The first step in treatment for spinal pain includes conservative modalities such as anti-inflammatory medications, physical therapy and chiropractic treatment. If pain persists beyond 3 months, the next option for treatment may involve minimally invasive methods. These methods include epidural injections, various nerve blocks, and intradiscal procedures such as percutaneous disc decompression, with or without the use of laser, as well as Nucleoplasty and Annuloplasty (Intradiscal Electrothermal Therapy).

Surgery is usually considered a last resort, though immediate surgery may be necessary for emergency situations of spinal cord or nerve root compression as well as in some cases of mechanical instability.

In order to determine where the problem originates, it may be necessary to perform diagnostic tests such as diagnostic nerve blocks, diagnostic provocative discograms and/or analgesic discograms. These will usually provide short term relief of pain but will help the doctor to determine your course of treatment for long term relief.

• Facet Joint Nerve Blocks
• Selective Nerve Root Blocks
• Discography

• Epidural injections
• Paravertebral facet joint injections/nerve blocks
• Transforaminal epidural injections
• Lysis of adhesions in the epidural space
• Sacroiliac joint injections
• Other peripheral joint and bursal injections

• Radiofrequency ablation of facet joint nerves

During the treatment process, it is important that you continue to follow up with your primary care physician for any other medical problems.