spinal injections

Spinal Injections: What Are They and How Do They Work?

The Bureau of Labor Statistics reports that one million back injuries sustained at work account for 20% of all workplace-related injuries and illnesses. This is second only to the common cold. In general, about 80% of the population has suffered from back pain.

For people who have radiculopathy (inflammation or damage to a nerve) or a herniated disc, spinal injections have proven to be one of the most effective treatments.

Needles can be scary, especially if they are meant for the spinal column. But they can be a lifesaver when it comes to back pain management.

Read on to find out what spinal injections are and why you might need one.

What Are Spinal Injections?

Spinal injections are also known as epidural injections. They are similar to the ones pregnant women get during childbirth. These injections are introduced into your epidural space, a space just outside the membrane protecting your spinal cord.

Epidural injections are also given during or after surgery as anesthesia and for treatment of chronic pain. Different medications are administered through these spinal injections including steroids, to manage pain and reduce inflammation in the back, legs, arms, and neck.

Doctors use an X-ray and a special dye to introduce the needle in the right place. This procedure is known as fluoroscopy Depending on where you’re experiencing pain, he or she will choose a location along the length of your spine closest to the inflamed and painful nerve.

The entire procedure takes about fifteen minutes and if you’re being medicated with a steroid, you should start to see the benefits in about 3 days. Pain relief differs in different people but on average it can last for months.

Who Can Get Treated with Spinal Injections?

There’s a wide variety of treatments available for back pain management. But there are certain conditions that are treatable by an epidural injection. They include pinched nerves, radiating pain from the spine, herniated disc and spinal stenosis.

Who Can’t Get Treated with Spinal Injections?

People with certain conditions should avoid spinal injections due to the risk.

These conditions include infections, diabetes mellitus, and blood clotting disorders. Also, people with the bleeding disorder, allergies to anesthetic agents or certain medications, and drug addictions should avoid it.

Depending on your condition, another treatment or pain relief option may be sought for you. Or the doctor may defer your injection until a favorable time.

How Do Spinal Injections Work?

Spinal injections deliver steroids and anesthetic directly into the epidural space. Occasionally, doctors may use a saline solution to flush the area and rid it of inflammatory chemicals in the space that causes the back pain.

Typically, doctors use a combination of cortisone, which is an anti-inflammatory medication and lidocaine, a quick-acting local anesthetic.

In general, spinal injections have two uses.

First, they are a diagnostic tool used to find the source of the pain. This can be in the back, leg, arm or neck.

Second, they help in pain relief. They are usually part of a comprehensive therapeutic program which almost always includes physiotherapy to improve spinal mobility and stability. This can include strengthening and stretching exercises.

Types of Spinal Injections

Spinal injections come in the following categories.

Epidural Injections

These relieve pain that radiates from the spine to an arm or leg. This occurs when a spinal nerve gets compressed or pinched.

Facet Joint Injections

They have both diagnostic and therapeutic value. They are commonly used when pain results from arthritic conditions or injuries. They are also used for pain relief in the neck, middle and lower back.

As a diagnostic procedure, the anesthetic gets injected into a joint or into the nerves that carry the pain signals. If the anesthetic reveals the nerve as the source of pain, then the pain signals get blocked permanently through radiofrequency ablation.

Sacroiliac Joint Injections

These are much like the facet joint injections. The sacroiliac joints are in the lower back, between the sacrum and ilium (pelvic) bones. These joints do cause lower back pain, usually unilaterally.

This injection also has both diagnostic and therapeutic value. To diagnose the pain, the SI join gets anesthetized with X-ray guidance.

This is the gold standard for diagnosing SI joint pain. If the pain improves with the anesthetic, then the pathology is confirmed.

As a therapy, a steroid injection will be given to relieve pain.

Provocation Diskography

This is a spinal injection only used for diagnosing pain. It does not relieve pain but rather causes it. This test gets done for those who have chronic back pain which doesn’t improve with conservative treatment.

Because of its ability to worsen back pain, it’s not performed commonly. But it can be useful for providing information if a surgery is being planned on the lower back.

