Rehabilitation Medicine

Back Pain and Spinal Care

Our interventional pain management team understands how debilitating your back and spinal pain can be. Our experts make sure that you not only know the cause, but source of your back and spinal pain so that our treatment can focus on eliminating specific triggers while restoring as much function as possible.

Treatments

Whether your pain comes from an injury or disease, our interventional pain management treatment of the back and spine includes diagnostic, rehabilitative, or a combination of both options.

Discography

Discography focuses on your physical response to pressure on specific spinal discs. This procedure injects a dye into your disc which causes pressure and will result in a response that will determine if your back pain is disc-related and what areas of your back need attention.

As one of the most reliable diagnostic tools for this type of pain, we recommend discography if you have undergone extensive tests and treatments, but still suffer from severe groin, hip, leg, or lower back pain.

Through this process, we also conduct fluoroscopic imaging which allows us to view your spine and each step of the process in detail. Once we receive your results, we will work with you to develop a personal treatment plan and get you back on the road to recovery. 

Epidural Steroid Injections

At Mount Sinai, our specialists in interventional pain management medicine may use an epidural steroid injection to decrease pain in the neck, lower back, arm, and leg. Our epidural injections are always performed using high-tech fluoroscopic imagery with the help of local anesthesia for your comfort. Often, relief is felt for several months before another injection may be needed.

Medical Acupuncture

Performed by physicians and therapists, medical acupuncture is an alternative form of medicine that stimulates points in specific areas throughout the body using very thin needles. Acupuncture causes natural chemicals to be released into the body to ease pain, improve functioning, and increase relaxation.

Our team may incorporate medical acupuncture into your comprehensive patient treatment plan, or you may choose to use it as your only form of treatment. Acupuncture may also be used in addition to the use of medications, osteopathic manipulation, joint or trigger point injections, physical therapy, psychotherapy, and herbal therapies.

Spinal Cord Stimulation

At Mount Sinai, we have perfected the procedure of spinal cord stimulation (SCS). As a medical treatment that targets chronic pain in the spinal cord, without requiring medications or major surgery, the spinal cord stimulator delivers a mild electrical current to disrupt pain signals.

Patients typically use SCS when standard treatment has not worked after at least six months and revision surgery is not an option. This treatment is often used to treat conditions such as complex regional pain syndrome, failed-back surgery syndrome, and neuropathy.

If you are a candidate for SCS, we will first perform a trial procedure that includes implanting a lead connected to an external programmer in your skin for five to seven days while you continue with your normal activities. If the trial is successful, we will implant a permanent system in your body.

During the implant procedure, the device is placed under your skin, usually with a small dose of anesthesia. If your spinal cord stimulator is no longer helping with your pain, it can be removed through a simple procedure. No matter the type of procedure you receive, you will be allowed to go home the same day.

Sympathetic Blocks

Our team of specialists in interventional pain management also offer sympathetic blocks as one part of your treatment. A sympathetic block is an injection of a local anesthetic into or around the sympathetic nerves which blocks pain receptors.

The most common blocks include:

  • Ganglion impar: A cluster of nerve cells usually centered outside the brain or spinal cord. The ganglion impar blocks reduce pain from the pelvis or tail bone
  • Lumbar sympathetic blocks: The lumbar sympathetic block targets the lower back and legs, reducing pain in those areas that is caused by degenerative disc disease, failed back surgery syndrome; reflex sympathetic dystrophy; complex regional pain syndrome; sympathetic maintained pain; or herpes zoster. A lumbar sympathetic block injection works by placing a local anesthetic in a specific location of the neck, where the nerve fibers are positioned, to block pain
  • Stellate ganglion: Stellate ganglion blocks are used to treat pain in the arm, head, neck, or chest

Compression Fracture Care

Compression fractures usually begin with tiny breaks in the vertebrae that can occur as bones get softer and weaker over time. These fractures can result in changes in the shape of your spine affecting your posture and making it more difficult to breathe while also causing pain and potentially, immobility.

Your doctor will interview you about your back pain and will perform a spinal X-ray to confirm your diagnosis. Next, a CT scan or MRI may be performed to reveal more detail about the bone, surrounding nerves, and the condition of other discs.. During this time, your doctors will also check to see if the cause of your compression fractures is due to arthritis, osteoporosis, and rule out any possibility of cancer.

Our specialists and therapists also offer our patients a comprehensive range of treatment for compression fractures. Treatments of compression fractures include:

  • Kyphoplasty: Minimally invasive procedure that rebuilds the vertebral space, using cement or a bone substitute.
  • Spinal bracing: Molded jackets or corset braces are constructed to stabilize and relieve pressure on the spine.