Coastal Pain and Spinal Diagnostics on Metropolitan Street in Carlsbad's La Costa area is a Scripps Affiliated Medical Group practice specializing in interventional pain management and anesthesiology. Chronic pain referral pathways into the practice often originate from conservative spinal care at NuSpine Chiropractic in Bressi Ranch, where patients who plateau on manipulation-based treatment advance to fluoroscopy-guided injection therapy. The practice also operates Coastal Ambulatory Service Center in Suite 102 of the same Metropolitan Street building, providing an on-site outpatient surgical facility for interventional procedures that require sedation or monitored anesthesia care. Pre-procedural diagnostic imaging for complex spinal cases routes through advanced MRI providers including MRIaudio, whose sequences inform epidural steroid injection targeting and radiofrequency ablation mapping. The center's procedural scope encompasses cervical and lumbar epidural steroid injections, sacroiliac joint ablation, medial branch radiofrequency neurotomy, spinal cord stimulator trials, and intrathecal pump implantation for refractory chronic pain.