Back pain is caused by a complicated structure of bones, joints, ligaments and muscles. When you sprain ligaments, strain muscles, rupture disks and irritate joints, these all can lead to back pain. Sports injuries or accidents can cause back pain as well as simple movements like bending over to pick up a child. Other factors to consider are arthritis, poor posture, obesity and psychological stress which can cause or complicate back pain. Back pain can also directly result from disease of the internal organs such as kidney stones, kidney infections, blood clots or bone loss. A knowledgeable chiropractor will rule out these findings before a treatment plan is put into place.

There has been a lot of research conducted on back pain. These findings are helpful in understanding the magnitude of back pain in our daily lives. The leading cause of disability worldwide is low back pain according to the Global Burden of Disease 2010. Back pain is one of the most common reasons for missed work. Back pain is the second most common reason for visits to the doctor’s office, outnumbered only by upper-respiratory infections. One half of all working Americans admit to having back pain symptoms each year. Experts estimate that as much as 80% of the population will experience a back problem at some time in their lives. Most cases of back pain are mechanical or non-organic—meaning they are not caused by serious conditions such as inflammatory arthritis, infection, fracture or cancer. Americans spend at least $50 billion each year on back pain.

The neck’s susceptibility to injury is due in part to biomechanics. Activities and events that affect cervical biomechanics include extended sitting, repetitive movement, accidents, falls and blows to the body or head, normal aging, and everyday wear and tear. Neck pain can be very bothersome, and it can have a variety of causes.

A neck adjustment (also known as cervical manipulation) is a precise procedure where pressure is applied to the joints of the neck, usually by hand. A neck adjustment works to improve the mobility of the spine and to restore range of motion. Patients typically notice an improved ability to turn and tilt the head as well as a reduction of pain, soreness and stiffness.

Our team here at Interventional Spine & Pain Management Center will develop a program of care that may combine more than one type of treatment depending on your personal needs. In addition to manipulation, the treatment plan may also include mobilization, massage or rehabilitative exercises.

The symptoms and type of neuropathy you may be suffering from largely depend on the types of nerves that are damaged. These include damaged motor nerves, sensory nerves, or autonomic nerves. With this in mind, it’s important to document what type of symptoms you may be experiencing prior to your visit to our office so we can better diagnose and treat your pain. To effectively treat the various types of neuropathy, we utilize a combination of natural therapeutic treatments such as acupuncture, corrective care, and nerve regeneration to reduce the severity of your discomfort.

We understand how unpleasant neuropathic pain is which is why we are proud to provide a comfortable, family-friendly office atmosphere for our patients. Our helpful, professional staff are here to help you manage your pain and help treat any underlying conditions.

The knee is a complex joint that relies heavily on ligaments and muscles for stability. The knee is a major weight bearing joint which makes it more susceptible to injury. To ensure your knee and surrounding areas are working in conjunction, we will be sure to examine your knee joint as well as your low back, pelvis, hip, ankle and foot.

Some things to consider when suffering from knee pain:

• Is it limiting your day-to-day or sporting activities?
• Have you tried painkillers and been told to rest with no long-term improvement?
• Have you been told you have arthritis and there is nothing that can be done?

Chiropractic treatment may well be the answer if you said yes to either of the questions above. Here at Interventional Spine & Pain Management Center, we care about our patients and getting them back to optimal health as quickly as possible. We will address your issue and customize your plan to best suit your needs.

Here at Interventional Spine & Pain Management Center, we regularly treat patients with sciatica. Since there are many disorders that cause sciatica, we will determine what is the root cause of your sciatica by taking a thorough patient history during your physical and neurological exam. In some instances, diagnostic testing such as an x-ray, MRI, CT scan and/or electrodiagnostic test (electromyography) might be necessary. These examinations and tests help to detect possible contraindications to spinal adjustments and other chiropractic therapies.

The best care for sciatic pain is to schedule regular chiropractic appointments. This allows us to better detect and correct any spinal dysfunction that may be a source of the sciatic pain.

When should I seek medical care?

Joint pain can occur in any joint of the body, but most patients who experience joint pain do so in the knees, hips, shoulders, and/or spine. Persistent and/or severe pain that prohibits your ability to complete everyday tasks should be evaluated by a doctor. If you notice redness, joint deformity, swelling, or reduced range of motion, it is time to schedule an appointment.

What treatments do you offer for joint pain?