Risks of Spinal Injections

All invasive procedures carry a certain amount of risk. With a .01 to .001% risk, infections are rare but possible. Bleeding can occur in patients taking certain medications or in people who have clotting, bleeding, and liver disorders.

Dural punctures do occur in 0.5% of the injections, where a doctor may breach the dural space leading to a wet tap that leads to a headache.

Direct trauma from the needle can also cause nerve damage. Yet, this is very rare since the procedure is done under visual guidance.

There may be some side effects of the steroid medication depending on which ones get used instead of the injection itself.

Some of them include severe localized pain which is temporary, headaches that resolve in 24 hours, insomnia, facial flushing, and fever (usually on the day of the injection).

You may also experience elevated blood sugar, anxiety, gastric ulcers, cataracts and a decreased immunity for a brief period.

Following your injection, if you experience a headache that improves on lying down then you may have a Dural puncture. You must relay this to the doctor.

Similarly, if you spike a fever of 101 degrees or more for over 24 hours, lose function or sensation in the extremities, or lose bowel or bladder control, speak to your doctor immediately.

Closing

Injections have never been a patient’s best option for getting treatment. But when you overcome your fear, it can be your best bet at getting healed. So, make sure that you consult your doctor about the various options that you have.

If you have any questions regarding the management of your back pain or need information about spinal injections, contact us.

Sacroiliac Joint Fusion with The iFuse Implant

DID YOU KNOW?

The Sacroiliac (SI) joint may be a pain generator in 15-30% of patients with chronic lower back pain and even higher (up to 43%) for patients with continued or new onset low back pain after a previous lumbar fusion.* Learn about SI joint dysfunction and treatment options from Dr. Carl Spivak, MD, a Neurosurgeon at Executive Spine Surgery.
*Rashbaum – Clin Spine Surg 2016
This event is co-sponsored by SI-BONE, Inc.
Important Safety Information: https://si-bone.com/risks

facet thermal ablation

How to Prepare for Facet Thermal Ablation

Back pain is an unfortunately common occurrence with an estimated 80% of the world population suffering from back pain at some point in their life. When that pain becomes chronic or when it is nerve pain, everyday activities can become excruciating.

Spinal and nerve pain caused by arthritis and/or joint degeneration can:

  • Limit mobility
  • Cause chronic pain
  • Make simple tasks impossible

Fortunately, there is a procedure called facet thermal ablation that can potentially alleviate this pain caused by issues in the facet joints of your spine.

Keep reading to learn about facet thermal ablation and how it can potentially help you.

What is Facet Thermal Ablation?

Facet thermal ablation is a minimally invasive procedure performed to alleviate pain in patients suffering from issues in the facet joints.

The facet joints in your spine refer to the joints in between the vertebrae the make your spine flexible. Cartilage is also found in these joints between the vertebrae to cushion the joints and the bones in your back.

When the cartilage wears down or when you’re suffering from disorders like arthritis, the way your facet joints line up and the way the bones touch changes. This can cause grinding, inflammation, tearing, and a loss of mobility.

These joints have a high concentration of sensitive nerves, making any damage or negative effects very painful. A facet thermal ablation is a procedure that can alleviate the pain and immobility caused by affected facet joints.

How Does Facet Thermal Ablation Work?

Unlike intense open surgical procedures that require anesthesia, this procedure is minimally invasive and requires no anesthesia. Instead, your back will be numbed and you’ll be given medication to help you relax.

You’ll be kept on conscious sedation so the doctor can ask you questions during the procedure. This might seem scary, but you’ll be completely relaxed and you probably won’t remember the procedure.

Next, the doctor will insert a needle into your back. The doctor will use something called a fluoroscope to guide the need into your back and find the areas causing pain and immobility.

Once in position, the doctor will insert a charged electrode into the tube. Using jolts of weak electricity via the electrode will essentially “numb” the nerves of the damaged facet joint.

This will prevent the nerves from sending pain signals to your brain, which will reduce the pain you feel in your back.

