At SWCA, we believe the best results come from mutual trust between physician and patient. Our team of Double Board-Certified physicians aims to put their extensive knowledge and combined years of experience towards helping you get back to being you. All of our patients can achieve optimum health with the right support system.



SWCA is a world-recognized team of spine experts offering revolutionary, professional, and effective healthcare. We specialize in minimally invasive treatments and our innovative practices are geared towards your health and wellness. From sophisticated and cutting-edge options to treat pain and optimize function to individualized treatment plans, SWCA looks forward to being a part of your healthy lifestyle. 

With the beautiful sunshine and mild Winters, athletics in Miami seem to run year round. But with the good, can come the bad. And this constant bend towards athleticism, can wreak havoc on our muscles and joints. We’ve all often heard of tennis elbow and golfer's elbow, but what is the real difference? And, what can be done so we can get back to our winning streak?

Tennis elbow involves pain in the dorsal aspect of forearm, usually involving the extensor carpi radialis brevis tendons at the lateral epicondyle. But it can also originate from the extensor carpi radialis longus tendons.

Golfer’s elbow involves pain in the medial aspect of the forearm near the elbow and usually involves the flexor carpi radialis but can also originate at the flexor carpi ulnaris tendons. To add further complications, bursitis may also accompany both tennis elbow and golf’s elbow.

A visit to your doctor will start with a conversation regarding your pain and physical examination. Your doctor may start a course of anti-inflammatory medications, ice, and/or injections. The risks of these injections, like all injections, include bleeding, infection, and mild pain at the site. Your doctor will be performing injections under sterile precautions. Another risk is possible tendon rupture or nerve damage, so making sure you are in the right hands matters.

The most common injection involves steroid and local anesthetic, but plasma rich platelets (PRP), or regenerative medicine may also be possible. Insurance coverage differs on these injections, so you should speak to your doctor ahead of the injection to be aware of the cost.

Dr. Josephine Clingan is Double Board-certified in Anesthesiology and Pain Medicine in Miami, Florida. Her office is located at 3661 South Miami Ave., Suite 1008, Miami, FL 33133.

To make an appointment with Dr. Clingan please call our offices 305.974.5533.

For anyone experiencing chronic back pain, our Intracept Procedure has provided much-needed relief. The Intracept Procedure is a minimally invasive solution that targets the basivertebral nerve in order to ease suffering from back pain.

You may not have heard of this nerve, but it’s a big part of what makes this treatment so unique. The basivertebral nerve is responsible for transmitting back pain signals from the vertebral endplates.

The procedure is favored by many because it doesn't involve an implant or structure of the spine. And even more appealing? The procedure provides almost instant and long-lasting relief.

The procedure itself is very simple. A small incision (3-5mm) is made for access instruments to reach the basivertebral nerve where heat from radiofrequency energy is applied in order to stop the transmission of pain signals.

This treatment is very different from other heat treatments as ours specifically target the basivertebral nerve - and it is important to note that no other treatments have proven long-lasting results.

Ideal patients are those who have suffered from chronic back pain for 6 months or more and have been responsive to other care. They also will show Type 1 or Type 2 Modic changes at L3 through S1 on an MRI. Your physician can better evaluate if you are a candidate for this procedure, which is performed in under two hours.

Most patients resume normal activities after just a week or two, which is far less recovery time than any form of surgery. You don’t have to let chronic back pain hold you back from your daily activities any more.

To learn more ask one of our team members at any of our 12 locations or contact us for an appointment to see if you qualify for Intracept Procedure today at 305.974.5533. 

There are an unfortunate amount of issues that can be responsible for chronic back pain - but also a growing number of solutions. Spinal arthritis is one of these conditions that cause people to have intense chronic back pain, and we use the revolutionary Radiofrequency Ablation to treat it.

Spinal arthritis can be classified as inflammation of the facet joints in the spine and also as the sacroiliac joints that lie between the spine and pelvis. This form of arthritis can be attributed to infections, autoimmune disorders, or other conditions, or simply just from natural wear and tear-of the body. Arthritis can appear anywhere along the spine, but most sufferers report pain in the lower back and neck. There are many painful symptoms of spinal arthritis, but the most common besides back and neck pain are stiffness, loss of flexibility, a grinding feeling when moving, swelling, headaches, or numbness. The most common form of spinal arthritis is Osteoarthritis which is caused by the cartilage from the joints breaking down over time, stimulating inflammation and pain.

The strain from the cervical thoracic lumbar spine is another condition that can be associated with axial cervical thoracic spine pain and difficulty with range of motion. This is usually developed because of degeneration of the joints, but also from outside forces such as injuries from a car accident or fall. The degenerative changes usually happen in older patients, but anyone can suffer from axial back pain, including young people who have had acute injuries. This modality fortunately is very treatable and manageable, improving quality of life and making you more functional.

Although it sounds complex, there’s actually a very simple solution to treating the pain caused by spinal arthritis. Radiofrequency ablation (RFA) is a minimally invasive way of reducing the nerve’s ability to transmit pain. It is an extremely safe and effective way to stop pain, and has been approved by the FDA. It’s an outpatient procedure with only 1-2 days of downtime, and we can perform it right here in our office.

An important aspect of the procedure is the Medial Branch Block (MBB), which helps your physician to diagnose the root cause of your chronic back pain in order to see if RFA will be effective. A medial branch block can be performed for the diagnosis as well as treatment of pain from the joints. The MBB involves the injection of a local anesthetic near the medial branch nerves to temporarily block the pain signal.

Dr. De La Peña will perform an MBB to decide if you’re a viable candidate for this procedure, and if so, you’ll be able to continue on to Radiofrequency ablation. After local anesthesia a special needle is injected at the site of the inflamed nerves. An electrode is then sent through the needle before a heat current is generated to warm the area to about 80 degrees Celcius in order to cauterize the pain nerves. Each injection site takes about 2-4 minutes and the procedure itself, under two hours. Once the nerves are cauterized, they are no longer able to transmit pain.

If Dr. De La Peña decides that RFA is a logical treatment for your condition, you’ll be in good company - almost 70% of patients in a clinical study reported good to excellent relief from their back pain. You can expect that relief to last anywhere from 6 months to a year, and in some cases, multiple years. Recovery time is also much less than surgical methods of reducing pain. RFA is proven to be safe and effective in helping patients ease pain and increase their mobility.

Patients who have had a variety of conditions are encouraged to apply. If you’re experiencing back pain or difficulty in range of motion from a laminectomy, you may be a great candidate. Patients feeling pain from fusions are also great candidates for this safe procedure.

Has your back pain gotten to a point of excruciating? We want to help you. Contact us at 305.974.5533 today for a consultation and how we can help you feel like your best self.