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Pain management

Water's Edge is a unique medical facility that offers a wide range of services to provide a comprehensive solution to manage chronic pain. Water's Edge provides nearly 10,000 square feet of modern offices, exam rooms and procedure rooms for pain treatments. A relaxing waiting area furnished with comfortable reclining chairs allows patients to contemplate the peaceful waters of Yakima's Lake Aspen while they await their procedures.

Our approach

Many Americans have worked hard and played hard during their lives. It is not unusual for farmers, ranchers and others whose livelihood involves physical activity to suffer chronic pain resulting from work-related accidents and other stresses. Others may experience pain from recreational injuries, surgery, diabetes, lifestyle choices, and other causes.

When pain sufferers seek relief, they often think of the immediate cessation of pain available from various medications, but at Water's Edge, our physicians and staff take a broad, multidisciplinary approach to managing many different types of pain. Our goal is to conduct a thorough examination to identify the root cause of your pain and through a variety of approaches, treat the cause, not just the symptoms of that pain.

Our approach to pain care is comprised of five basic elements.

Medication management

Oral medication

At Water's Edge we use a variety of oral medications, including both narcotic and non-narcotic medications to treat chronic pain. However, sometimes routine oral medications can cause side effects, such as upset stomach or inability to focus, and can result in additional problems for patients. Our goal is to identify a multi-faceted approach to reducing pain. This may include oral medications used in conjunction with procedures or rehabilitation to reduce the dosage and frequency of prescribed oral medications.

Injected medications

Some medications can be injected near or into the spine, muscles, joints and soft tissues. Injections allow the medications to enter target areas more quickly, and often with fewer side effects than oral medications.

Some injection therapies include:

  • Local anesthetics and corticosteroids injected between vertebrae into the space around the spinal cord to treat neck, shoulder, arm, leg, and back pain.
  • Local anesthetics and steroids injected into facet joints between vertebrae to treat neck and back pain due to spinal injuries.
  • Local anesthetics and steroids injected into the sacroiliac joint connecting the bottom of the spine with the pelvis for low-back and buttock pain.
  • Local anesthetic injected to block the sympathetic nerves along the spine to reset the cycle of devastating arm and leg nerve pain.
  • Medicine injections into various large and small joints can improve the discomfort caused by arthritis
  • Trigger-point medication injections can be performed to treat muscle and soft tissue pain.
  • For inoperable cancer or back pain, Water's Edge can implant pain pumps to put painkillers and anti-spasm products directly into the spinal fluid.

Medication injections can be used for treatment as well as diagnostic purposes. For instance, if a local anesthetic injected into a facet joint causes an immediate cessation of pain, then doctors can more accurately diagnose the source of a patient's pain.

In order to maximize patient safety and compliance, our physicians monitors medication use with urine/blood screens, patient/provider contracts, pharmacy checks, pill counts and other measures. Patients must take medications only as prescribed or seek help from another provider.

Our goal is to find a holistic approach to managing pain that reduces the need for regimented medications.

Rehabilitative therapy

The goal of pain management is to help the patient return to the highest level of function and independence possible, while improving the overall quality of life - physically, emotionally and socially. Rehabilitation is a key element in helping patients return to their normal lives. Used alone or in conjunction with other pain management approaches, rehabilitation therapies can assist in reducing the suffering experienced by a person with chronic pain.

In order to help reach these goals, rehabilitative pain management programs are customized to each patient. They may include the following:

  • A functional capacity evaluation to determine work ability and assess needs for further patient conditioning.
  • Coping-skills training to teach stress reduction, interpersonal skills, and reduce the use of illness as a way of coping.
  • Education to teach the causes of pain and the behaviors that are likely to make it better or worse.
  • Psychotherapy to reduce depression, anxiety, anger or other emotions which increase pain.
  • Vocational counseling to assist re-entry into the job market.
  • Occupational therapy to improve performance of tasks at home and at work.

Rehabilitation therapies help doctors find a holistic solution to pain management that can reduce the dependence on drug and procedure therapies.

Adjunctive or alternative approaches

At Water's Edge, our approach to pain management is to look at all available treatments to find a holistic, multidisciplinary approach to managing chronic pain. Some patients seek out alternative or adjunctive therapies when conventional medicines have failed. Others find alternative medicines to be more congruent with their own values, beliefs, and philosophical orientations toward health and life. At Water's edge we marry traditional therapies and alternative therapies to find the best solution for each individual patient.

Some alternative or adjunctive therapies include:

  • Anti-depressant medications.
  • Antiepileptic medications.
  • Mind-body therapies (relaxation, meditation, guided imagery, and hypnosis).
  • Acupuncture.
  • Chiropractic treatment and massage.
  • Therapeutic touch and reiki healing.
  • Dietary approaches to treating pain.
  • Nutritional supplements.
  • Herbal remedies.

