Minimally Invasive

Endoscopic Discectomy

About

An endoscopic discectomy is a procedure performed by a tubular device. It is designed to relieve pain caused by the roots in your back pressing together.

How It Helps

An endoscopic discectomy can help treat herniated discs.

Endoscopic Foraminotomy

About

An endoscopic foraminotomy is a minimally invasive procedure used to relieve pressure on your nerve roots. This pressure can be caused by compression from bone spurs, disc herniations, scar tissue or even excessive ligaments.

How It Helps

An endoscopic foraminotomy can help treat arthritis of the spine, bone spurs, bulging discs/herniations, failed back surgery, foraminal narrowing, spine degeneration and sciatica.

Endoscopic Decompression

About

An endoscopic decompression is the reduction of lumbar pain by removing causal pain sources whilst preserving motion at the segment by mobilization of the annulus.

How It Helps

An endoscopic decompression can help treat spinal stenosis.

Interventional Spine Procedures

Transforaminal Epidural Injections

About

A transforaminal epidural injection is given to patients with leg and/or back pain to relieve pain without invasive surgery. These injections allow the body time to heal in an effort to avoid more invasive surgeries.

How It Helps

A transforaminal epidural injection can help treat large disc herniations, foraminal stenosis and lateral disc herniations.

Interlaminar Epidural Steroid Injections

About

An epidural injection helps deliver steroids into the epidural space around spinal nerve roots to relieve pain - back pain, leg pain, or other pain - caused by irritated spinal nerves. The epidural steroid injection reduces the inflammation of those nerves, which is often the source of the pain.

How It Helps

An interlaminar epidural steroid injection can help provide relief for nerve irritation along the spine.

Caudal Epidural Steroid Injections

About

The covering over the nerve roots in the spine is called the dura. The sleeve-like space surrounding the dura is called the epidural space. Nerves travel through the epidural space before they travel into your legs. The nerves leave the spine from small nerve holes. These nerves may become inflamed due to irritation from a damaged disc or from contact with a bone spur. Inflammation of these nerves may cause pain in your low back, hip, buttock, and legs. An epidural injection places anti-inflammatory medicine (cortisone) into the epidural space to reduce nerve inflammation and hopefully reduce your symptoms. By stopping or limiting nerve inflammation we may promote healing, and speed up mother nature, thereby reducing your pain.

How It Helps

A caudal epidural steroid injection can help reduce back and joint inflammation.

Epidural Lysis of Adhesions

About

Also known as the “Racz Procedure, this procedure’s name comes from “adhesion” meaning scar tissue and “lysis” meaning to dissolve or destroy. The procedure has proven effective treating chronic back and neck pain due to scar tissue formation. Scar tissue can form around nerve roots causing constant unrelenting pain. Adhesions are typically formed due to inflammation and irritation in the epidural space.

How It Helps

The procedure has proven effective treating chronic back and neck pain due to scar tissue formation.

Facet Joint Injections

About

Facet joints are small joints at each segment of the spine that provide stability and help guide motion. The facet joints can become painful due to arthritis of the spine, a back injury, or mechanical stress to the back. A cervical, thoracic or lumbar facet joint injection involves injecting a small amount of local anesthetic (numbing agent) and/or steroid medication, which can anesthetize the facet joints and block the pain. The pain relief from a facet joint injection is intended to help a patient better tolerate a physical therapy routine to rehabilitate his or her injury or back condition.

How It Helps

Facet joint injections can help treat arthritis or provide other types of pain relief.

Radiofrequency Ablation

About

Radiofrequency ablation is a minimally invasive procedure that is performed with local anesthetic and mild sedation. As with many spinal injections, radiofrequency neurotomy is best performed under fluoroscopy (live x-ray) for guidance in properly targeting and placing the needle (and for avoiding nerve or other injury).

How It Helps

RFA is used to help patients with chronic (long-lasting) low-back and neck pain and pain related to the degeneration of joints from arthritis.

Medial Branch Blocks

About

Medial branch nerves are small nerves that feed out from the facet joints in the spine and carry pain signals from the facet joints to the brain. The medial branch block is often used as part of a 2-step diagnostic and treatment approach.

