- Epidural steroid injections
- Epidural steroid injection (ESI)
- Transforaminal lumbar epidural steroid injection (TFESI)
- Facet joint injections
- Median branch nerve block
- Radiofrequency ablation
- Trigger point injections
- Bursa injections
- Joint injections
- Sacroiliac joint injections
- Intrathecal Pump Therapy – delivers small, targeted doses of medication directly to the spinal fluid for pain and cancer relief.
- Neuromodulation – treats chronic pain relief through the alteration of nerve activity for relief of pain either through electrical stimulation or medication administered directly to a target site by means of implanted devices.
- Spinal cord stimulator
- Dorsal root ganglion stimulator
- Peripheral nerve stimulation
- Lumbar muscle stimulator Reactive
- Minimally invasive lumbar compression
- Cancer pain relief (celius plexus block, lumbar sympathetic plexus block and glangion of impar block)
Minimally Invasive Spine Surgery (MISS)
MISS is the latest advanced technology available to perform spinal surgeries through small, less than one inch long, incisions. It involves the use of special surgical instruments, devices and advanced imaging techniques to visualize and perform the surgery through such small incisions. MISS is aimed at minimizing damage to the muscles and surrounding structures.
Common minimally invasive spine surgeries include:
- Disc decompression
- Lumbar disc decompression surgery – treats compressed nerves in the lower (lumbar) spine
- Cervical disc decompression surgery – removes any structures compressing the nerves in the neck
- Lumbar fusion
- Anterior lumbar fusion – uses an anterior (front, through the abdominal region) approach to fuse (mend) the lumbar spine bones together
- Lateral lumbar fusion – treats disc problems in the low back, joining two or more bones of the spine to stop painful motion, decompress pinched nerves, and correct scoliosis
- Posterior lumbar fusion – mending two or more lumbar spine bones together along the sides of the bone
- Sacroiliac joint fusion
- Disc replacement to relieve neck pain as well as restores the normal range of motion of the neck.
Kyphoplasty is a minimally-invasive procedure to relieve pain due to vertebral compression fracture. Similar to vertebroplasty, it’s performed under general or local anesthesia.
Using live X-ray imaging, a large needle is inserted through the skin into the vertebra and a balloon is inserted through the needle. The balloon is then inflated until the desired vertebral height is obtained. The balloon is then removed and the empty space created between the vertebrae is injected with cement, which quickly hardens, restoring height, and providing strength and stability to the vertebra.
Spinal Corrective Surgeries
Adult Scoliosis Correction surgery is recommended if you fail to respond to nonsurgical treatment or the curvature progresses and becomes greater than 45-degrees, or is a cause of cardiopulmonary complications. In some cases, spinal stabilization and fusion are employed to prevent the progression of the disease.
Spinal Cord Stimulation Therapy – if open surgery to decompress the nerves is unlikely to help back and leg pain, an operation to implant a spinal cord stimulator is performed, sending electrical impulses to the areas of the spinal cord, causing the pain and interfering with the transmission of pain signals to the brain.
Neuromodulation – treats chronic pain relief through the alteration of nerve activity for relief of pain either through electrical stimulation or medication administered directly to a target site by means of implanted devices.
- Spinal cord stimulator
- Dorsal root ganglion stimulator
- Peripheral nerve stimulation
- Lumbar muscle stimulator Reactive8
There are many modern nonsurgical options to help correct or alleviate painful spinal conditions or deformities. Our practice offers a holistic approach to your care, with a treatment plan that includes a wide range of nonsurgical options that can improve your quality of life. From medications that can help reduce pain to neuromodulation to relieve pain through electrical stimulation and physical therapy to improve movement, our team will ensure your treatment meets your health and wellness goals.
Back and neck pain are the most common health problems experienced by most people, at some point of their lives. People with back pain or neck pain may experience difficulty in performing daily routine activities.
There are several lifestyle changes that can relieve stress and lessen back and neck pain. Some of the preventive measures which can help include:
Activity modifications: From proper posture to following bending and lifting techniques, patients can help alleviate pain and strengthen their back. Daily exercise can also help improve spine stability and prevent extra stress.
