Treatments
From precise, image-guided injections to the newest minimally invasive and implantable therapies, our physicians match each treatment to the source of your pain.
Advanced therapies
When injections and medications aren't enough, these newer options can offer longer-lasting relief, often without major surgery. Many are also options for patients who aren't surgical candidates, whether their pain isn't surgically correctable, as with nonsurgical radicular pain or CRPS, or age and health make major spine surgery too risky.
For chronic back, leg, and nerve pain
Spinal cord stimulation
A small device, implanted in a minimally invasive outpatient procedure, sends gentle electrical pulses to the spinal cord to quiet pain signals before they reach the brain. You try it for about a week first, so you know it helps before deciding on an implant. We offer two of the most advanced systems available.
For chronic low back pain from degenerative discs
VIA Disc NP
A tissue allograft placed into the center of a degenerated disc through a thin needle, supplementing the cushioning your disc has lost. It's a same-day outpatient procedure with no incision and no implant, for patients who haven't improved with conservative care.
Peripheral nerve stimulation (SPRINT® and ReActiv8®)
For chronic low back, cluneal, shoulder, knee, and other nerve pain
SPRINT places a thin lead next to the target nerve through a needle for a 60-day treatment, then is removed with no permanent implant. ReActiv8 is an implanted system that stimulates the nerves controlling the multifidus muscle to restore spinal stability in chronic mechanical low back pain.
Basivertebral nerve ablation
For chronic low back pain from the vertebrae
Targets the nerve inside the vertebra that carries pain from damaged endplates. It’s intended for low back pain lasting at least 6 months despite conservative care, with endplate changes (Modic type 1 or 2) visible on MRI. A same-day procedure with no implant.
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SI joint fusion (LINQ® and TRAQ™)
For chronic sacroiliac joint pain
Stabilizes the SI joint with a small implant and bone graft placed from the back through an incision about an inch long. It’s intended for SI joint pain confirmed by diagnostic injections that hasn’t responded to conservative care, and is typically a same-day outpatient procedure using a tissue-sparing posterior approach.
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Percutaneous lumbar decompression (mild® and LiFT™)
For lumbar spinal stenosis with neurogenic claudication
Under fluoroscopic guidance, hypertrophied ligamentum flavum and small amounts of lamina are removed through a small portal or incision, enlarging the spinal canal and relieving nerve compression. Same-day procedures with no implant.
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Genicular nerve ablation
For chronic knee pain from osteoarthritis or after knee replacement
After a diagnostic genicular nerve block confirms the pain source, radiofrequency probes are placed under X-ray guidance alongside the genicular nerves. A controlled thermal lesion interrupts pain transmission from the knee, often for 6 to 12 months or longer.
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Kyphoplasty and vertebroplasty
For painful vertebral compression fractures
The fractured vertebra is accessed through a needle under fluoroscopy. In kyphoplasty, a balloon first creates a cavity and can restore some height; bone cement then stabilizes the fracture, often relieving pain within days.
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Spinal radiofrequency ablation
For facet joint arthritis pain in the neck, mid back, and low back
After diagnostic medial branch blocks confirm the facet joints as the pain source, a radiofrequency probe creates a precise thermal lesion of the medial branch nerves under X-ray guidance, interrupting pain signals for cervical, thoracic, and lumbosacral facet pain. Relief often lasts 6 to 12 months or longer.
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Epidural steroid injections
For radicular pain, including sciatica
Corticosteroid and local anesthetic are delivered to the epidural space near inflamed nerve roots under live X-ray guidance with contrast, using interlaminar, transforaminal, or caudal approaches.
Learn moreAll treatments
Injections and procedures are performed by our physicians, using X-ray or ultrasound guidance for precise placement.
