Work Injuries & Workers' Compensation
Expert care and honest documentation for injured workers — from a practice with no incentive except your recovery.
Work Injuries & Workers' Compensation is a symptom. The source is the answer.
An injured worker occupies one of the most compromised positions in American medicine. The system surrounding them is crowded with parties who have interests of their own: employers, insurers, attorneys, marketing companies, device vendors, imaging centers, surgical facilities, and, unfortunately, some physicians and therapists.
The result is that injured workers are frequently over-treated, under-treated, over-imaged, rushed toward surgery or implants, or kept in treatment far longer than their injury requires — depending on whose interests are being served.
We are physician-owned and independent. No corporate parent, no volume quota, no referral arrangement that shapes what we recommend. We diagnose your injury accurately, treat it precisely, document it honestly, and return you to function as quickly and safely as we can. That is the entire job.
It is worth stating plainly what an injured worker is up against, because the system rarely explains itself. An employer has an interest in a claim resolving quickly and cheaply. An insurer has an interest in minimizing payout. Some attorneys have an interest in documented severity. Some clinics have an interest in a long treatment schedule. Device vendors, imaging centers, and surgical facilities each profit from volume. Marketing companies profit from referrals.
None of these parties is necessarily acting in bad faith. But every one of them has an interest that is not identical to the patient’s, and the patient is the only person in the room without a financial stake in the outcome — while being the only person whose body is at issue.
An injured worker deserves a physician whose only interest is their recovery. In this system, that has become surprisingly rare.
What we do — and refuse to do
We document what is true
Our records reflect exactly what we find: no exaggeration to support a claim, no minimization to please an insurer. An honest record protects the patient more than a favorable one, because an honest record withstands scrutiny.
We don't over-treat, and we don't over-image
Every study and every procedure must be justified by the clinical picture. Unnecessary imaging generates incidental findings that lead to unnecessary treatment. We order what you need.
We don't rush toward surgery or implants
A spinal cord stimulator or a surgery is a legitimate option for the right patient at the right time. We treat both as a genuine last resort, after we’ve found the root cause, treated it, and rehabilitated it — not as an early default.
We never prescribe opioids as a strategy
Dr. Joshi has never prescribed OxyContin or oxycodone in over three decades, and he warned of the opioid epidemic before it was acknowledged. Injured workers were among the epidemic’s greatest casualties. We treat the source of pain instead.
We have no financial arrangements that shape your care
We are independent and physician-owned. Nearly four out of five U.S. physicians now answer to a hospital system, insurer, or private-equity owner. We answer to the patient.
We return you to function, not to a schedule
The goal is durable recovery and safe return to work — not the maximum number of billable visits, and not a premature discharge to satisfy a payer.
What can cause work injuries & workers' compensation
Below are the conditions we most commonly identify and treat. Many patients have more than one contributing source at the same time — which is precisely why careful diagnosis matters.
Common Work-Related Injuries
Lumbar & Cervical Strain and Disc Injury
Lifting, twisting, and repetitive loading injuries producing back or neck pain, sometimes with disc herniation and radiating nerve pain into the arm or leg.
Shoulder, Knee & Joint Injuries
Rotator cuff injury, meniscal injury, bursitis, and tendinopathy from overhead work, kneeling, lifting, and repetitive motion.
Repetitive Strain & Nerve Entrapment
Carpal tunnel, cubital tunnel, and tendinopathies from repetitive tasks — precisely diagnosable and often highly treatable without surgery.
Falls, Crush Injuries & Fractures
Acute traumatic injury with fracture, soft-tissue damage, or nerve injury requiring careful assessment for both structural and neuropathic pain.
Injuries That Are Frequently Missed
Facet-Mediated Pain
One of the most common and most frequently missed sources of post-injury back and neck pain. It often doesn’t appear on imaging — so it goes untreated while the patient is told nothing is wrong.
Sacroiliac Joint Injury
A commonly overlooked source of low back and buttock pain after a fall, lifting injury, or motor vehicle collision.
Complex Regional Pain Syndrome (CRPS)
Can follow even a minor work injury or a surgery. Early recognition is critical; delayed diagnosis is the single greatest harm most CRPS patients suffer.
Central Sensitization
When a work injury’s pain persists, the nervous system can amplify. The patient is then labeled a malingerer. They are not — their pain processing has changed, and that is treatable.
Why Injured Workers Are Vulnerable
Competing Interests
Employers, insurers, attorneys, marketing companies, device vendors, and facilities all have financial stakes in the outcome. The patient rarely has an advocate whose only interest is their health.