This is repeated for each joint that is in pain. The entire procedure only takes around 40 minutes and will produce little to no scarring.

What Conditions Can Be Helped with This Procedure?

You could be experiencing facet joint pain for a number of different reasons. A few of the most common conditions that can be helped with a facet thermal ablation procedure are:

  • Osteoarthritis
  • Facet Joint Syndrome
  • Joint Degeneration
  • Facet Hypertrophy
  • Facet Disease

Since each of these conditions affect the facet joints and result in joint and nerve pain, this procedure is commonly used as a treatment.

What Symptoms Will This Procedure Relieve?

Facet thermal ablation essentially numbs the nerves in the facet joints that are causing pain and immobility. This will help a number of your symptoms.

Pain. Because the nerves in the affected joints will be numbed by this procedure, you won’t feel the persistent or chronic pain that you were experiencing because of the joint degeneration.

Mobility. Patients find that this type of procedure can help their mobility in their neck and back.

Inflammation. Joint inflammation is a common symptom of arthritis and facet joint diseases. This procedure can reduce the inflammation in the joint and help reduce pain caused by that inflammation.

How to Prepare for Facet Thermal Ablation

Here’s what to expect:

Getting Approved

In order to be approved as a candidate for this procedure, you’ll need to make an appointment with an appropriate physician. They will be able to talk with you about your condition, examine you, and determine whether this procedure will benefit you.

Some physicians may recommend getting an X-ray or an MRI to examine your spine. You also likely won’t be approved for this procedure if you haven’t tried other treatments such as physical therapy or medication.

The Procedure

Once you are approved to get this procedure, you’ll be able to schedule an appointment. This is a minimally invasive outpatient procedure, which means it doesn’t require as much prep as a more intense and more invasive procedure.

The procedure itself takes around 30 minutes with an added 1-2 hours for observation and preparation pre- and post-procedure. Be sure to schedule this on a day when you don’t have work or school, as you will likely be out of commission for that day.

Aftercare

You should also arrange for a friend or family member to accompany you. Because of the sedation and the pain you might feel after the procedure, you’ll need them to drive you home.

Be sure to plan some low-key days in the 2 or 3 days following the procedure. You shouldn’t be doing any exercise or strenuous activity as you heal.

It can’t hurt to prepare some “sick day” supplies for the days following the procedures, like some comfort food or your favorite movies!

Wrapping Up

A facet thermal ablation can be a lifesaver for those suffering from chronic back pain. That might seem dramatic, but relief from chronic pain and immobility can give someone the freedom they need to live a normal life.

At Executive Spine Surgery, Dr. Carl Spivak will provide you with high-quality care that will make you feel safe and taken care of. If you have any questions or want to schedule an appointment to learn more about this procedure, contact us.

stem cell disc regeneration

How Does Stem Cell Disc Regeneration Work?

For many people, pain in the legs, hip, and back can be quite unpleasant.

One common cause of this pain is a degenerated disc, which is also known as degenerative disc disease. In the US, this condition is common as there are about 3 million cases every year.

Well, there are different treatments for such pain, including physical therapy, muscle relaxants, analgesic, nucleoplasty, and nonsteroidal non-inflammatory drugs. Surgical procedures may also be necessary for some instances.

One of the recent additions to the treatment options is stem cell disc regeneration. This procedure is already being advertised as an effective option for back pain. But, do you know how it works?

Keep on reading to learn more.

What Is Degenerative Disc Disease?

Degenerative disc disease occurs when normal activities that occur in the disc cause pain.

Ideally, these activities take place in nearly everyone over time. However, not everyone feels pain. Depending on your lifestyle, the disc can wear faster than in other people. When they get worn-out, you’ll start feeling pain.

Discs in the spine are made up of water. As you age, the water is lost, and the discs become thinner than before. This means your discs can’t absorb shock well. Also, they’re less cushioned, and this increases your risk of low back pain.

Also, the stress of daily activities can lead to tiny tears in the out water that contains nerves. Your discs may push through the tears, and this is what’s known as a herniated disc. When this happens, you’ll feel pain.

What is Stem Cell Disc Regeneration?