Spine injections
- Epidural steroid injectionsInterlaminar, transforaminal, and caudal injections for radicular pain from inflamed or compressed spinal nerve roots
- Selective nerve root blocksTargeted injection at a single nerve root to confirm and treat the nerve generating pain
- Facet injections and medial branch blocksDiagnostic and therapeutic injections for facet joint arthritis, used to confirm candidacy for radiofrequency ablation
- Epidural neuroplastyCatheter-directed adhesiolysis of epidural scar tissue around nerve roots after spine surgery
Nerve ablation
- Spinal radiofrequency ablation (RFTC)Thermal lesioning of the medial branch nerves for cervical, thoracic, and lumbosacral facet pain
- Genicular nerve ablationRadiofrequency lesioning of the genicular nerves for chronic knee pain
- Basivertebral nerve ablationAblation of the nerve within the vertebral body for vertebrogenic low back pain with Modic changes on MRI
Joints and muscles
- Sacroiliac joint injectionsImage-guided diagnostic and therapeutic injection of the sacroiliac joint
- Sacroiliac joint fusionPosterior fusion with LINQ® or TRAQ™ implants for confirmed SI joint pain
- Intra-articular joint injectionsImage-guided injections of the hip, knee, shoulder, and other joints for arthritis pain
- Bursa injectionsCorticosteroid injection for bursitis of the hip, shoulder, and knee
- Trigger point injectionsInjection of taut muscle bands to relieve myofascial pain
Nerve blocks and headache care
- Occipital nerve blocksFor occipital neuralgia and cervicogenic headache
- Sphenopalatine, glossopharyngeal, and trigeminal nerve blocksFor trigeminal and glossopharyngeal neuralgia, facial pain, and refractory headache
- Stellate ganglion blocksSympathetic block for CRPS and sympathetically mediated pain of the face, neck, and arm
- Sympathetic nerve blocksLumbar sympathetic and other sympathetic blocks for CRPS and sympathetically mediated pain
- Cluneal nerve blocks and stimulationDiagnostic blocks and peripheral nerve stimulation for low back and buttock pain from cluneal nerve entrapment
- Ganglion impar blocksFor coccydynia and perineal pain
- Botox® (botulinum toxin) injectionsPreventive treatment for chronic migraine, and targeted injections for cervical and other focal dystonias
Stimulation and minimally invasive procedures
- Spinal cord stimulationEvoke by Saluda and HFX by Nevro
- Peripheral nerve stimulationSPRINT® 60-day PNS and ReActiv8® restorative neurostimulation
- VIA Disc NPAllograft supplementation for degenerative disc disease
- Percutaneous lumbar decompressionmild® and LiFT™ for lumbar stenosis from ligamentum flavum hypertrophy
- Kyphoplasty and vertebroplastyVertebral augmentation for painful osteoporotic and other compression fractures
Diagnostic testing
- EMG and nerve conduction studies (NCV)Electrodiagnostic testing for radiculopathy, peripheral neuropathy, and nerve entrapment
- Lumbar discographyProvocative testing to identify a painful disc before treatment
- Pharmacogenetic testingA one-time cheek swab, analyzed at our partner lab in Little Rock, shows how your body metabolizes nerve pain, anti-inflammatory, muscle relaxant, cardiovascular, mood, and many other medications. Results help identify medications less likely to cause adverse effects, especially if past medications haven’t worked.
- Laboratory and toxicology testingBaseline blood work and periodic toxicology testing for diagnostic evaluation and controlled substance monitoring, consistent with CMS and CDC recommendations for long-term medication therapy
- Behavioral health and risk screeningValidated screening for mood, anxiety, and substance use risk before and during long-term medication therapy, with coordination of behavioral health care when needed
Medication management
- Chronic pain medication managementComprehensive, guideline-based management of medications for chronic pain, coordinated with your procedural care
- Medication-assisted treatmentTreatment for opioid and other substance use disorders, including buprenorphine therapy with Sublocade®, Suboxone®, and Zubsolv®
Not sure which treatment is right for you?
You don't need to know the name of a procedure to get started. Our physicians will review your symptoms, exam, and imaging to find the source of your pain and recommend the right next step.
Botox is a registered trademark of Allergan, an AbbVie company. Procedure images courtesy of Stryker, PainTEQ, SPR Therapeutics, Mainstay Medical, Saluda Medical, Nevro, and Vivex Biologics. Epidural illustration: Blausen.com staff, “Medical gallery of Blausen Medical 2014,” WikiJournal of Medicine, CC BY 3.0, cropped.