Carpal Tunnel Syndrome
Carpal tunnel syndrome is a common problem that affects the use of your hand, and is caused by compression of the median nerve at the wrist. It most often occurs when the median nerve in the wrist becomes inflamed after being aggravated by repetitive movements.
Our providers offer conservative and surgical options.
Independent Medical Examination
With great care and detail we perform Impairment Ratings (IR) if you have a permanent impairment from an injury. We also conduct Independent Medical Examinations (IME) providing a knowledgeable, unbiased opinion on the injury.
Cerebral Spinal Fluid Shunt System
Insertion, repair, or removal of Cerebral Spinal Fluid Shunt Systems.
Electrodiagnotic Studies (EMG/NCS)
Nerve conduction studies (NCS) measure the speed in which nerves conduct electrical signals. Electrodes are attached to different positions on the skin's surface and then small electrical currents are applied.
Electromyography (EMG) measures the electrical activity of muscles during movement. A small sterile needle electrode is placed into different muscle areas and the electrical activity is recorded on the electromyograph.
Our providers offer several minimally invasive interventional treatment options for spine pain; epidural steroid injections (ESI), faucet injections, SI joint injections, and medial branch blocks. These may provide an alternative to conventional surgery.
Trigger Point Injections
Trigger Point Injections are used to treat painful areas of knotted muscles. Trigger points can irritate the adjoining nerves leading to pain the surrounding area and sometimes circulating to other parts of the body. The injection is typically successful at relieving the pain.
The ulnar nerve travels from the shoulder to the hand and helps you move your arm, wrist, and hand. The nerve can become inflamed or entrapped from injury, long-term pressure, or repetitive movements. We offer conservative and surgical options.
Physical Medicine and Rehabilitation
Physical Medicine and rehabilitation (PM&R), also known as physiatry or rehabilitation medicine, aims to enhance and restore functional ability and quality of life to those with physical impairments or disabilities affecting the brain, spinal cord, nerves, bones, joints, ligaments, muscles, and tendons. The goal of the physiatrist is to maximize patients' independence in activities of daily living and improve quality of life.
Radiofrequency Ablation (RFA)
Radiofrequency ablation is a minimally invasive procedure that destroys nerve fibers that carry pain signals to the brain. It can provide lasting relief from chronic pain, especially in the low back, neck, and arthritic joints.
Chronic Migraine Management Including Botox
Our providers work together to provide you the best treatment options for your migraines, including lifestyle and home remedies, medications, and injections. BOTOX ® is indicated for headache prophylaxis in adult patients with Chronic Migraine (≥ 15 days per month with headache lasting 4 hours a day or longer).
Botox for Spasticity
BOTOX ® is indicated for the treatment of spasticity in patients 2 years of age and older. It is injected into the affected muscles helping to reduce stiffness and tightness caused by spasticity.
Department of Labor & Industries
Master Lever Therapists Pilot Program for Injured Workers
Available through the office of Robert G.R. Lang, M.D. Inc.
Do you have patients on L&I that just are not recovering but you cannot figure out why? Do you have
patients who cry during their office visits? Or patients who are so frustrated with the system that you
spend the majority of your visits counseling them? If you do, there is assistance available to help…the
Master's Level Therapists (MLT) Pilot Program.
What can MLTs do for my patients?
Help workers overcome obstacles that are impeding their recovery from work-related injury
or illness by providing brief therapy to assist workers with a variety of mental health issues including:
depression, anxiety, anger, frustrations, and addictions.
MLTs may also help workers cope with chronic pain, accept a disability or develop a new normal
that aids in life during the recovery period.
MLTs can also help provide information that may aid in your requests for mental health
evaluations and other referrals (such as behavioral optometrists) and provide workers with assistance in
locating and accessing community resources (such as food and rent assistance).
How do MLTs help workers?
MLTs have a Master's degree in the field of social work and/or counseling. Each referral is
granted 8 initial sessions and an additional 8 sessions may be requested, if needed, to help the injured
worker return to work in a timely manner or aid them in accepting that they may not be able to
return to their previous employment . MLTs use their counseling skills to assist workers in
identifying their own strengths while also educating on skills and resources that assist workers in
coping with chronic pain, frustrations, anxiety, depression, and other issues.
How does a doctor make a referral?
Contact Dr. Lang's office with the worker's name, claim number and reason for therapy
referral. We contact the worker and schedule an appointment either in-person or via tele-health,
whichever is easiest for the worker.
What are the MLTs hours?
Our therapists have a variety of hours available, including evening, daytime, and weekend hours.
Besides seeing workers in the Olympia office, telehealth can be done through most smartphones or laptop
computers via Zoom, Google Duo, FaceTime and other apps. We will explain the systems to the workers
and aid them in using the various apps if an in-person visit is not convenient.