General Practitioners

• Arthritis
• Fibromyalgia
  Inflammation of the joint between hip and lower part of the spine can be associated with back and leg pain. This joint is called the sacroiliac joint and can be irritated by a variety of conditions including spinal deformity, previous spine surgery, and other conditions including fibromyalgia.
• Primary Care
  The most important factor in treatment of this condition is identifying the cause of facial pain. The patient may be seen by their primary care physician and referred to either a neurologist or oral surgeon who can diagnose trigeminal neuralgia.  It is important to confirm the cause of facial pain as blood vessel compression of the trigeminal nerve.  A variety of tests including MRI of the brain may need to be performed to correctly identify the problem.

Ophthalmologists

• Ophthalmology
• Laser Eye Surgery

Neurologists

• Neurology
  Technische Universitat, Berlin Germany, Intensive German language and German medical language training. Accompanying Neurology clinical experience at The Charite’; Humbolt Universitat. Berlin Germany.
• Carpal Tunnel Syndrome
  A nerve pinched in the wrist is called carpal tunnel syndrome. A ligament is pinching the nerve as it enters the hand which causes numbness and tingling in the hand, mostly thumb and index finger, with burning numbness extending backwards into the arm and sometimes neck.  This condition can be worse at night and confused with a pinched nerve in the neck.
• Multiple Sclerosis
  Inflammation of the trigeminal nerve itself caused by problems with the immune system or infections involving the base of the brain may cause facial pain on both sides (MS or multiple sclerosis). A virus can also involve the trigeminal nerve and cause a rash over the face with residual burning pain after the rash and blisters have healed (herpes zoster or shingles).

Psychiatrists

• Depression

Endocrinologist

• Diabetes Care
• Thyroid

Radiologist

• Ultrasound
• MRI
  Excellent Doctor all around, best Neurosurgeon on the island of Oahu, I believe!! Three other doctors said there was nothing wrong with my neck but I showed Dr. Graham my x-ray and MRI and he identified three herniated disc and proposed a surgical solution right away! I’m very grateful as I am was in​ a lot of pain. Read More...
• X-Rays
• Computed Tomography
  Nerve inflammation. Some conditions cause the nerve to become inflamed or swollen which then results in leg pain and/or numbness.  There may not be any evidence of nerve compression on MRI or CT scan of the lower back.
• Radiation Therapy
  Radiosurgery is a technique where high-dose radiation therapy is administered to a section of the trigeminal nerve. This is a technique which intentionally damages the pain fibers and treats the facial pain.  This is referred to as gamma knife therapy which is a same-day awake procedure and involves using local anesthetic to numb the scalp so that a circular frame can be attached to the head with small pins.  The patient undergoes an MRI and CT scan prior to the procedure and the radiation is given while the patient is awake lying on a special bed that positions the head to receive the x-ray dose.  Usually the patient is in the facility for 3-4 hours and the gamma knife treatment lasts about one hour.  This treatment usually takes approximately one month before the facial pain starts to decrease.  The procedure is about 75% successful after 1 year but then gradually the pain can return.  Overall cure rate is about 50-60%.  Often, a second radiosurgery can be given for return of facial pain.

Surgeons

• General Surgery
  General Surgery Internship, under Darryl Hiyama M.D., Charles Chandler M.D. and Carmac Holmes M.D. University of California, Los Angeles (UCLA) Medical Center.
• Sciatica
  Pinched nerve in lower back. The nerves in the lower back exit the spine in pairs and travel down the legs.  If a nerve gets compressed as it exists, this can cause pain radiating down the leg (sciatica) numbness and tingling in the leg, and sometimes leg or ankle weakness.  The location of pain or numbness depends on which nerve is being pinched and on which side.  The usual location of pain travels from the buttocks, down the back of the thigh, to the outside part of the calf.
• Pinched Nerve
  Pinched nerve in the neck. The nerves exit the spinal cord in the neck and travel through openings in the spine which are like tunnels or conduits which contain the exiting nerve.  These nerves exit the spine in pairs and travel into the arms.  If a nerve gets compressed in this tunnel called a foramen, arm pain, numbness, and weakness could develop.  As in the lower back, the location of pain, numbness, or weakness depends on the nerve which is being pinched.  The usual locations of pain travels from the neck down the outside of the arm and into the thumb and index finger.  Associated pain can also be present along the shoulder blade and at the base of the neck.
• Minimally Invasive Surgery
  Micro-decompression (laminotomy/medial facetectomy)-also a minimally invasive surgery using the same size of incision as a microdiscectomy, involves opening the narrow canal or tube that the nerves must pass through to reach the legs. Usually excess arthritic bone is removed from around the nerves to enlarge the spinal canal and relieve the nerve compression.  Disc material may or may not be removed.  Depending on your insurance, this procedure may also be performed as same day surgery or overnight hospital stay.  After surgery care is similar to those patients who undergo microdiscectomy.  This procedure helps relieve the back and leg pain associated with walking and allows the person to walk farther and at a faster pace.
• Neurosurgery
  Dr. Graham is a board-certified neurosurgeon with over 30 years of experience. He has performed over 10,000 neurosurgical procedures and is most qualified to treat your condition. We offer minimally invasive spine, brain tumor, pituitary, trigeminal/ facial nerve surgery, and Gamma Knife radiosurgery. Dr. Graham and his 5 friendly staff members are here to help you!

Plastic Surgeons

• Botox
  Usually medications such as Botox (botulinum toxin) can be injected into the facial muscles and decreased facial spasm results. This medication may last from 3-6 months in reducing the facial spasm before it must be repeated. A side effect is facial weakness with droopy appearance of the face.  Usually a neurologist administers this medication.  Other medications can be given as well to help decrease the abnormal nerve activity.  These medications treat the symptoms but do not treat the cause of the facial spasm.

Dermatologists

• Cyst
• Lesions
  Presentation of “The lateral extracavitary approach for primary single stage decompression, arthrodesis, and instrumentation of thoracic and lumbar lesions: Clinical outcomes in 32 consecutive patients at 1-year” IMAST conference, Banf, Canada July 2005.
• Burns

Physical Therapists

• Physical Therapy
  Once the correct diagnosis is made, a treatment plan can be custom-tailored for each patient based on the current technology available and the lifestyle goals of the individual. Oftentimes spine surgery for back and leg pain will not be necessary. The condition can be treated with physical therapy, steroid injections, and adjustment of activity level.  This treatment is called conservative therapy.
• Frozen Shoulder
• Slipped Disc
• Neck Pain
• Back Pain