medical Hypotheses, that connected the stellate ganglion block across complex regional pain syndrome (CRPS), hot flashes, and PTSD through a shared sympathetic-nervous-system mechanism. It remains one of the most influential and most-cited theoretical contributions in interventional pain. It is the basis behind the connection between central sensitization and peripheral pain.
First Surgery-Center-Based Ketamine Program
Roughly two decades ago — when fewer than five outpatient ketamine programs existed in the entire country, and none were based in a surgery center — Dr. Joshi built the first surgery-center-based outpatient ketamine infusion program. That surgical-grade safety infrastructure set it apart then, and the program is still running today: PTSD, CRPS, central sensitization, fibromyalgia, anxiety, and depression.
Pioneering Procedural Techniques
Dr. Joshi developed techniques the field is still catching up, including the blunt-needle approach to transforaminal epidural steroid injections, a genuine safety advance that reduces the risk of catastrophic intravascular and intraneural injury, and the single-needle lateral approach to cervical medial branch blocks and radiofrequency ablation, improving precision and patient comfort.
Numerous Regenerative-Medicine Innovations
Beyond interventional procedures, Dr. Joshi has advanced numerous regenerative-medicine techniques, such as orthobiologic, platelet-rich plasma (PRP), autologous lipoaspirate stem cells, and exosome approaches designed to help the body repair tissue and resolve pain at its source, rather than mask it.
Counterfeit Medicine Pioneer
At the WHO in 1999, Dr. Joshi became among the first American physicians to encounter the global counterfeit-medicine problem firsthand — years before it registered in U.S. medicine. He went on to teach the field about it, delivering the first CME course on counterfeit pain medications, including counterfeit fentanyl, at PAINWeek in 2015. From 2014 he served as Chief Medical Officer of Stealth Mark, whose microtaggant authentication technology — originally developed by 3M — was among the most advanced anti-counterfeiting tools available. The same early vantage point that let him foresee the opioid epidemic let him see this threat too.
Most physicians practice today's medicine. Dr. Joshi draws on all of it.
Dr. Joshi is one of the only interventional pain physicians to have studied Ayurvedic medicine — a healing tradition thousands of years old. We don’t practice Ayurveda. We draw on its philosophy: treat the whole body, understand each person’s individual constitution, and favor natural, safe options wherever they will truly serve the patient.
That’s the past. The present is a complete command of modern medicine and science — the diagnostics, the procedures, the evidence. And the future is the vision and creativity to build what comes next, which is exactly what Dr. Joshi has done again and again, from remote pain care to objective, wearable-free movement testing.
Most physicians work from a narrow slice of the timeline. We work from the whole of it.
Less radiation. By design and backed by published science.
Every fluoroscopically guided spine or joint procedure uses X-ray. And because chronic pain often requires procedures repeated over many years, that exposure accumulates. Most physicians never address it. Dr. Joshi’s technique is deliberately engineered to minimize it: low-dose imaging and a few precisely targeted spot images instead of continuous, live, full-dose “movie” X-ray.
minimum reduction vs. conventional continuous fluoroscopy
reduction achievable at the high end, per our dose data
compromise in accuracy — same precision, less exposure
Peer-reviewed interventional-pain studies confirm both the method and reductions of this magnitude and, critically, that lowering the dose this way does not reduce procedural accuracy. Lower cumulative radiation means lower long-term risk. That’s not a shortcut. It’s a higher standard almost no one else bothers to meet.
Reduction figures reflect National Pain Centers’ own procedural dose data versus conventional continuous-fluoroscopy technique; individual results vary by procedure and patient. Peer-reviewed literature on pulsed and low-dose fluoroscopy supports the mechanism and magnitude of reduction.
Not all physicians are the same.
Every physician who treats you carries credentials, but a credential is a floor, not a ceiling. Just as two professional athletes can have vastly different levels of skill, so can two qualified physicians. Technique, precision, and hand-eye accuracy vary enormously from one to the next. In image-guided procedures, that difference is measured in millimeters.
At National Pain Centers, Dr. Joshi personally performs your procedure. It is never handed off to a technician, a student, a resident, or rotating staff. You are treated by the physician who developed and mastered the technique, not by whoever happens to be assigned that day. Because of his anesthesiology training, we can offer sedation during procedures that many practices cannot, along with hand-selected products and injectable medications chosen for quality, never for the lowest bid.
The details other practices rush past
Precision isn’t only about where the needle goes. It’s a dozen small decisions most patients never see — and we make every one of them the way we’d want them made for ourselves.
We actually numb you first
Before a procedure, we take the time to thoroughly anesthetize the skin and underlying tissue with local anesthetic — properly, not as a token gesture. It’s a step many providers rush or skimp on, and it’s the difference between a procedure you merely tolerate and one you barely feel.
Comfort done right takes an extra minute. We take it.
Sedation without opioids
When sedation is used, we use ketamine-based, non-opioid sedation — not fentanyl. Opioid sedation exposes your body to unnecessary opioids, can complicate workplace drug testing, and can actually increase your sensitivity to pain (a phenomenon called opioid-induced hyperalgesia). Ketamine does the opposite: it isn’t an opioid, it can reduce the brain’s hypersensitivity to pain, and it may even lower opioid tolerance a patient has already developed.
Sedation that works with your recovery — and keeps unnecessary opioids out of your body.
Smaller needles, by design
For radiofrequency ablation, Dr. Joshi’s technique is deliberately different from most practiced anywhere in the world. His accuracy is precise enough to use smaller-gauge needles, where many providers reach for much larger ones — 18-gauge, and in some cases as large as 14-gauge — to compensate with an oversized lesion. Bigger needles and bigger lesions mean more trauma to healthy surrounding tissue, more discomfort, and sometimes longer-term problems.