Over-Treatment & Under-Treatment
Depending on incentives, injured workers may receive unnecessary procedures or be denied necessary ones. Both cause lasting harm.
The Opioid Legacy
Injured workers were prescribed opioids at devastating rates, with lasting consequences. We were warning about this before the epidemic was acknowledged.
Being Disbelieved
Patients whose pain outlasts an expected timeline are frequently told it’s in their heads. Usually, it means the actual pain generator was never identified.
What Good Care Looks Like After a Work Injury
Accurate Diagnosis Before Any Treatment
Treatment aimed at the wrong structure delays recovery, generates unnecessary risk, and produces a record of “failed treatment” that follows the patient through their claim.
Objective Functional Measurement
In a system where injured workers are routinely doubted, objective data on how you actually move is protective — documenting genuine impairment, and documenting genuine recovery.
The Least Invasive Effective Treatment
Start with what is precise and reversible. Escalate only when the evidence and the patient’s course genuinely warrant it. Implants and surgery are legitimate tools, and they are last resorts.
A Clear Path Back to Function
Return to work when it is genuinely safe, neither prematurely nor after unnecessary delay. Both errors harm the patient, and only objective measurement distinguishes them.
When a work injury is an emergency
Seek immediate care — call 911 or go to an emergency room — for: loss of bowel or bladder control; progressive weakness or numbness; severe pain after major trauma; obvious deformity or suspected fracture; a hot, swollen joint with fever; or head injury with confusion, vomiting, or loss of consciousness. Report every work injury to your employer promptly, in accordance with your state’s requirements.
Diagnosis is a procedure, not a guess
Imaging alone rarely provides the answer. Findings of degeneration are extraordinarily common in people with no pain whatsoever — so an abnormal image doesn’t prove we’ve found the culprit. Conversely, some of the most treatable causes may not appear on imaging at all.
So we build the diagnosis from several converging sources:
01 — A genuinely thorough history and physical examination
Mechanism of injury, symptom evolution, and a careful examination. Our visits are longer than the industry norm — and in workers’ compensation, where documentation matters enormously, that thoroughness protects the patient.
02 — Appropriate, justified imaging
We order the studies your clinical picture requires — no more. Over-imaging produces incidental findings that lead to unnecessary treatment, a well-documented harm in this population.
03 — Virtual MSK Movement Assessment
Objective, wearable-free measurement of how you actually move. In a system where injured workers are routinely doubted, objective functional data is a powerful and honest record of impairment and of genuine recovery.
04 — Diagnostic nerve blocks
Anesthetizing a specific structure to confirm it as the pain source — a precise answer that both directs treatment and provides objective evidence of a real, identifiable injury.
This is the difference between treating a picture and treating a patient. We confirm the source before committing you to a therapeutic procedure.
Precise, non-opioid, physician-performed care
Once we know the source, treatment can be targeted. Every procedure is performed personally by Dr. Joshi, using low-dose imaging, non-opioid sedation when appropriate, and hand-selected medications and products. We do not delegate procedures, and we do not use opioids as a treatment strategy.
Precise Interventional Procedures
Medial branch blocks, radiofrequency ablation, epidural injections, joint and sacroiliac injections — targeted to the confirmed pain generator and performed personally by Dr. Joshi.
Every procedure uses low-dose imaging (reducing radiation exposure substantially versus conventional continuous fluoroscopy), non-opioid ketamine-based sedation, hand-selected medications, smaller-gauge needles, and tissue-sparing technique.
Regenerative Medicine for Appropriate Candidates
Physician-performed PRP and orthobiologic approaches, offered only when the evidence and the patient’s condition genuinely support it — and declined when they don’t.
Ketamine Infusion Therapy
For work-related CRPS and for pain amplified by central sensitization. We built America’s first surgery-center-based outpatient ketamine program.
Rehabilitation & Return-to-Function Programming
Recovery is the goal, not merely pain relief. Our multi-disciplinary team, including chiropractic and musculoskeletal expertise, builds rehabilitation into every plan with a clear path back to work.
Honest, Thorough Documentation
Clear, accurate reporting for your employer, insurer, and attorney as appropriate — reflecting exactly what we find. We do not shade findings in any direction.
An honest record is a durable record. Documentation written to please a party rather than to describe reality collapses under scrutiny — and the patient is left holding the consequences.
What We Refuse to Do
We do not prescribe opioids as a treatment strategy. We do not order unnecessary imaging or procedures. We do not rush patients toward implants or surgery. We do not have referral arrangements that shape our recommendations.