How It Helps

A medial branch block is simply diagnostic. After the test, a physician will determine what additional treatments you may need.

Discography

About

A discogram, or discography, is an interventional diagnostic imaging test that helps determine whether a specific intervertebral disc may be the source of back pain. Intervertebral discs are sponge-like cushions between the vertebrae, or bones, of the spine. Discs act as a sort of shock absorber for the spine and help provide flexibility. Each disc has a strong outer layer called an annulus and a center part, called a nucleus, made of a soft, rubber-like material. When discs bulge or rupture, they may press on the nerves of the spinal column and cause pain or weakness. In a discogram, a contrast liquid is injected into the center of one or more spinal discs using x-ray guidance. This injection may temporarily reproduce the patient's back pain symptoms. As part of the procedure, an x-ray or CT scan also may be performed to obtain pictures of the injected disc.

How It Helps

A discogram is typically performed to help diagnose the cause of back pain and to guide the treatment of abnormal discs. The procedure also may be performed prior to surgery to help identify discs that need to be treated or removed.

Sacroiliac Joint Injections

About

The purpose of a sacroiliac joint injection is two-fold: to diagnose the source of a patient's pain, and to provide therapeutic pain relief. At times, these are separated and a patient will undergo a purely diagnostic or therapeutic injection, although often the two are combined into one injection.

How It Helps

A sacroiliac (SI) joint injection—also called a sacroiliac joint block—is primarily used either to diagnose or treat low back pain and/or sciatica symptoms associated with sacroiliac joint dysfunction.

Sympathetic Blocks

About

A sympathetic nerve block involves injecting numbing medicine around the sympathetic nerves in the low back or neck. By doing this, the sympathetic nervous system in that area is temporarily 'switched' off in hopes of reducing or eliminating pain. If the pain is substantially improved after the block, then a diagnosis of sympathetically mediated pain is established. The therapeutic effects of the anesthetic can occur, at times, longer than would be normally expected. The goal is to reset the sympathetic tone to a normal state of regulation. If the initial block is successful, then additional blocks may be repeated if the pain continues to sequentially diminish.

How It Helps

Sympathetic blocks temporarily “numb” the pain in the sympathetic nervous system.

Intercostal Nerve Blocks

About

An intercostal nerve block is an injection of medication that helps relieve pain in the chest area caused by a herpes zoster infection (or “shingles”) or a surgical incision. Intercostal nerves are located under each rib. When one of these nerves or the tissue around it gets irritated or inflamed, it can cause pain. A steroid medication and local anesthetic injected under the rib can help reduce the inflammation and alleviate the pain. Intercostal nerve blocks also can be used to help diagnose the source of pain.

How It Helps

An intercostal nerve block helps relieve pain in the chest area.

Stellate Ganglion Blocks

About

The stellate ganglion is part of the sympathetic nervous system that is located in your neck, on either side of your voice box. A stellate ganglion block is an injection of medication into these nerves that can help relieve pain in the head, neck, upper arm and upper chest. It also can help increase circulation and blood supply to the arm.

How It Helps

A stellate ganglion block is an injection of medication into these nerves that can help relieve pain in the head, neck, upper arm and upper chest. It also can help increase circulation and blood supply to the arm.

Facet Joint Thermal Ablation

About

Facet thermal ablation is a minimally invasive surgical procedure is used to treat arthritic, injured or degenerative facet joints. The facet joints link the vertebrae together and enable forward movement, backward motion and twisting of the spine. Over time, as cartilage and connective tissues in the facet joints lose elasticity and begin to wear away, the bony parts of the joint can rub together, causing limited mobility and a number of painful symptoms. Often, in an attempt to repair and protect themselves, facet joints develop growths called bone spurs that can press against spinal nerves and cause painful symptoms.

How It Helps

The aim of a facet thermal ablation is to deaden the affected local nerve and clean off the joint with a laser.

Spinal Cord Stimulator

About

Spinal cord stimulation, also called neurostimulation, directs mild electrical pulses to interfere with pain messages reaching the brain. A small device implanted near the spine generates these pulses. The implanted generator used in spinal cord stimulation has similarities to a cardiac pacemaker, leading some to call the device a pacemaker for pain.

