Non-Surgical Spine Care
Chattanooga Spine & Body specializes in non-surgical or conservative treatment for neck, back and other spinal problems. Multiple treatment modalities are utilized to treat patients.
Simple conservative treatments utilized to treat patients include medications such as non-steroidal anti-inflammatories, muscle relaxers, and pain medications. Function and strength may also be improved through appropriate exercises and stretching for spinal muscles.
If simple conservative treatments are not effective, then interventional spinal injections can be performed to provide relief. Some of the spinal procedures performed at Chattanooga Spine & Body include the following:
- Sacroiliac joint injections
- Lumbar/cervical facet injections
- Lumbar epidural injections
- Cervical epidural injections
- Piriformis/Sciatic nerve injections
- Coccyx injections
Conservative Treatment Definition
Conservative management is an approach to treating back pain, neck pain and related spinal conditions utilizing non-surgical treatment options, such as physical therapy, medication and injections.
In the context of treating back pain, “conservative” treatment is not the inverse of aggressive treatment. Most episodes of back pain can be treated through conservative care and a combination of several conservative treatments is often recommended to alleviate pain and rehabilitate the lower back.
If a condition requires emergency care, conservative management may be passed up for surgical intervention. In general, surgery for lower back pain is considered only if conservative treatments fail and the pain persists for an extended period of time and limits the individual’s ability to function.
Epidural Steroid Injections
The most commonly performed injection is an epidural steroid injection. In this approach, a steroid is injected directly around the dura, the sac around the nerve roots that contains cerebrospinal fluid (the fluid that the nerve roots are bathed in). Prior to the injection, the skin is anesthetized by using a small needle to numb the area in the low back (a local anesthetic).
Cervical, Thoracic and Lumbar Facet Joint Injections
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.
Facet joint injections usually have two goals: to help diagnose the cause and location of pain and also to provide pain relief:
- Diagnostic goals: By placing numbing medicine into the facet joint, the amount of immediate pain relief experienced by the patient will help determine if the facet joint is a source of pain. If complete pain relief is achieved while the facet joint is numb, it means that joint is likely a source of pain.
- Pain relief goals: Along with the numbing medication, a facet joint injection also includes injecting time-release steroid (cortisone) into the facet joint to reduce inflammation, which can sometimes provide longer-term pain relief.
The injection procedure may also be called a facet block, as its purpose is to block the pain.
Sacroiliac Joint Injection
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.
The sacroiliac joints lie next to the spine and connect the sacrum with the hip on both sides. There are two sacroiliac joints, one on the right and one on the left. Joint inflammation and/or dysfunction in this area can cause pain. Read more about Sacroiliac Joint Dysfunction.
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.