If over-the-counter medications prove unable to relieve your pain, we may then proceed with other treatments such as prescription medications, epidural steroid injections, and/or nerve blocks. Strengthening the muscles surrounding the joint is important to healing and preventing future flare ups, so we may recommend at-home exercises or physical therapy as well. In some cases, we may recommend regenerative therapy (such as stem cell therapy) to help with the healing of your joints. During this type of regenerative therapy we will take a sample of your bone marrow and inject it into the damaged joints. Bone marrow has a high concentration of stem cells that have the ability to stimulate the growth of new bone and cartilage cells to help restore your joints to normal functionality and comfort.

As you get older, however, you are more likely to develop back pain due to conditions associated with age-related degeneration, such as:

• Herniated disc
• Degenerative disc disease
• Facet joint arthritis
• Sacroiliac Joint dysfunction
• Spinal stenosis

How do you treat lower back pain that does not respond to conventional treatment?

Back pain that is not relieved by conventional methods of treatment should be assessed by a doctor. At Interventional Spine & Pain Management Center, Dr. Manocha utilizes a variety of treatment options for your lower back pain such as:

Lumbar epidural steroid injection

Dr. Manocha injects steroids into the epidural space between your spine and the spinal cord. Using real-time Fluoroscopy (X-ray imaging), he precisely places the needle near the inflamed nerves. As the steroid bathes the nerves in the area, inflammation is diminished, and your pain is relieved.

Lumbar radiofrequency neurotomy

Dr. Manocha uses radiofrequency energy to “burn” the specific sensory nerves which are sending pain signals from the facet joints to your brain. The heat temporarily damages theses nerve, which in turn stops the nerve from sending the painful signals to your brain.

Lumbar Facet joint block

Arthritic facet joints of the spine are injected with local anesthetic and steroids. This reduces the inflammation in the joints which helps relieve back pain.

Lumbar transforaminal epidural steroid injection

This steroid injection is directed into an area in the spine called the transforaminal space, where it directly targets nerve roots at a specific vertebra. By comparison, an injection into the epidural space allows the medication to reach numerous nerves in the surrounding area.

Sacroiliac (SI) joint injection

The sacroiliac joint is where the lower portion of your spine where it connects with each hip bone. SI joint dysfunction causes pain in your lower back as well as your hip, so this injection helps relieve back pain. An SI joint injection generally contains a local anesthetic for quick but short-lived pain relief and steroids for longer-lasting results.

To learn whether you are a good candidate for interventional treatments to relieve back pain, call Interventional Spine and Pain Management Center or request a phone call from our staff by completing the online form.

How can I prevent back pain in the future?

Maintaining a healthy diet and weight, remaining active, and avoiding prolonged inactivity or bed rest are all important ways to avoid back pain. Before doing exercises or any physical activity, it is recommended to warm up and/or stretch. Some other preventative measures are to maintain proper posture, wear comfortable, low-heeled shoes and sleep on a mattress of medium firmness to minimize any curvature in your spine. It is always good to remember to lift with your knees, do not twist when lifting, and keep objects close to your body. It is also important to avoid is smoking as it impairs blood flow resulting in oxygen and nutrient deprivation to spinal tissues.

What symptoms develop due to spinal stenosis?

Inflammation and pain develop as your nerves are compressed. You may also experience symptoms that often occur when nerves are damaged or irritated, such as tingling, numbness, and muscle weakness.

Spinal stenosis most often affects the lower back or neck. In addition to feeling pain in those areas, you may also have symptoms anywhere along the affected nerve. Many patients with spinal stenosis have symptoms of neurogenic claudication (Pain and heaviness in the legs which is relieved by bending forward or sitting).

How is spinal stenosis treated?

When you still have pain despite conventional medical treatment like medication and physical therapy, Dr. Manocha offers Interventional techniques. He specializes in innovative therapies that effectively relieve your pain by treating the source of the problem.

Dr. Manocha recommends the following for spinal stenosis:

Epidural steroid injections

Dr. Manocha injects steroids into the epidural space between your spine and the spinal cord. Using real-time Fluoroscopy (X-ray imaging), he precisely places the needle near the inflamed nerves. As the steroid bathes the nerves in the area, inflammation is diminished, and your pain is relieved.