This is typically a medical process that involves the injection of stem cells into the disc. According to its proponents, the treatment works by preventing or slowing the degenerative process of the discs. It achieves this facilitating the production of new disc cells.

Scientists have already tried this injection on animals, such as rabbits, and it yielded promising results. As such, this has been a welcoming idea in the treatment of back pain in humans.

It’s hypothesized that stem cells turn into cartilage cells when injected into the disc. This allows the disc to regenerate and consequently, alleviating the pain. Doctors can harvest the stem cells from adults to use in treatment.

What Happens During the Procedure?

Well, the stem cell disc regeneration treatment is still in its infancy stage. However, experimental stem cell treatments have healed the damage that has occurred on the disc.

The procedure is minimally invasive. The doctor first extracts bone marrow from the patient’s hip bone. Then, they separate the stem cells through a procedure known as centrifugation. Alternatively, stem cells can be obtained from abdominal fat through a process called liposuction.

Your doctor will then use an X-ray to determine the ideal spot for injecting the stem cells. You can return to your normal routine after the injection.

Does it Work?

According to doctors, patients usually experience improvement two to three months after the treatment. Plus, you only need one treatment to get better.

However, in some cases, patients may need two or three injections. Also, a patient can’t have more than three injections within a span of 12 months.

Many doctors are claiming that disk regeneration using stem cells is the only effective alternative treatment for fusion and back surgery. It’s noted that the injection helps the disc to regenerate at a healthy rate. As such, patients should not worry about any possible complications.

Doctors also recommend undergoing physical rehabilitation following the treatment. Keep in mind that your recovery will depend on the degree of your spinal disc damage.

Why Use Stem Cells

Stem cells are ideal for this procedure because of their ability to repopulate. Essentially, they’re able to differentiate into discogenic cells.

In the past, doctors used to use embryonic stem cells. These are stem cells that are derived from the inner mass of the human embryo. Today, this is not the case since the adult stem cells are ideal for use, too.

Doctors can derive adult stem cells from the bone marrow or the adipose tissue. It’s noted that adipose-derived stem cells offer the ideal matrix for stem cell disc regeneration. This is because of their ability to generate the cartilage faster than bone marrow-derived cells.

Stem cells have also shown to communicate with nucleus pulpusus (NP) cells. This helps to produce anabolic growth factors that boost the cell function.

Possible Risks

As with any injection, there are potential risks, such as bleeding, infection, and nerve damage. Also, the risks depend on the area that’s receiving the injection.

It’s important to note that there’s no risk of allergy. This is because the doctor uses the patient’s own stem cells. With that in mind, every case is unique. At this time, there are no reports of any complications from patients.

There are FDA studies and trials that ongoing to help doctors understand more about the stem cell disc regeneration therapy.

What Does this Mean for Patients?

Several health centers and facilities, including Executive Spine Surgery, are already offering stem cell injections for degenerative discs. If you’re considering this treatment, it helps to find reputable doctors to provide it.

A good doctor will monitor your closely for potential benefits and side effects after getting the injection. Plus, they’ll help you know whether the treatment will work for you. This is because a severely degenerated disc has proven nearly irresponsive to treatment.

Severely degenerated discs that have lost all of their height usually have fewer cells living in them.

Final Thoughts

While stem cell disc regeneration has yielded promising results, it’s worth working with a doctor that assesses your situation well. Ideally, this treatment has considerable potential in revolutionizing the treatment of disc degeneration, herniations, and cartilage defects.

At Executive Spine Surgery, we treatment disc problems, such as bulbing, herniations, and degeneration. We offer a personalized approach to ensure all unique issues are addressed. THrough our minimally invasive treatments and pain management procedures, we’re sure to help you recover from your back pain.

Well, do you have any question about disc regeneration or back pain? Feel free to reach out to us, and we’ll be glad to help.

stem cells

Can Stem Cells Fix a Discogenic Back Pain?

Discogenic low back pain is a disabling condition. It is the third largest healthcare expense in the U.S. It is also second only to the common cold as a cause of missed work.

