Non-Opioid Pain Management in NYC
Most chronic pain does not need opioids to be controlled — it needs the right structure treated directly. Modal Pain Management is an interventional, opioid-sparing practice in Midtown Manhattan, where the first move is finding the source of your pain, not writing a prescription.
Book a ConsultationWhy interventional pain care is opioid-sparing by design
Opioids work by dulling pain perception throughout the entire nervous system. They do not fix the cause, the relief fades as tolerance climbs, and the risks accumulate with every refill. Interventional pain medicine starts from the opposite end. The job of a fellowship-trained pain physician is to identify the exact pain generator — a facet joint, an inflamed nerve root, an entrapped peripheral nerve, a degenerating disc — and treat that structure precisely, under image guidance. When you treat the source, you usually do not need a medication that blankets the whole body.
That is the difference between a clinic that manages pain and one that manages prescriptions. Dr. Alex Movshis is dual board-certified by the American Board of Anesthesiology in Anesthesiology and Pain Medicine and completed an ACGME-accredited interventional pain fellowship at the Icahn School of Medicine at Mount Sinai. Every injection is performed with fluoroscopic or ultrasound guidance for accuracy.
What "non-opioid" means here — and what it doesn't
Being opioid-sparing is not an ideology that withholds care. It is a clinical default. The overwhelming majority of patients at Modal are treated without any opioid prescription, because the interventional tools resolve the pain that opioids would only have masked. There remain narrow, honest exceptions — a short course after a specific procedure, or a monitored role in select cancer and palliative situations — where a short-acting opioid is the appropriate choice. What this practice does not do is start patients on open-ended, escalating opioid regimens. If chronic opioid therapy is genuinely the right path for your case, Dr. Movshis will tell you directly and help coordinate that care.
The non-opioid tools we actually use
These are the treatments that do the work in an opioid-sparing practice. Each targets a specific kind of pain generator:
- Epidural steroid injections — for radiating nerve pain from a herniated disc or spinal stenosis.
- Medial branch blocks and radiofrequency ablation — for facet-joint pain in the neck and back, with ablation extending relief for months.
- Nerve blocks — to interrupt a specific peripheral or occipital nerve driving the pain.
- Trigger point injections — for myofascial pain and muscle knots.
- Platelet-rich plasma (PRP) — for select tendon and joint conditions.
- BOTOX (neuromodulator) therapy — for chronic migraine under the PREEMPT protocol.
- Physical therapy and non-opioid medication — anti-inflammatories and neuropathic agents that address the mechanism rather than blunting perception.
Conditions managed without opioids
The same opioid-sparing approach applies across the conditions seen most often at the practice: chronic back pain, sciatica, neck pain, headaches and migraines, joint pain, and nerve pain including peripheral nerve entrapment and post-surgical nerve pain. Each is evaluated to identify the pain generator before any treatment begins.
What the first visit looks like
The consultation is diagnostic, not a medication conversation. Dr. Movshis reviews your history and any imaging, examines you to localize the pain, and explains which structure is most likely responsible and which targeted treatment fits. If a diagnostic block would clarify the source, that is planned. You leave with a specific interventional plan and a clear sense of what relief to expect — and from which procedure. The office is at 369 Lexington Avenue, Floor 25, in Midtown Manhattan (NYC 10017), steps from Grand Central, and same-week appointments are routinely available.
Non-Opioid Pain Management — FAQ
Modal Pain Management in Midtown Manhattan (369 Lexington Avenue, Floor 25, NYC 10017) is an interventional pain practice built around opioid-sparing treatment. The default plan is image-guided injections, nerve blocks, radiofrequency ablation, physical therapy, and non-opioid medication — not a prescription pad. Opioids are not the product here. Call (646) 290-6660 or book a visit.
For most chronic pain, yes. Opioids blunt the perception of pain everywhere in the body and lose effectiveness over time as tolerance builds. Interventional pain medicine works differently: it finds the specific structure generating the pain — a facet joint, a compressed nerve root, an irritated peripheral nerve — and treats it directly with a targeted injection, a nerve block, or radiofrequency ablation. That is why a fellowship-trained pain physician can resolve pain that opioids only masked.
The practice is opioid-sparing by design, and the great majority of patients are managed without any opioid prescription. There are narrow situations — a short course after a specific procedure, or a carefully monitored role in select cancer or palliative cases — where a short-acting opioid is appropriate. What Modal does not do is run an open-ended, escalating opioid model. If long-term opioids are the right answer for your situation, Dr. Movshis will say so and coordinate care rather than simply continuing prescriptions.
For mechanical and nerve-related back pain, the evidence-backed options include epidural steroid injections for radiating nerve pain, medial branch blocks and radiofrequency ablation for facet-joint pain, trigger point injections for myofascial pain, physical therapy, and non-opioid medications such as anti-inflammatories and neuropathic agents. The right combination depends on which structure is generating the pain, which is what the first visit establishes.
Often, yes — and frequently better than opioids, which tend to underperform for neuropathic pain specifically. Nerve blocks can interrupt the pain signal and, when a block confirms the source, radiofrequency ablation can extend relief for months. Conditions such as peripheral nerve entrapment and post-surgical nerve pain are managed this way at Modal without reliance on opioids.
Modal Pain Management accepts most major commercial PPO plans, including Aetna and Cigna, for consultations and interventional procedures. Benefits are verified before your visit at no charge. The practice does not accept Medicare, Medicaid, HMO plans, or workers' compensation. See the insurance page for the full list.