Not all spine issues require surgery. In fact, only about 10 to 15 percent of people with back and neck problems are candidates for surgery. Most people can find relief with a non-surgical option. To treat pain without surgery, we first try to pinpoint your “pain generator.” That means we locate the bone, joint, muscle, disc, or nerve that is causing the pain and treat it with physical therapy, alternative treatments, an injection of pain-relieving medication, a nerve block, or a combination of treatments. Our expert pain management team will help you determine which treatments are best for you.
Some people find their back or neck pain can be relieved with:
The following special injections and procedures may also bring relief without surgery.
Spinal Joint Block
Spinal joint blocks are injections given in specific locations to block pain signals. They are given with local anesthesia, meaning you are not completely unconscious, but you do not feel anything in the area of the injection.
For the procedure, you will lie face-down on a table. We will first inject a numbing agent using a very small needle. Your doctor will then use X-ray images (called fluoroscopy) to guide the placement of a larger needle containing the blocking agent. The injection only takes a few minutes. Afterward, you must be driven home and should rest for the remainder of the day. Most people can return to normal activities the next day.
The long-term response to spinal blocks varies. Most people feel relief within a week. Generally people who have recent or new pain get more relief than people who have been experiencing pain for a long time. As with any medical procedure, there are some risks involved. These may include infection, bleeding, worsening of symptoms, or headache. Your physician will discuss all of the risks with you before the procedure. We offer the following nerve block procedures:
Peripheral Joint Injection
Peripheral Nerve Block
Peripheral nerve blocks are given to control pain coming from a nerve, also known as a neuralgia. We inject a local anesthetic and a steroid near the injured nerve to block pain signals along the nerves. In cases of specific sensory nerves, cold (cryotherapy) or heat (radiofrequency lesioning) may also be used to provide longer-term relief for six to nine months.
Peripheral nerve blocks are commonly used for:
Complications from a peripheral nerve block are rare, but may include bruising, infection, or nerve injury. If the injection site is inflamed or irritated after the injection, applying ice for 20 minutes three times a day may help.
This procedure may be ordered for persistent low-back pain that does not respond to other treatments. A lumbar discography may be necessary to prepare for back surgery. The procedure uses X-ray technology called fluoroscopy to get a clear picture of the inner workings of each disc in the lower spine.
For the procedure, you will lie on your stomach on a table. You will receive local anesthesia to numb the area being examined. Next, a very small needled is guided to the center of each disc being examined. The discs are then “pressurized” one at a time. Pressurization consists of injecting small amounts of a sterile liquid into the center of each disc. You will be asked to focus on and describe the sensations you feel. You will be asked to give one of three answers:
If you feel pain from the injection, you will be asked if the pain is familiar (what you feel all the time), or unfamiliar (new pain).
The pressurized discs are photographed with fluoroscopic equipment. The needles are removed and the procedure is typically over within an hour. Some people experience pain from the procedure. You may use acetaminophen, ibuprofen, or apply an ice pack to ease the soreness.
Spinal Cord Stimulator
Nerve damage pain that does not respond to any other treatment may benefit from a spinal cord stimulator. This device sends electrical impulses to the nerves to interrupt the pain signals so they cannot reach the brain.
This procedure is done in two stages. In the first stage, you lie face-down on a table while a local anesthetic is used to numb the skin and tissue. Guided by X-ray images, your doctor will place wires on your spinal cord. You’ll be given an external device to create an electrical current in the wires and block the pain. If the temporary device does in fact relieve your pain, you will come back for the second stage of the procedure.
For the second stage, you will receive sedation through an I.V. needle. Your doctor will implant a generator to provide permanent electrical stimulation. If your pain is in your lower back or legs, the generator will be placed on the side of your abdomen. If your pain is in your upper back or arms, the generator will be placed in your chest. The batteries in the generator typically last several years, but they cannot be recharged or replaced.
Most people can return home the same day. You will need somebody to drive you home and you should take it easy for a day or two. You may use acetaminophen, ibuprofen, or apply an ice pack if you feel sore after the procedure.