Many people who live with discogenic back pain have limited treatment options. Non-surgical treatments, such as physical therapy and opioid pain medication, aren’t always effective.

The injection of stem cells into the disc is being pursued as an alternative to both non-surgical and surgical treatments.

Read further to learn more about this exciting, new technique that offers long-term pain relief.

Discogenic Back Pain

Discogenic pain begins from one or more damaged spinal discs. It is usually due to degenerative disc disease and happens naturally with age. Sometimes, a ruptured or herniated disc is the cause of pain. It is rarely seen after 60 years of age.

Symptoms of this disorder include:

  • Increased pain when sitting, coughing and sneezing, and leaning forward
  • Leg pain, called radiculopathy, when sitting, standing, and walking
  • Usually chronic in nature

Discogenic pain is most often diagnosed by MRI. When standard treatments fail, the physician orders a discography (or discogram). This is a special x-ray where the radiologist injects dye into the discs and takes x-rays. It helps determine if the patient has more than one disc causing the pain.

The most common treatment for this disorder is surgery, which has many risks. Other treatments include physical therapy, medications, and spinal injections. Alternative therapies such as acupuncture and yoga may also be helpful.

Doctors are now turning to stem cell therapy to treat patients with uncontrolled back pain.

Stem Cells and Pain Management

Stem cells are cells that have not transformed into their specific function in the body. They include bone marrow, skin cells, and embryonic cells. Their main function is to replace damaged cells and promote tissue regeneration.

The doctor aspirates bone marrow from the hip bone of the patient. The bone marrow has many different types of cells including stem cells. Then, the lab spins the aspirated sample in a centrifuge to separate the different types of cells.

Stem cell disc regeneration is the process where the physician injects the cells into a patient’s spine. He/she uses x-ray imaging as guidance to locate the correct location. With time, the cells begin to differentiate with the growth of new disc tissue. Complete disc regeneration occurs from a couple months to a year. Many patients experience total relief of their pain within a few months.

Researchers reviewed many studies using different types of stem cells. They found improvement in discogenic pain in all but one study.

Researchers think stem cells work to decrease the pain and inflammation in the spine. They also function to repair the damaged tissue. These studies show that stem cells can increase the new growth of the disc tissue.

The exact mechanisms of this novel treatment are still unknown. Yet, it creates a less invasive choice for people suffering from back pain.

Patient Criteria

Because this is such a new therapy, there are no official guidelines in place. Some physicians recommend it for younger patients with mild disc damage. Others make the decision on a case-by-case basis. The patient also needs to know that health insurance doesn’t cover it. Most facilities require cash payments.

Risks and Benefits

Stem cell therapy is so new that the long-term risks and benefits are still unknown.

Benefits include:

  • Reduction of pain
  • Decreased inflammation
  • Replace bone, cartilage, and disc cells
  • Less invasive and shorter recovery time than surgery
  • Minimal pain with the procedure
  • Little to no adverse effects

Risks involved include:

  • The best stem cell type and the best way to administer it is unknown
  • The potential for infection at aspiration and injection sites
  • Pain and swelling
  • Rash and redness at the site

There are no serious adverse effects reported to date. But, there are also no long-term studies to compare results. Doctors suggest weighing the pros and cons to determine if this is a good fit for each patient.

Questions for Your Doctor

Write down your questions before coming to the appointment. You won’t forget to ask about important concerns. You will leave informed and confident about your decision.

  1. How do you calculate the number of cells needed per injection?
  2. Is there a difference between stem cell therapy for disc regeneration and cancer therapy?
  3. What is the risk of contamination?
  4. Do other conditions like diabetes or smoking affect the regeneration?
  5. What is your success/fail rate?
  6. Have you seen any adverse side effects from this treatment?

Future Implications

There are still unknown aspects of stem cell therapy. Future research should include long-term studies to rule out complications not already known.

In the future, the use of stem cells can decrease or end the pain. It can help avoid thousands of unnecessary surgeries. The disc causes unbearable back pain when they deteriorate. There is no cushion from the discs creating unrelenting pain.

