Live Life Better

ECPC Apex Interventional Pain and Spine

Dr. Brian Keogh and Dr. Jose Avila are expert, board-certified interventional pain medicine physicians available to evaluate and treat your painful condition. Our highly skilled team includes Ali Elios, PA-C, Christine Koenig, FNP, DNP, April Bailey, PA-C and Kiara Yak, PA-C. We are proud to provide a customized, patient-centered, interventional approach to pain management, which allows us to give you the optimal care for your specific needs.

We can treat almost any painful condition, including but not limited to back and neck pain, radiculopathy, sciatica, degenerated discs, herniated discs, failed back surgery syndrome, complex regional pain syndrome (CRPS), vertebral compression fractures, diabetic neuropathy, neuropathic pain, fibromyalgia, myofascial pain, headaches and migraines, thoracic outlet syndrome, and arthritis and sports injuries.

We offer innovative, non-surgical and interventional pain treatment options designed around the underlying cause of your pain. Our physicians are highly skilled in a wide range of treatment options, including epidural steroid injections, cervical selective nerve root blocks, cervical medial-branch blocks, facet-joint injections, sacroiliac-joint injections, spinal cord stimulation, and therapeutic radiofrequency ablation. We also offer sympathetic-nerve blocks, trigger-point injections, bursitis injections, platelet-rich plasma (PRP) injections, prolotherapy, and pain medication management.

For selected patients, we also offer advanced and minimally invasive treatments including knee genicular nerve blocks for knee pain, Kyphoplasty for painful vertebral compression fractures, the MILD® Procedure for certain patients with lumbar spinal stenosis, and the Intracept® Procedure for appropriately selected patients with vertebrogenic low back pain. We also offer BOTOX® for Chronic Migraine as a preventive treatment for appropriately selected patients with chronic migraine, as well as Celiac Plexus Blocks for certain types of abdominal and visceral pain.

We know how debilitating a painful condition can be and the ways it can impact your relationships, work, activities and enjoyment of life. We promise to provide you with a compassionate, evidence-based pain management experience so you can get back to what matters most. We feel privileged to serve you and look forward to helping you on your road to better health.

Our Services

  • Flouroscopy Or Ultrasound Guided Spinal Injections
  • Neuromodulation
  • Other Injection Therapies
  • Implantable Technologies
  • Medical Management
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Conditions We Treat

This is a small sampling of the conditions we treat.

Neck Pain

Neck pain occurs in people of all ages and can come from bad posture, sleep position, ruptured discs, torticollis, and more. Good neck health includes practicing good posture, standing often if you sit a lot at work, sleeping in a healthy position, and being active. Symptoms of neck pain includes tightness and stiffness in the neck, the inability to turn the head, constant headaches, and numbness, weakness, or pain in or around the neck.
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Knee Pain

Knees are a very important part of your body and are subject to wear and tear over the years. Arthritis is a large cause of knee pain. If the orthopedic doctors can’t offer you a surgery, ECPC doctors can provide steroid injections or genicular nerve ablations.
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Back and Leg Pain

Intense back pain with extension to the legs and feet that is described as burning and throbbing often indicate a herniated disc. Riding in a car and sitting in a hard chair can greatly increase this pain. If physical therapy and conservative measures do not improve pain, you may benefit from an injection in your spine to decrease the inflammation. Visit an ECPC pain specialist and find a treatment plan that works for you.
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Cancer Pain

Some people who are diagnosed with cancer don’t experience any pain related to the cancer itself, but some do. Cancer pain can vary depending on the type of cancer you have, the type of treatment you are receiving, and even what part of the body it is affecting.
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Back Pain

At some point or another, most people will suffer from lower back pain, whether it be from age, an injury, or from an activity. There are many things you can do to relieve back pain, from stretches, medications, and heating pads. You can also change your habits to prevent future injuries. Things like exercising regularly, eating better, and avoiding bad habits like smoking can keep you from getting injured. Being active and working out help keep your body and muscles moving, making strains and tears less likely.
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Muscle Pain

Muscle pain is a common issue that can occur anywhere in your body. Muscle soreness of knots can be triggered by dehydration, fatigue, stress, and over-exercising.. To prevent muscle tension, it is important to drink plenty of water and stretch before working out or being active. Persistent muscle pain despite conservative treatments may be improved with trigger point injections.
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Headaches/Migraines

Headaches are painful episodes that can completely incapacitate someone. Increasingly painful headaches that last for hours or days are known as migraines. Migraines can make you nauseous, sensitive to sound or light, and are typically specific to one side of your head. Generally, migraines are genetic and run in families. Headaches are typically categorized into two types — primary and secondary.
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Complex Regional Pain

Complex Regional Pain Syndrome is a condition that can affect your legs, feet, arms, or hands. This condition is typically caused by problems in the central nervous system, and usually develops after an injury, surgery, or heart attack, and is most commonly found in women around 40 years old. Symptoms of Complex Regional Pain Syndrome can include a burning or intense pain, pain throughout an entire limb, sensitivity to touch, swelling, stiff or achy joints, or even involuntary jerking.
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Diabetic Peripheral Neuropathy

Diabetic peripheral neuropathy is a painful condition that often affects the nerves in the feet and legs. When blood sugar gets too high, the nerves in your body can become injured causing diabetic peripheral neuropathy.
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Fibromyalgia

Fibromyalgia is a condition that can cause fatigue, pain, or tenderness in various muscles. Typically, fibromyalgia can lead to additional conditions, including arthritis, lupus, and IBS. Normally triggered by stress, fibromyalgia can be dealt with by reducing anxiety/stress and exercising frequently.
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Meralgia Paresthetica

