Non-surgical Treatments for Back and Neck Pain

Although Dr. Milani is a spinal surgeon, most problems are initially treated with conservative treatments of various kinds. Therapy, epidural steroid injections (ESI’s), facet joint injections, bracing, and medication management are a few of the common non-surgical methods used. Many patients will improve enough with these treatments that surgery becomes unnecessary. Dr. Milani works closely with a highly skilled physical medicine practitioner who can perform many of the injection procedures and also performs some of these himself. A coordinated effort is very often the best approach.

Epidural Steroid Injection

Epidural steroid injection is a spinal injection using anesthetic and steroid (an anti-inflammatory drug) placed in the region of compressed or inflamed nerves. The procedure is performed with x-ray guidance using a machine called an image intensifier. This allows the material to be place very precisely in the area of the inflamed and painful nerve. It is used for such problems such as herniated disc, spinal stenosis and other forms of nerve irritation. The procedure is usually performed using sedation and local anesthetic as a day procedure at a hospital or ambulatory center. It is performed very commonly and is a quick procedure that can be associated with temporary or permanent relief of arm or leg pain caused by nerve inflammation in the neck or back. Although more than one injection is sometimes required, a single injection can, in some cases, be effective enough to provide good pain relief.