How It Helps

Spinal cord stimulation (SCS) delivers mild electrical stimulation to nerves along the spinal column, modifying or blocking nerve activity in a non-medicinal way to minimize the sensation of pain reaching the brain.

Electrodiagnostic Testing

Electromyography

About

Electromyography (EMG) is a diagnostic procedure to assess the health of muscles and the nerve cells that control them (motor neurons). Motor neurons transmit electrical signals that cause muscles to contract. An EMG translates these signals into graphs, sounds or numerical values that a specialist interprets. An EMG uses tiny devices called electrodes to transmit or detect electrical signals. During a needle EMG, a needle electrode inserted directly into a muscle records the electrical activity in that muscle.

How It Helps

Your doctor may order an EMG if you have signs or symptoms that may indicate a nerve or muscle disorder.

Nerve Conduction Studies

About

A nerve conduction velocity (NCV) test is used to assess nerve damage and dysfunction. Also known as a nerve conduction study, the procedure measures how quickly electrical signals move through your peripheral nerves. Your peripheral nerves are located outside of your brain and along your spinal cord. These nerves help you control your muscles and experience the senses. Healthy nerves send electrical signals more quickly and with greater strength than damaged nerves.

How It Helps

An NCV test can be used to diagnose a number of muscular and neuromuscular disorders, including, herniated disk disease, sciatic nerve problems and peripheral nerve injury.

Myofascial Injections

Trigger Point Injections

About

In the TPI procedure, a health care professional inserts a small needle into the patient's trigger point. The injection contains a local anesthetic or saline and may include a corticosteroid. With the injection, the trigger point is made inactive and the pain is alleviated. Usually, a brief course of treatment will result in sustained relief. Injections are given in a doctor's office and usually take just a few minutes. Several sites may be injected in one visit. If a patient has an allergy to a certain drug, a dry-needle technique (involving no medications) can be used.

How It Helps

TPI is used to treat many muscle groups, especially those in the arms, legs, lower back, and neck. In addition, TPI can be used to treat fibromyalgia and tension headaches. The technique is also used to alleviate myofascial pain syndrome (chronic pain involving tissue that surrounds muscle) that does not respond to other treatments.

Acupuncture

Acupuncture

About

A traditional Chinese medicine, acupuncture is most commonly used to treat pain. Typically, the process involves inserting extremely small needles through your skin at specific points in your body. Many Western practices believe that acupuncture can help stimulate nerves, muscles and connective tissue.

How It Helps

Acupuncture has been shown to help treat headaches, low back pain, neck pain and osteoarthritis.

Chiropractic

Spinal Manipulation

About

Spinal manipulation, or spinal manipulative therapy is the combination of moving and jolting joints, massage, exercise and physical therapy. It’s purpose is to relieve pressure on joints, reduce inflammation and improve nerve function.

How It Helps

Typically, spinal manipulation is used to relieve pressure on joints, reduce inflammation and improve nerve function.

IASTM

About

Instrument Assisted Soft Tissue Mobilization (IASTM) is a tool that helps our providers location and treat patients with soft tissue dysfunction.

How It Helps

IASTM is typically used to help treat all types of tendonitis, neck pain and various strains and sprains.

Muscle Therapy

About

Muscle therapy is a treatment that manipulates the soft tissues of your body using different degrees or pressure and movement. Muscle therapy is generally used in conjunction with other kinds of treatments.

How It Helps

Muscle therapy is an effective treatment for reducing inflammation and relieving various types of back pain.

Mobilization

About

The goal of spinal mobilization is to restore or enhance joint function. A provider may choose mobilization because it is patient preference, or due to a variety of other types of individual factors.

How It Helps

Spinal mobilization is used to treat back pain and reduce nerve inflammation.

Extremity Manipulating/Adjusting

About

Extremity manipulating is a term referring to a group of applied therapeutic movements. These types of movements are used with aim of inducing intervertebral movement by directing forces to the vertebrae.

How It Helps

Typically, extremity manipulating and adjusting can help alleviate all kinds of back pain and help reduce inflammation.