Objective Functional Documentation
The Virtual MSK Movement Assessment produces objective, wearable-free data on range, control, and compensation. For a patient whose credibility is questioned by default, that record is a genuine protection.
Coordinated Multi-Disciplinary Rehabilitation
Our team — including chiropractic and musculoskeletal expertise — builds rehabilitation into the plan from the start, because pain relief without restored function is not recovery.
We don't rush to implant
A spinal cord stimulator is a legitimate 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 find the root cause, address it, and rehabilitate it. Only when the better options are truly exhausted do we consider going there.
The same procedure is not the same procedure
Two practices can list the same procedure on a website and deliver profoundly different experiences, risks, and outcomes. Here is what changes when the details are done right.
Performed personally by Dr. Joshi
Never delegated to a technician, resident, or rotating staff. You’re treated by the physician who developed and teaches the technique — and in image-guided procedures, the difference between physicians is measured in millimeters.
Dramatically less radiation
Pulsed, low-dose imaging and a few precisely targeted spot images instead of continuous live X-ray. Based on our own procedural dose data, this reduces radiation exposure by at least 50% — and often far more — versus conventional continuous fluoroscopy, with no compromise in accuracy. For conditions treated repeatedly over years, that difference compounds.
Non-opioid sedation
When sedation is used, we use ketamine-based sedation, not fentanyl. Opioid sedation exposes you to unnecessary opioids, can complicate workplace drug testing, and can actually increase pain sensitivity. Ketamine can do the opposite.
Smaller needles, tissue-sparing lesions
Precision means we don’t need to be destructive to be effective — smaller-gauge needles and lower-temperature, longer-duration ablation that spares the healthy tissue around the target.
We actually numb you first
Thorough local anesthesia of skin and underlying tissue before the procedure begins. It takes an extra minute. We take it.
Independent, and obsessive about quality
Nearly four out of five U.S. physicians now answer to a corporate owner. We’re physician-owned, so our only incentive is your outcome. What a practice refuses to do tells you as much as what it offers.
Work Injuries & Workers' Compensation, answered
Rules vary by state and by the specifics of your claim. Many states allow injured workers to select or change their treating physician within certain parameters. We’re glad to discuss your situation — and the choice of physician matters more in workers’ compensation than in almost any other setting.
No. A normal MRI does not mean nothing is wrong. Facet-mediated pain, SI joint injury, and CRPS frequently don’t appear on imaging. Being disbelieved is one of the most common harms injured workers suffer — and it usually means the actual pain generator was never identified.
No. Dr. Joshi has never prescribed OxyContin or oxycodone in more than three decades of practice, and he predicted the opioid epidemic in the late 1990s. Injured workers were among that epidemic’s greatest casualties. We treat the source of pain rather than suppressing the signal.
Because injured workers are among the most over-treated and over-imaged patients in medicine, and because the parties surrounding a claim often have financial interests in more treatment. We are independent and physician-owned. Our only interest is your recovery.
We provide honest, thorough documentation to whichever parties are appropriately involved in your claim. We do not shade our findings to favor anyone. An accurate record serves you better than a favorable one.
As quickly as is genuinely safe, and no faster. Premature return risks re-injury; unnecessary delay harms your livelihood and your recovery. We use objective functional measurement rather than guesswork to make that call.
Independent medical examinations are part of the system, and their findings may differ from your treating physician’s. What protects you is a thorough, honest, objectively documented record from a physician whose only interest is your recovery. That is the record that withstands scrutiny.
Yes, routinely. Facet-mediated pain, sacroiliac joint injury, CRPS, and central sensitization frequently produce severe, genuine pain with entirely normal imaging. A normal scan means the answer lies elsewhere — not that there is no answer.
Then the diagnosis deserves to be revisited. Prolonged treatment without improvement usually means the actual pain generator was never identified. Repeating an ineffective treatment for longer is not a plan.
Find out what's actually causing your pain.
A precise diagnosis is the beginning of a real solution. Let’s find your pain generator — and treat it.
This page is provided for general educational purposes and does not constitute medical advice, diagnosis, or treatment, nor does it create a physician-patient relationship. Individual results vary, and no specific outcome is promised or guaranteed. Radiation-reduction figures reflect National Pain Centers’ own procedural dose data compared with conventional continuous-fluoroscopy technique. Certain regenerative therapies are considered emerging or investigational and are not FDA-approved for all uses. Always consult a qualified physician regarding your medical condition. If you are experiencing a medical emergency, call 911.