Researchers expect to slow down the breakdown of aging discs. Initial data from current research shows this is a promising therapy for discogenic back pain.

How We Can Help

Stem cell therapy often gives welcomed relief from this painful condition. It also creates the regeneration of tissue to heal the damaged discs. Patients who have exhausted all available treatments now have an alternative to surgery.

There are no guarantees with any medical procedure. Alternatives for these patients include surgery and narcotic pain medications.

Understanding the use of stem cell therapies is crucial for patients to weigh all their options. Sometimes this is the only treatment option left. It provides a better solution while decreasing the time for recovery and the costs seen with surgery.

Disk regeneration helps patients suffering from long-term, disabling pain. It allows them to return to a life without pain. They can begin to take part in activities that their pain prevented them from doing.

If you’re dealing with disabling back pain, contact us to find out if stem cell therapy is for you. We will direct you to the next steps to take to find out if you are a good candidate for the procedure.

spinal injections

Are You a Candidate for Spinal Injections?

Every time you move, you wonder if more pain will follow. That’s what life looks like when you’re suffering from chronic pain such as back or neck pain. Fortunately, spinal injections may give you the relief you desperately need from this type of pain.

Getting spinal injections involves having anti-inflammatory steroidal compounds — for example, cortisone — injected into your body so that you can experience temporary relief from your chronic pain.

These injections decrease swelling around your nerve, thus easing the irritation there.

Steroid injections may provide more relief than over-the-counter medications. Here’s a rundown of what makes you a candidate for these injections.

Let’s get started!

Candidates for Spinal Injections

You are a candidate for steroid injections if you are struggling with an irritated or compressed nerve.

You may also be eligible for injections if you have a spinal joint that is degenerating, leading to localized pain, tingling, muscle weakness, radiating pain or numbness.

The following conditions can produce such symptoms.

Osteoarthritis

With osteoarthritis, or degenerative joint disease, the cartilage that provides cushion at the top of your bones wears down, thus causing pain and swelling. This condition might also cause bone spurs to develop.

Spondylolisthesis

Spondylolisthesis refers to the condition where a vertebra — a bone in your spine — slips, usually at your spine’s base.

Vertebrae can easily slip over a bone, backward or forward as a result of spondylolysis, a fracture or defect of part of a vertebra.

Sciatica

Sciatica is typically characterized by several symptoms, including chronic pain in one leg or buttock, pain that worsens when you’re sitting, or a searing, burning or tingling sensation in your leg.

Other signs you have sciatica include trouble moving your toes, leg, and foot, or even radiating pain that impacts your leg and even your toes and foot.

Herniated Disc

If you have a herniated disc problem, this means one of your discs, or rubbery cushions, between your vertebrae has a problem.

Specifically, the softer part inside the disc pushes out via a tear present in the disc’s tougher exterior.

Herniated discs can easily irritate the surrounding nerves, thus leading to weakness, pain, and numbness.

Failed Back Surgery Syndrome

Also known as FBSS, this condition generally refers to the condition you face if you’ve undergone an unsuccessful spine surgery or back surgery.

Unfortunately, this is not an uncommon issue, as even with the best surgeon, having a 100% successful result is not always guaranteed.

Spinal Stenosis

This condition refers to the narrowing of your spine’s spaces, which can place pressure on your spine’s nerves. Stenosis usually occurs in the neck and lower back areas.

Although some spinal stenosis sufferers might not have symptoms, others experience muscle weakness, tingling, pain and numbness. And these symptoms could become worse over time.

Before You Get Injections

Before you can receive spinal injections, you typically have to try more conservative, less invasive treatment options first. These include chiropractic manipulation, hot/cold therapy, exercise, and stretching.

Of course, every individual responds to these treatments differently. If they prove not to be effective for you, then you may be eligible to receive injections to manage your back or neck pain.

The injections work by decreasing the inflammation causing you discomfort around the spinal nerve that has become irritated.

Injection Treatment

Steroid injections can be given in multiple areas of the body. One of these areas is your epidural space — the area of the spinal canal that the nerve roots and spinal cord pass through.