Lifestyle choices clinic

Logically, most people understand that anything in excess is not likely to be healthy. However, sometimes it's difficult to apply that logic to our lifestyles. Too much alcohol, caffeine, nicotine, or even too much activity can have negative effects on our bodies. On the other hand, a lack of exercise, not getting outdoors in the sunlight, or eating unhealthy foods can also wreak havoc on our lives.

The Lifestyle Choices Clinic at Water's Edge was developed to help those with chronic pain related to their lifestyle find resources to help manage that pain.

Some lifestyle choices that can help you better manage your chronic pain are listed below.

  • Eating a healthy and nutritious diet improves the chemical balance in the body and allows for better reception of pain management therapies.
  • Drinking plenty of water and keeping the body hydrated helps reduce stress to muscles, tissue, and other parts of the body.
  • Exercise increases endorphins which can mask the perception of pain and create an overall feeling of wellness.
  • Getting outdoors in the fresh air and sunlight can increase the body's production of vitamin D, which has been found to be lacking in some pain patients.
  • Avoiding excessive alcohol, nicotine and caffeine can help improve sleeping habits and reduce stress on the body.
  • Faith, prayer, and meditation have been found to help people better handle the physiological aspects of pain.

The Lifestyle Choices Clinic can help you find ways to incorporate good life style choices into your daily life. For more information, call 509.574.3805.

Education is the key that ties all of these elements together. We teach people how to manage their pain so they can lead normal, balanced lives.

Water's edge is a referral-based practice. We work closely with your primary care physician to understand any underlying medical conditions that might effect your treatment. A referral is required to be treated at Water's Edge. Talk to your doctor to see if our services are right for you.

Our treatments

For neck and arm pain:

  • Cervical Interlaminar Epidural Steroid Injection.
  • Cervical Transforaminal Epidural Steroid Injection.
  • Cervical Selective Nerve Root Block.

For chronic neck pain and headache:

  • Cervical Facet Injection.
  • Cervical Medial Branch Block.
  • Cervical Radiofrequency Ablation (RFA).

For diagnosing disc pain:

  • Discography.

For diagnosing disc pain in the low back and leg:

  • Lumbar Discography.

For low back and leg pain:

  • Lumbar Caudal Epidural Steroid Injection.
  • Lumbar Interlaminar Epidural Steroid Injection.
  • Lumbar Transforaminal Epidural Steroid Injection.
  • Lumbar Selective Nerve Root Block.

For chronic low back pain:

  • Lumbar Facet Injection.
  • Lumbar Medial Branch Block.
  • Lumbar Radiofrequency Ablation (RFA).

For chronic low back and buttock pain:

  • Sacroiliac Joint Injection.

For upper and middle back pain:

  • Thoracic Interlaminar Epidural Steroid Injection.
  • Thoracic Transforaminal Epidural Steroid Injection.
  • Thoracic Selective Nerve Root Block.

For chronic upper and middle back pain:

  • Thoracic Facet Injection.
  • Thoracic Medial Branch Block.
  • Thoracic Radiofrequency Ablation (RFA).

Other services:

  • Sympathetic and Stellate Ganglion Blocks.
  • Epidural Lysis of Adhesions (RACZ procedure).
  • Spinal Cord Stimulators.
  • Intrathecal Pain Pumps /Baclofen Pumps.
  • Psychological Counseling.

Meet Our Physicians

Henry Kim, MD

  • Board certified in Physical Medicine & Rehabilitation and in Pain Medicine
  • Trained at Loma Linda University for Residency and Fellowship
  • Initially completed residency in Internal Medicine and practiced at Sharp Rees-Stealy in San Diego, CA as an Internist.
  • Then went back and completed a residency in PM&R and fellowship in Anesthesia Pain
  • Prior to Yakima, Dr. Kim was Director of Spine Clinic at Kaiser Foundation Rehabilitation Center, Vallejo, CA

Joe Kim, MD

  • Board certified in Anesthesiology and Pain Medicine
  • Residency at Columbia Presbyterian Hospital, New York and fellowship training completed at Johns Hopkins, Baltimore
  • Clinical interests include neuro-modulation, lifestyle education in the prevention and recovery of chronic pain
  • Can perform advanced procedures such as CT guided injections and chemical ablations (phenol)

Daniel Kwon, MD

  • Board certified in Physical Medicine & Rehabilitation and in Pain Medicine
  • Trained at Loma Linda University for Residency and Fellowship
  • Previously worked in Palm Springs (private practice) and Loma Linda University as an assistant professor
  • Interest in intra-thecal therapies (implanted pumps) and spinal cord stimulators
Position currently open

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Advanced Practice Providers

  • Julie Carlton, PA-C

  • Wayne Clark, ARNP

  • Caroline Clark, ARNP (part-time)

  • Jeff Cowman, PA-C

  • John Brisson, PA-C