Precision means we don’t have to be destructive to be effective.
Tissue-sparing ablation
How the lesion is created matters just as much. Dr. Joshi uses a longer-duration, slightly lower-temperature technique that is tissue-sparing — targeting the nerve while preserving the tissue around it. Many providers run very high-temperature lesions that permanently destroy tissue. That isn’t a benefit; it’s collateral damage, and it can carry its own complications.
Relief shouldn’t require boiling away healthy tissue you’ll never get back.
Why we don't over-do it: pain is protective
There’s a hidden danger in ablating too aggressively. Pain is a warning system — it tells you when something is wrong. Destroy too much, and a patient can lose that signal entirely, then unknowingly move in ways that cause real injury they simply can’t feel. Targeted, tissue-sparing ablation relieves the pain you came in for without switching off the protection that keeps you safe.
None of this is complicated — it’s just care. We do procedures the way we’d want them done to us, and we don’t mind spending a few extra minutes to protect tissue, preserve function, and prevent injuries that could otherwise last a lifetime. A practice racing to shave thirty seconds off a procedure is optimizing for the wrong thing.
We don't rush to implant.
A spinal cord stimulator is a real tool — for the right patient, at the right time. But it’s an implant, and we treat it as a genuine last resort, not an early default reached for after a couple of quick attempts. First we do the harder work: find the root cause, diagnose it precisely, treat it, and rehabilitate it. Only when we’ve truly exhausted the better options — and an implant is genuinely the right answer — do we go there.
Reaching for the most aggressive, irreversible option early is easy. Doing it last, and only when it’s right, is the standard we hold.
Almost four out of five physicians now answer to a corporation — not the patient.
According to the Physicians Advocacy Institute, roughly 78% of U.S. physicians are now employed by a hospital system, insurer, or corporate entity, up from about a quarter just over a decade ago. Only about one in five physicians remains independent. As the Institute itself notes, corporate owners carry a fiduciary duty to shareholders and are motivated to put profits first, which can conflict with what’s best for the patient.
National Pain Centers is physician-owned. That means our incentives are aligned with exactly one thing: your outcome, not the volume targets, throughput quotas, or lowest-bid supply contracts that shape care in large corporate and hospital-employed settings. When your physician is your advocate, everything downstream changes.
Regenerative medicine — without the hype.
Regenerative therapies — orthobiologics, platelet-rich plasma (PRP), and, for patients who want them, stem cell and exosome options — have become one of the most promising and most abused corners of medicine. The promise is real. So is the problem: the space has filled with franchises, med-spas, and non-physician operators marketing miracle cures the science doesn’t yet support — often to people in pain who deserve better than a sales pitch.
We take the opposite approach. National Pain Centers was an early, physician-led adopter of regenerative medicine, not a bandwagon follower — and every regenerative procedure is performed and overseen by a physician, using quality-controlled biologics, with careful attention to who is, and isn’t, an appropriate candidate. We don’t sell hope by the vial.
Just as important: we’ll tell you the truth. We’re candid about what the evidence supports today, what’s still emerging or investigational, and what any therapy can and can’t reasonably be expected to do for your situation. For some patients, regenerative options are a genuinely valuable tool. For others, they aren’t the right choice — and we’ll say so.
→Is a physician actually performing it?
→How many years have they done it?
→Will they tell you when it’s not right for you?
Regenerative therapies vary in their level of clinical evidence; some are considered emerging or investigational and are not FDA-approved for all uses. Candidacy and expected benefit are determined individually, and individual results vary.
An interventional pain practice — and so much more
Pain is rarely one-dimensional, and neither are we.
National Pain Centers is built on interventional pain expertise. But our team’s combined experience spans more than 100 years across many fields of medicine — so we can understand the whole problem, not just the part that fits a single specialty. That range is the point: it’s what lets us find the true root of a problem, address it from more than one angle, and rehabilitate it — instead of forcing every patient through the same narrow door.
Reflects the combined training and professional experience of our team, not a list of services offered.
The standard doesn't stop at Dr. Joshi.
You’ll spend far more time with our team than with any headline — so we chose them with the same care you’d want in the person treating you.
Everything on this page is a standard — and a standard is only real if everyone holds it. Every member of the National Pain Centers team was personally and deliberately selected. Not only for experience and credentials, but for what a résumé can’t show: compassion, character, ethics, and an uncompromising commitment to doing things right. Because most of your care — most of your visits, your questions, and the small moments that decide how it actually feels to be a patient — happens with them. We hold every one of them to the category-of-one standard, because you deserve it at every touchpoint, not just the headline one. We are obsessive in our pursuit of perfection — and we hire for it.
Years in the field, not months.
Verified, current, and real.
People you’re genuinely glad to see.
You’re a person, never a chart.
No shortcuts, ever.
The right call, even when it’s harder.
A compass that doesn’t move.
The same in the room and out of it.
Eight questions worth asking
You’d be surprised how few practices can answer “yes” to all of them. Dr. Joshi answers yes to every one.
Certification is voluntary — confirm it, don’t assume it.
The foundation for neuraxial precision, procedural safety, and sedation.
An ACGME-accredited fellowship — not a weekend course.
Or is it delegated to a technician, resident, or rotating staff?
Pulsed, low-dose, spot imaging — not continuous fluoroscopy.
Physician-owned means aligned incentives.
Not a technician at a franchise or med-spa.
The real expert will tell you when a therapy isn’t right for you.
Experience the category-of-one difference.
The same standards that make National Pain Centers different are built into every level of The Sovereign Program, our membership designed around access, precision, and outcomes.