  • Endoscopic Discectomy
  • Endoscopic Foraminotomy
  • Endoscopic Decompression
  • Transforaminal Epidural Injections
  • Interlaminar Epidural Steroid Injections
  • Caudal Epidural Steroid Injections
  • Epidural Lysis of Adhesions
  • Facet Joint Injections
  • Radiofrequency Ablation
  • Medial Branch Blocks
  • Discography
  • Sacroiliac Joint Injections
  • Sympathetic Blocks
  • Intercostal Nerve Blocks
  • Stellate Ganglion Blocks
  • Facet Joint Thermal Ablation
  • Spinal Cord Stimulator
  • Electromyography
  • Nerve Conduction Studies
  • Trigger Point Injections
  • Acupuncture
  • Spinal Manipulation
  • IASTM
  • Muscle Therapy
  • Mobilization
  • Extremity Manipulating/Adjusting

About

An endoscopic discectomy is a procedure performed by a tubular device. It is designed to relieve pain caused by the roots in your back pressing together.

How It Helps

An endoscopic discectomy can help treat herniated discs.

About

An endoscopic foraminotomy is a minimally invasive procedure used to relieve pressure on your nerve roots. This pressure can be caused by compression from bone spurs, disc herniations, scar tissue or even excessive ligaments.

How It Helps

An endoscopic foraminotomy can help treat arthritis of the spine, bone spurs, bulging discs/herniations, failed back surgery, foraminal narrowing, spine degeneration and sciatica.

About

An endoscopic decompression is the reduction of lumbar pain by removing causal pain sources whilst preserving motion at the segment by mobilization of the annulus.

How It Helps

An endoscopic decompression can help treat spinal stenosis.

About

A transforaminal epidural injection is given to patients with leg and/or back pain to relieve pain without invasive surgery. These injections allow the body time to heal in an effort to avoid more invasive surgeries.

How It Helps

A transforaminal epidural injection can help treat large disc herniations, foraminal stenosis and lateral disc herniations.

About

An epidural injection helps deliver steroids into the epidural space around spinal nerve roots to relieve pain - back pain, leg pain, or other pain - caused by irritated spinal nerves. The epidural steroid injection reduces the inflammation of those nerves, which is often the source of the pain.

How It Helps

An interlaminar epidural steroid injection can help provide relief for nerve irritation along the spine.

About

The covering over the nerve roots in the spine is called the dura. The sleeve-like space surrounding the dura is called the epidural space. Nerves travel through the epidural space before they travel into your legs. The nerves leave the spine from small nerve holes. These nerves may become inflamed due to irritation from a damaged disc or from contact with a bone spur. Inflammation of these nerves may cause pain in your low back, hip, buttock, and legs. An epidural injection places anti-inflammatory medicine (cortisone) into the epidural space to reduce nerve inflammation and hopefully reduce your symptoms. By stopping or limiting nerve inflammation we may promote healing, and speed up mother nature, thereby reducing your pain.

How It Helps

A caudal epidural steroid injection can help reduce back and joint inflammation.

About

Also known as the “Racz Procedure, this procedure’s name comes from “adhesion” meaning scar tissue and “lysis” meaning to dissolve or destroy. The procedure has proven effective treating chronic back and neck pain due to scar tissue formation. Scar tissue can form around nerve roots causing constant unrelenting pain. Adhesions are typically formed due to inflammation and irritation in the epidural space.

How It Helps

The procedure has proven effective treating chronic back and neck pain due to scar tissue formation.

About

Facet joints are small joints at each segment of the spine that provide stability and help guide motion. The facet joints can become painful due to arthritis of the spine, a back injury, or mechanical stress to the back. A cervical, thoracic or lumbar facet joint injection involves injecting a small amount of local anesthetic (numbing agent) and/or steroid medication, which can anesthetize the facet joints and block the pain. The pain relief from a facet joint injection is intended to help a patient better tolerate a physical therapy routine to rehabilitate his or her injury or back condition.

How It Helps

Facet joint injections can help treat arthritis or provide other types of pain relief.