Nutrition: Eating healthy plays a vital role in maintaining a healthy spine. Good nutrition helps in managing pain and disability in the patient suffering from different types of spinal disorders. Damage to the spine can occur due to daily wear and tear or due to injuries from work, sports or accidents. Poor nutrition and inadequate hydration can increase the incidence of such injuries.
- Adequate dietary protein, along with vitamins A, B6, C, E and minerals such as zinc and copper are essential for maintaining strong and healthy connective tissue.
- Minerals such as calcium, phosphorus, magnesium, and boron are essential for healthy bones. Healthy nutrition is required for repair and maintenance of bones. Lack of nutrition can lead to bone disease such as osteoporosis.
- Calcium helps improve bone density. Other factors such as vitamin D, collagen, magnesium, and L-lysine are also essential for maintaining healthy bones. Calcium metabolism can be hampered due to various conditions, some of which include:
Massage: A popular treatment option for people suffering from back and neck pain, massage requires patients to be engaged and active participants in the therapy. Massage not only eases muscle tension, but specialized spine massage therapy can help reduce muscle spasms and inflammation.
Medications to relieve pain include NSAIDs, narcotic analgesics (to relieve acute pain, such as pain that is felt immediately following an injury or a surgical procedure), antimigraine drugs and anesthesia. These medications should be taken only on doctor’s advice as they can cause serious adverse effects.
Over-the-counter pain relievers are medications available without a doctor’s prescription. They include:
- Acetaminophen (Tylenol) and NSAIDs help to reduce fever and alleviate pain caused by general muscle aches and stiffness.
- Topical pain relievers (Aspercreme, Ben-Gay, and Capsaicin) include creams, lotions and sprays that are applied to the skin of painful muscles or joints to ease pain.
Opioid pain medications: are typically prescribed for patients with chronic nonmalignant pain, including low back pain who experience high levels of comfort while not developing toxicity to the body or having any indication of psychological dependence or addiction.
- Because of possible toxicity to the body, physical dependence, and the loss of efficacy due to developmental tolerance and psychological dependence or addiction, opioid medical care or narcotic administration is widely rejected in the treatment of back pain.
- Opioid therapy should be considered as a last resort in cases of unrelieved pain despite alternative medications (such as use of non-opioid drugs). Patients should be informed regarding the side effects of opioids and suggested to follow-up with their doctor regularly.
Corticosteroids are used to reduce swelling caused due to inflammation. When used to control pain, corticosteroids can be prescribed in the form of pills or injections.
Muscle relaxers are drugs that are commonly used to treat acute muscle problems. Sometimes, they can help treat painful muscle spasms. These medications help in reducing muscle tone and tension in skeletal muscles. Some muscle relaxers have direct effect on the skeletal muscle fibers, while others work at the level of the spinal cord.
Physical Therapy, using physical techniques and methods, such as exercise, massage and acupuncture, in the treatment of certain chronic pain conditions.
As one of the foremost necessary treatment modes of back pain recovery, well-trained, skilled therapists can help facilitate movement improvement and manage pain through safe stretching, conditioning, and strengthening exercise techniques. Patients are also instructed about the varied exercise regimens to extend the activity level thereby strengthening the muscles. Most patients manage low back pain and associated symptoms with therapy and medications without surgical intervention.
Physical therapy may include:
- Hot or cold packs
- Transcutaneous electrical nerve stimulation
- Spinal manipulation
- Aqua therapy
Occupational Therapy helps develop, recover or maintain daily living and work skills. Licensed therapists work with patients on the activities that “occupy” their time, such as climbing stairs or getting in and out of cars. Therapists work with patients to learn what day-to-day activities are most important to patients and find a way to increase their engagement in these activities.
Like physical therapy, occupational therapy may use task-specific, highly repetitive exercise to regain function after injury. Occupational therapy may include:
- Eating with adaptive utensils or plate guards
- Grooming with universal cuffs
- Getting dressed on a bed
- Using leg-lifters to transfer
- Going up and down stairs
- Modified bathing
- Modified movements to enter and exit a vehicle