Meralgia paresthetica is described as burning pain, tingling, or numbness in or around your outer thigh. This condition occurs when the lateral femoral cutaneous nerve is squeezed or compressed. This nerve can become compressed from tight clothing, obesity, pregnancy, or having scar tissue that occurs from injuries. Treating meralgia paresthetica depends on how damaged the nerves are and the symptoms that it causes. When symptoms occur, they are typically only on one side of the body, and can start off mild and worsen over time.
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Sacroiliac Joint

The sacroiliac joints are located where the spine and pelvis meet. Sacroiliac joint pain can cause stiffness and pain in the lower back and legs and is often mistaken as pain from a herniated disc. Typically, standing or sitting for too long can make the pain even worse. This pain can occur from arthritis, pregnancy, or injury/infection in the sacroiliac joints.
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Shingles Pain

Shingles is an itchy, painful rash that occurs on a single side of the face or body. The rash typically shows up as scabbed over blisters. Shingles is most common in older adults but can affect anyone who has had chicken pox. Once someone has had chicken pox, the virus stays in the body and can potentially reactivate and develop into shingles. Similar to chicken pox, once a person has shingles, it is likely they will never get it again. Shingles is not contagious, but it is possible to pass it on to someone who has never had the chicken pox or the chicken pox vaccine.
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Trigeminal Neuralgia

Trigeminal Neuralgia is a type of neuropathic condition that causes facial pain from the trigeminal nerve. Typically occurring on one side of the face, symptoms include pain that can last from a few seconds to multiple minutes. Trigeminal neuralgia is often random but can be brought on by face injuries or dental surgeries. Other known causes include blood vessels and nerves contacting, causing the nerve to be exposed and sensitive. Many times, trigeminal neuralgia shows up with sudden and extreme burning or stabbing facial pain. The other type of pain that can occur is more dull but still sore.
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Neck Pain

Knee Pain

Back and Leg Pain

Cancer Pain

Back Pain

Muscle Pain

Headaches/Migraines

Complex Regional Pain

Diabetic Peripheral Neuropathy

Fibromyalgia

Meralgia Paresthetica

Sacroiliac Joint

Shingles Pain

Trigeminal Neuralgia

Patient Testimonials

"I have been coming here for a month now and the staff are amazing! They are very nice, caring, kind, sweet and so supportive! They all actually really care and want to help and do the best for you in your situation and medical conditions! Can’t say enough good things about every single person who works there! I will def be with them forever! I promise you won’t be sorry for picking ECPC for your pain and medical care! "

Patient Testimonials

"My husband and I both see Ali and we love her expertise, compassion, professionalism and courtesy so much. Highly recommend everyone here! The staff is also so wonderful as well."

Patient Testimonials

"The staff are so kind, they are always there to help me in any way I need. I travel 1 hour 10 minutes just to see them. Thank you so much, I could not walk without your help."

Patient Testimonials

"THE BEST OF THE BEST!"

Patient Testimonials

"One day I was having such a bad time with my sciatic nerve and I found ECPC and decided to call. When I got there he was welcoming and treated me so kind. All the staff was great. These people had care for me and my pain in such incredible way. Thank you all for helping me. If you’re in pain you should really call ECPC. God bless you all."

Contact ECPC Apex

1001 West Williams Street, Suite 103
Apex, NC 27502

(919) 439-7867

Hours:

Monday - Thursday 8:00am - 4:00pm
Friday 8:00am - 3:00pm
Fax: 919-573-9594

    Our Providers

    • Brian H. Keogh, Jr., MD, FAAPMR

      • Brian H. Keogh, Jr., MD, FAAPMR

      BOARD CERTIFICATIONS
      • American Board of Physical Medicine and Rehabilitation / Pain Medicine Subspecialty Certification
      • Subspecialty Certified in Pain Medicine
      EDUCATION
      • Emory University School of Medicine, Atlanta, GA, Fellowship in Pain Medicine, 2015
      • Indiana University School of Medicine, Indianapolis, IN, Residency in Physical Medicine and Rehabilitation, 2014
      • University of Colorado School of Medicine, Aurora, CO, Internship in Internal Medicine, 2011
      • University of Colorado School of Medicine, Aurora, CO, Doctor of Medicine 2010
      • University of Northern Colorado, Greeley, CO, Bachelors of Science 2004
    • Ali Elios, PA-C

      • Ali Elios, PA-C

      BOARD CERTIFICATIONS

      • Board Certified Physician Assistant

      EDUCATION

      • Nova Southeastern University, Masters in Medical Science
      • Florida State University, BA in Biology
    • Kiara Yak, PA-C

      • Kiara Yak, PA-C

      BOARD CERTIFICATIONS

      • Board Certified Physician Assistant

      EDUCATION

      • High Point University, Masters of Physician Assistant Studies
      • Montclair State University, BA in Athletic Training
    • Jose G. Avila-Calles, MD, PhD

      • Jose G. Avila-Calles, MD, PhD

      BOARD CERTIFICATIONS

      • Board Certified in Anesthesiology

      • Subspeciality Board-Certified in Interventional Pain Medicine

      EDUCATION

      • Emory University School of Medicine, Atlanta GA, Fellowship in Pain Medicine

      • Emory University School of Medicine, Atlanta GA, Residency in Anesthesiology

      • University of Alberta, Edmonton, Canada, Ph.D. in Experimental Transplant Surgery

      • Imperial College London, UK, Master’s in Surgical Sciences

      • University of Zulia School of Medicine, Venezuela, Doctor of Medicine 1997