About

Radiofrequency ablation is a minimally invasive procedure that is performed with local anesthetic and mild sedation. As with many spinal injections, radiofrequency neurotomy is best performed under fluoroscopy (live x-ray) for guidance in properly targeting and placing the needle (and for avoiding nerve or other injury).

How It Helps

RFA is used to help patients with chronic (long-lasting) low-back and neck pain and pain related to the degeneration of joints from arthritis.

About

Medial branch nerves are small nerves that feed out from the facet joints in the spine and carry pain signals from the facet joints to the brain. The medial branch block is often used as part of a 2-step diagnostic and treatment approach.

How It Helps

A medial branch block is simply diagnostic. After the test, a physician will determine what additional treatments you may need.

About

A discogram, or discography, is an interventional diagnostic imaging test that helps determine whether a specific intervertebral disc may be the source of back pain. Intervertebral discs are sponge-like cushions between the vertebrae, or bones, of the spine. Discs act as a sort of shock absorber for the spine and help provide flexibility. Each disc has a strong outer layer called an annulus and a center part, called a nucleus, made of a soft, rubber-like material. When discs bulge or rupture, they may press on the nerves of the spinal column and cause pain or weakness. In a discogram, a contrast liquid is injected into the center of one or more spinal discs using x-ray guidance. This injection may temporarily reproduce the patient's back pain symptoms. As part of the procedure, an x-ray or CT scan also may be performed to obtain pictures of the injected disc.

How It Helps

A discogram is typically performed to help diagnose the cause of back pain and to guide the treatment of abnormal discs. The procedure also may be performed prior to surgery to help identify discs that need to be treated or removed.

About

The purpose of a sacroiliac joint injection is two-fold: to diagnose the source of a patient's pain, and to provide therapeutic pain relief. At times, these are separated and a patient will undergo a purely diagnostic or therapeutic injection, although often the two are combined into one injection.

How It Helps

A sacroiliac (SI) joint injection—also called a sacroiliac joint block—is primarily used either to diagnose or treat low back pain and/or sciatica symptoms associated with sacroiliac joint dysfunction.

About

A sympathetic nerve block involves injecting numbing medicine around the sympathetic nerves in the low back or neck. By doing this, the sympathetic nervous system in that area is temporarily 'switched' off in hopes of reducing or eliminating pain. If the pain is substantially improved after the block, then a diagnosis of sympathetically mediated pain is established. The therapeutic effects of the anesthetic can occur, at times, longer than would be normally expected. The goal is to reset the sympathetic tone to a normal state of regulation. If the initial block is successful, then additional blocks may be repeated if the pain continues to sequentially diminish.

How It Helps

Sympathetic blocks temporarily “numb” the pain in the sympathetic nervous system.

About

An intercostal nerve block is an injection of medication that helps relieve pain in the chest area caused by a herpes zoster infection (or “shingles”) or a surgical incision. Intercostal nerves are located under each rib. When one of these nerves or the tissue around it gets irritated or inflamed, it can cause pain. A steroid medication and local anesthetic injected under the rib can help reduce the inflammation and alleviate the pain. Intercostal nerve blocks also can be used to help diagnose the source of pain.

How It Helps

An intercostal nerve block helps relieve pain in the chest area.

About

The stellate ganglion is part of the sympathetic nervous system that is located in your neck, on either side of your voice box. A stellate ganglion block is an injection of medication into these nerves that can help relieve pain in the head, neck, upper arm and upper chest. It also can help increase circulation and blood supply to the arm.

How It Helps

A stellate ganglion block is an injection of medication into these nerves that can help relieve pain in the head, neck, upper arm and upper chest. It also can help increase circulation and blood supply to the arm.

About

Facet thermal ablation is a minimally invasive surgical procedure is used to treat arthritic, injured or degenerative facet joints. The facet joints link the vertebrae together and enable forward movement, backward motion and twisting of the spine. Over time, as cartilage and connective tissues in the facet joints lose elasticity and begin to wear away, the bony parts of the joint can rub together, causing limited mobility and a number of painful symptoms. Often, in an attempt to repair and protect themselves, facet joints develop growths called bone spurs that can press against spinal nerves and cause painful symptoms.

