813-533-6259 ✉ breakthrupain@gmail.com   

Breakthru - Acute Pain & Ketamine Clinic in Channelside, Tampa, FL

“Challenges are what make life interesting and overcoming them is what makes life meaningful.” ~ Joshua J. Ma

Peripheral Neuropathy can negatively impact a patient’s everyday quality of life, as well as socially and psychologically. Neuropathic pain can have a variety of causes such as traumatic injuries, infections, metabolic problems, or inherited causes. Typically, the nerves are damage outside the brain and spinal cord (peripheral nerves), often causing weakness, numbness, and pain in hands and feet. It can also affect other areas of the body.

What are some signs and symptoms?

  • Sharp, jabbing, throbbing or burning pain

  • Muscle weakness

  • Gradual onset of numbness, prickling or tingling in feet or hands

  • Pain during activities that shouldn’t result in pain

  • Extreme sensitivity to touch

What is the step-wise approach for treatment?

A comprehensive step-wise approach is used for the management for Neuropathic Pain with the best practices and treatment guidelines. Dr. Kalava can determine the best plan tailored to your needs and guide you through this effective treatment process at any stage in the step-wise process.


Approximately 4 to 6 Weeks

  • TCAS (Tricyclic Anti- Depressants)

  • SNRIs (Seraotonin - Norepinephrine Reuptake Inhibitors)

  • Gabapentanoids

  • Topicals (Focal NP) ~ Cream or Patch

    If Patient’s Response is inadequate move to STEP 2

STEP 1



Approximately 4 to 6 Weeks

  • Tramodol

  • Combination with Treatment 01 Therapies

If Patient’s Response is inadequate move to STEP 3

STEP 2



Approximately 4 to 6 Weeks

  • SSRIs (Selective Serotonin Reuptake Inhibitors)

  • Anticonvulsants NMDA Antagonists

  • Interventional therapies

If Patient’s Response is inadequate move to STEP 4

STEP 3




In Office Trial

  • Neuromodulation ~ Peripheral Nerve Stimulation

    (Learn More)

    • Greater than 50% pain relief during trial prior to implant

If Patient’s Response is inadequate move to STEP 5

STEP 4




In Office Trial

  • Neuromodulation ~ Peripheral Nerve Stimulation

    (Learn More)

    • Greater than 50% pain relief during trial prior to implant

If Patient’s Response is inadequate move to STEP 5

STEP 5



  • Targeted Drug Therapy

  • Greater than 50% pain relief prior to implant

STEP 6