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Despite medical advancements making for shorter recovery times, spinal surgery is still a big deal, and something that many people wish to avoid. Luckily, there are plenty of non-surgical options for spinal care that you can try first.
“When someone comes into our clinic with back or neck pain, we will do a thorough history and perform a complete musculoskeletal examination. We will review all of their diagnostic imaging to try and find out exactly where the pain is coming from, or simply identify their pain generator.”
Once doctors know where the pain is coming from, they can determine how to treat it. Conservative methods may include chiropractic care, acupuncture, physical therapy, or medications like anti-inflammatories.
In patients with herniated discs that are causing radicular pain in the arms (from a herniated disc in the neck) or legs (from a herniated disc in the back), a more aggressive treatment such as epidural steroid injections may be necessary.
The injections are done in the office under live x-ray (fluoroscopy).
“We use multiple medications with our epidural steroid injections including anesthetic and corticosteroids, which can both help inflammation and subsequently relieve pain,” explains Dr. Arora. “The whole procedure takes about 15 minutes, you’re awake during the entire procedure and you can resume your activities that day.”
If the first injection isn’t successful, doctors may recommend a second, not to exceed three injections in a six-month period.
For arthritis, specifically of the facet joints, Dr. Arora may use a technique called radiofrequency neurotomy. After identifying the affected nerves, they’re numbed and radio waves pass through a needle to the nerve. This creates a thermal lesion of the nerve that will inhibit its ability to send pain signals to the affected joints.
The benefits of this procedure are generally in the 6-12 month range, with some patients’ results lasting years. The procedure can be repeated if the pain does return.
“We try to keep you away from more invasive surgeries but sometimes those are required to improve your pain and most importantly, help you return to your previous level of activity,” Dr. Arora says.