How It Helps

The aim of a facet thermal ablation is to deaden the affected local nerve and clean off the joint with a laser.

About

Spinal cord stimulation, also called neurostimulation, directs mild electrical pulses to interfere with pain messages reaching the brain. A small device implanted near the spine generates these pulses. The implanted generator used in spinal cord stimulation has similarities to a cardiac pacemaker, leading some to call the device a pacemaker for pain.

How It Helps

Spinal cord stimulation (SCS) delivers mild electrical stimulation to nerves along the spinal column, modifying or blocking nerve activity in a non-medicinal way to minimize the sensation of pain reaching the brain.

About

Electromyography (EMG) is a diagnostic procedure to assess the health of muscles and the nerve cells that control them (motor neurons). Motor neurons transmit electrical signals that cause muscles to contract. An EMG translates these signals into graphs, sounds or numerical values that a specialist interprets. An EMG uses tiny devices called electrodes to transmit or detect electrical signals. During a needle EMG, a needle electrode inserted directly into a muscle records the electrical activity in that muscle.

How It Helps

Your doctor may order an EMG if you have signs or symptoms that may indicate a nerve or muscle disorder.

About

A nerve conduction velocity (NCV) test is used to assess nerve damage and dysfunction. Also known as a nerve conduction study, the procedure measures how quickly electrical signals move through your peripheral nerves. Your peripheral nerves are located outside of your brain and along your spinal cord. These nerves help you control your muscles and experience the senses. Healthy nerves send electrical signals more quickly and with greater strength than damaged nerves.

How It Helps

An NCV test can be used to diagnose a number of muscular and neuromuscular disorders, including, herniated disk disease, sciatic nerve problems and peripheral nerve injury.

About

In the TPI procedure, a health care professional inserts a small needle into the patient's trigger point. The injection contains a local anesthetic or saline and may include a corticosteroid. With the injection, the trigger point is made inactive and the pain is alleviated. Usually, a brief course of treatment will result in sustained relief. Injections are given in a doctor's office and usually take just a few minutes. Several sites may be injected in one visit. If a patient has an allergy to a certain drug, a dry-needle technique (involving no medications) can be used.

How It Helps

TPI is used to treat many muscle groups, especially those in the arms, legs, lower back, and neck. In addition, TPI can be used to treat fibromyalgia and tension headaches. The technique is also used to alleviate myofascial pain syndrome (chronic pain involving tissue that surrounds muscle) that does not respond to other treatments.

About

A traditional Chinese medicine, acupuncture is most commonly used to treat pain. Typically, the process involves inserting extremely small needles through your skin at specific points in your body. Many Western practices believe that acupuncture can help stimulate nerves, muscles and connective tissue.

How It Helps

Acupuncture has been shown to help treat headaches, low back pain, neck pain and osteoarthritis.

About

Spinal manipulation, or spinal manipulative therapy is the combination of moving and jolting joints, massage, exercise and physical therapy. It’s purpose is to relieve pressure on joints, reduce inflammation and improve nerve function.

How It Helps

Typically, spinal manipulation is used to relieve pressure on joints, reduce inflammation and improve nerve function.

About

Instrument Assisted Soft Tissue Mobilization (IASTM) is a tool that helps our providers location and treat patients with soft tissue dysfunction.

How It Helps

IASTM is typically used to help treat all types of tendonitis, neck pain and various strains and sprains.

About

Muscle therapy is a treatment that manipulates the soft tissues of your body using different degrees or pressure and movement. Muscle therapy is generally used in conjunction with other kinds of treatments.

How It Helps

Muscle therapy is an effective treatment for reducing inflammation and relieving various types of back pain.

About

The goal of spinal mobilization is to restore or enhance joint function. A provider may choose mobilization because it is patient preference, or due to a variety of other types of individual factors.

How It Helps

Spinal mobilization is used to treat back pain and reduce nerve inflammation.

About

Extremity manipulating is a term referring to a group of applied therapeutic movements. These types of movements are used with aim of inducing intervertebral movement by directing forces to the vertebrae.

How It Helps

Typically, extremity manipulating and adjusting can help alleviate all kinds of back pain and help reduce inflammation.