At MD Pain, we use the least invasive and most effective methods to reduce pain and suffering.
Reasons To See Your Doctor
Numbness
Weakness
A recent fall
Trauma
Disc Pain
Causes & Symptoms
Discs are the cushions between the vertebrae that sustain wear and tear with aging, sports, and normal daily activities. This wear can lead to pain that is worse when lifting, sitting or standing for longer periods of time, and may radiate into the buttocks or legs.
Treatment
Options include epidural steroid injections and minimally invasive procedures such as VIADisc, an injection of allographic disc nuclear structures to restore normal disc function.
Compression Fractures
Causes & Symptoms
Compression fractures are caused by trauma to the bone or by diseases that weaken the bone such as osteoporosis, tumors or infection.
Treatment
Options include bracing, activity modification, and procedures such as kyphoplasty, a minimally invasive procedure in which bone cement is injected into the fracture.
Vertebral Endplate/Vertebrogenic Pain
Causes & Symptoms
As discs dehydrate with age, there is increased friction on the bone surrounding the disc. This can lead to bone spurs and inflammation extending into the vertebral body leading to back pain.
Treatment
Often this pain can be definitively treated without the need for invasive surgical treatment via INTRACEPT, radiofrequency ablation of the nerves to the vertebral endplates.
Spinal Stenosis
Causes & Symptoms
Gradually accumulating degenerative arthritic changes lead to bone spur formation and eventual narrowing of the spinal canal. This leads to pain, numbness, or weakness when walking or standing for too long.
Treatment
Includes a range of minimally invasive options to improve the ability to stand and walk, including epidural steroid injection, MILD Procedure (Minimally Invasive Lumbar Decompression) and VERTIFLEX placement.
Facet Pain
Causes & Symptoms
The joints in the spine provide range of motion and, like other joints, can develop inflammation and arthritic changes. This inflammation leads to pain with standing, rotating and extending.
Treatment
Options include radiofrequency neuroablation to treat the innervation to the joint, providing longer-term relief of the pain.
SI Joint Pain
Causes & Symptoms
Arthritic changes in the lumbar and sacral areas lead to pain in the back and buttocks regions.
Treatment
Options range from injections into the joint, radiofrequency ablation of the joint, and minimally invasive fusion of the joint via SI BONE procedure.
Our Recommended Treatment Options
Physical Modalities
Physical modalities such as physical therapy and chiropractic care help you maintain activity while improving muscle strength and pain control. This treatment is offered by coordinating with a chiropractor or physical therapist.
Medications
We may prescribe medications when necessary, including non-steroidal anti-inflammatory drugs (NSAIDS), muscle relaxants, anti-depressants, anti-convulsants, narcotics, or topical pain relievers.
Due to potential side effects, we take a conservative approach to the use of medications.
Injections
Injections are performed with an X-ray to accurately place medication around the pain source. These procedures are minimally invasive and allow you to return to normal activity with little or no recovery time.
Alternative Therapies
We may also recommend alternative therapies through an outside specialist, including acupuncture, yoga, pilates, biofeedback, and/ or cognitive behavioral therapy.
Injection Procedures Include:
Epidural steroid injections: used to treat nerve pain, degenerative disc disease, and stenosis. Using X-ray guidance, medication is placed near the painful area to decrease inflammation and alleviate pain.
Selective nerve root block: used to determine which nerve is the cause of the pain. Using X-rays, medication is injected near the nerve to determine if it is the source of the pain.
Facet joint injection or Medial branch block: used to treat arthritis pain in the spine. These joints allow flexion extension and rotation of the spine. Through the examination of X-rays, medication is placed in these small joints or around the nerves that innervate these joints. Confirmation of the joint as the cause of the pain may lead to a procedure called radio-frequency ablation (RFA) which can provide six months to two years of relief.
Sacroiliac joint injection: used to treat buttock or upper leg pain. With X-ray guidance, medication is placed in the joint. This injection, combined with physical therapy, may improve joint mobility and pain.
Kyphoplasty / vertebroplasty: this procedure is used to treat severe pain related to a compression fracture in the spine. By studying X-rays, a cavity is created which allows cement to be placed in the vertebral body to help stabilize the fracture.
Discogram: this procedure is used to determine the source of pain. It is a diagnostic procedure in which dye is injected into the disc to determine which, if any, disc(s) is the cause of the pain. This is often performed in conjunction with surgical consultation.
Spinal cord stimulator (SCS): a trial involved placement of temporary electrodes into the epidural space. These wires are connected to a temporary battery and programmed to cover the painful area. If the SCS provides significant relief of the pain, a permanent device may be implanted.