Minimally Invasion Lumbar Decompression (MILD)

MILD is an early treatment option to consider if more conservative therapies, such as physical therapy or pain medications, are not providing adequate relief. The MILD Procedure addresses a major root cause of Lumbar Spinal Stenosis by removing excess ligament tissue to restore space in the spinal canal. This Procedure typically takes less than an hour and can be performed through a single, tiny incision.

Vertiflex Superion® Indirect Decompression System (Superion)

The Superion is a small titanium device that is implanted between two spinous processes using minimally invasive surgery. The implant has a central supporting piece with two wing-like attachments.

Dr. Manocha activates the spacer’s arm to create proper space for the appropriate nerves.

It usually only takes 30 minutes to insert the Superion device. When your procedure is over, your pain is significantly reduced.

When you need treatment that works to relieve neck, arm, back, and leg pain, schedule an appointment by calling Interventional Spine and Pain Management Center or request a call from an experienced staff member using the online contact form.

Why regenerative medicine?

Many of us suffer from some form of pain and discomfort and though medication can help alleviate the symptoms, sometimes that isn’t enough. This is especially true for patients who struggle with chronic pain. While treatment options such as prescription medicine, surgeries, or other forms of medical treatment can help, it can be overwhelming to find a treatment that is best suited for your specific symptoms and goals. Regenerative medicine provides an alternative option that is both safe and effective in treating chronic pain.

What conditions can be treated with regenerative medicine?

While there are many conditions that can be treated with regenerative medicine, we specialize in that which aids in the alleviation and prevention of chronic pain. Conditions such as arthritis, neuropathy, joint disorders, nerve compression, and degenerative disc disease are all conditions with which regenerative medicine can help. During your consultation we will discuss whether regenerative medicine is the right avenue of treatment for your specific condition and needs.

What should I expect during treatment?

During regenerative therapy we will take a sample of your bone marrow and inject it into the damaged or injured area. Bone marrow has a high concentration of stem cells that have the ability to stimulate the growth of new bone, cartilage, nerve, and soft tissue cells to help restore your body to normal functionality and comfort. While it may take some time for your body to develop the new, healthy cells, many patients begin seeing improvement in mobility and comfort 4-6 weeks after treatment. These results will continue to improve over time, and are long-lasting.

Who is a candidate for SCS/DRG?
This treatment approach is a good option for many patients, and Dr. Manocha can help you decide if it is a right option for you. Spinal cord stimulation offers a pain relief path in the following circumstances:

• Conservative therapies have proven ineffective
• Additional surgery is not recommended
• There are no medical conditions that could interfere with the procedure
• There is no active depression or drug addiction

Spinal cord stimulation is most effective when used in the early stages of chronic pain before the condition turns disabling.

How do they work?

Both SCS and DRG stimulators are devices that are implanted into the body, along the nerves in the spine and disrupting pain signals from being sent to the brain. The type of device needed will depend on the location of your pain, as SCS devices and DRG are placed along different nerves and thus control different areas where pain may be experienced. Both types of devices are equipped with an external remote so that you can adjust your level of pain relief.

What conditions can spinal cord stimulation treat?

Spinal cord stimulation can effectively treat numerous conditions, including but not limited to:

• Failed back surgery syndrome (Post Laminectomy Syndrome)
• Arachnoiditis (Clumping, scarring and inflammation of the spinal nerves)
• Complex regional pain syndrome
• Sciatica
• Chronic arm/leg pain
• Peripheral vascular disease
• Multiple sclerosis

The best way to determine the right treatment path begins with a thorough diagnostic exam with Dr. Manocha.

Two stages

The trial stage offers you a chance to “test drive” stimulation system. The procedure is done on an outpatient basis, and you will be able to return home shortly afterward. If you take certain blood-thinning medications, you may need to stop those drugs for 3-7 days before your appointment.

You will receive mild sedation along with local anesthetic to numb your lower back area. Dr. Manocha uses X-ray fluoroscopy to guide a treatment needle into your epidural space and place the trial leads, which is connected to an external generator you wear on a belt.

For the next 4-7 days, you will wear the device and keep a record of your pain relief. You should perform a range of activities to see how SCS/DRG works under different conditions. The results of your trial can help you and Dr. Manocha decide if permanent spinal cord stimulation is right for you.

What can I expect after the procedure?

While the procedure for placing the device is minimally invasive, you will need to allow time for the incisions to heal afterwards. We will give you complete aftercare instructions for how to care for your incisions, as well as any lifestyle modifications that may need to be made to prevent damaging your device and supporting equipment.