NECK & BACK PAIN
Neck and back pain (NBP) can be among the most debilitating conditions from which people suffer. Since 1995 we’ve been helping people with NBP recover from their injuries and reduce or alleviate their pain non-surgically, even people who have already had surgery and still have pain.
A complete discussion of the causes of, and treatments for, NBP could fill an entire book and is beyond the scope of a brief web page discussion. But there are some basic things that we can outline.
Perhaps one of the most important things to note is that the spinal disc causes pain only in a very small percentage of cases. Physicians in general, and spine surgeons in particular, love to focus on the disc. But far more commonly NBP comes from the extradiscal structures, such as the facet joints & capsules, muscles & tendons, ligaments, and nerves.
In addition, damage to extradiscal structures can refer pain to more distant areas. For example, sprains or arthritis involving the facet joints can cause pain not only around the spine but also can refer pain to more distant areas. Consider the pain referral pattern from the L4-5 facet joint, one of the small joints in the low back. As you can see in the accompanying image, the L4-5 facet classically can cause pain in the hip, buttocks, groin, front of the thigh, and down the back of the leg mimicking sciatica!
Similarly, look at the pain referral pattern from the ligaments that support the sacroiliac joint at the base of the spine. It looks very similar to the pattern from the L4-5 facet!
This among the many reasons why diagnosing the cause(s) of NBP can be challenging. And of course, nothing says that you can’t have more than one cause of your pain!
In our practice we use a combination of the patient history, a comprehensive physical exam, supported by careful and judicious use of x-rays and MRIs to help with diagnosis. We also frequently utilize various diagnostic Novocain injections to help identify pain generators. By numbing a structure temporarily you can often get a good sense as to whether it’s causing pain. We then can employ more specific strategies to treat the problem more permanently.
What about “pain management” injections?” Many patients we see have gone through a litany of invasive pain management procedures, including epidural steroid injections, facet injections and medial branch blocks, sacroiliac joint (SI joint) injections, nerve blocks, and even procedures to “kill” the nerves (known as radiofrequency ablation). While all of these have a role at some point in the diagnostic workup, virtually NONE of them actually fix the underlying problem. And many pain management practices love doing these injections over and over because they are reimbursed well by insurance companies!
In our practice we don’t simply want to “manage” your neck or back pain. We want to FIX your neck or back pain when possible! Using strategies such as Regenerative Medicine treatments (prolotherapy, Prolozone, PRP, stem cell treatments, etc) we often can reduce or even eliminate chronic neck and/or back pain in many cases. While every person and condition is unique, and there are never any guarantees, we have a great deal of success in helping people with chronic pain.