Yet another area subjected to these injections is your facet joints — the bones responsible for connecting your vertebrae and allowing them to move.

Finally, the sacroiliac joints — the areas where the pelvis and sacrum meet — also receive injections.

However, getting these injections too often may disrupt your body’s natural hormone balance. That’s because the effects of steroids mirror those of certain hormones that the body produces.

Note that the effects of cortisone do wear off after a while. For this reason, if your doctor determines that you need more than one shot, you’ll likely be limited to three injections over the course of a year.

Also, if you decide to go with injections, it’s recommended that you get them about a month and a half apart.

If a shot is successful, you should be able to tell this within a couple days to five days.

Of course, any relief you experience will be temporary — in other words, the positive effects will last maybe several weeks to a year. But at least you’ll be able to function more normally during this time.

While you’re feeling better, you may want to take part in physical therapy, as this may help you in resolving the underlying problem.

What Happens When Injections Don’t Work?

Unfortunately, sometimes spinal injections aren’t quite enough to manage your debilitating back or neck pain. But don’t worry — there is hope.

In this situation, you may quickly become a candidate for spine surgery that is minimally invasive.

For instance, you may be directed to undergo decompression surgery. This is perfect for anyone with a compressed nerve along his or her spinal cord, which leads to both radiating and local pain.

Another surgery option is stabilization surgery. This procedure is more precise and less invasive than conventional open back fusion surgery.

This procedure involves making a tiny incision in your side or back. Through the incision, your surgeon can remove a diseased vertebra or disc. Then, he or she will insert bone and an implant to give your body immediate pain relief and stability.

Your medical history and MRI results will help your doctor to determine if you’re a candidate for these types of surgeries.

How We Can Help

We offer high-quality spine surgery for patients dealing with severe chronic pain.

We can typically perform surgical procedures in an outpatient setting, so you don’t have to worry about an overnight stay.

In addition, most of our patients are able to go back to work or resume their daily activities in three months.

If spinal injections just aren’t working for you, contact us to find out more about how spine surgery may help you to get your quality of life back.

back pain

Stem Cells, PRP and Back Pain

Are you one of the 8 in 10 Americans who suffer from back pain each year? Did you know that back pain is one of the most commonly cited reasons for missing work? And is the second most common reason for seeking medical treatment?

Keep reading to learn more about back pain and the detrimental impacts it can have on adults.

Ohhhh….My Back

Have you ever expressed these words? Had to miss out on a scheduled activity because of back pain? Found yourself immobile, unable to take care of your everyday obligations due to back pain? You’re not alone.

Back pain, especially lower back pain, is on the rise, with over 33% of adults age 65 and over reporting that they experienced pain in their lower backs. Americans spend over $50 billion dollars a year on various back pain treatments and over 60% of those people experience a recurrence of back pain within two years.

There are a number of conditions that can contribute to your discomfort, some of which include what you spend your day doing. Many people with back pain report spending a good portion of their day sitting at a desk.

Not only does back pain impact your ability to do your job, it can also impact your daily household tasks, sleep, and ability to exercise. Dealing with back pain on a day to day basis decreases your quality of life and can impact those around you as well.

But, just because it seems like everyone has back pain these days doesn’t mean you have to live with it! Stem cell therapy and platelet rich plasma (PRP) therapy are two cutting-edge, minimally invasive treatments that can alleviate your pain. Read on to learn more about these two therapies.

What is Stem Cell Therapy and PRP Therapy?

Stem cell therapy and PRP therapy are two unique ways to treat pain, injuries, and illness. Some of the conditions that can be treated with these therapies include:

  • arthritis
  • back pain/injury
  • joint pain/injury
  • spinal cord injury
  • multiple sclerosis

In simple terms, stem cell therapy and PRP therapy use your own stem cells or plasma, taken from your body, to repair, regrow, or regenerate damaged cells.

Stem cell therapy involves the extraction of your stem cells from your bone marrow or your fat tissue. The stem cells are then injected into the site of the pain, where they transform into the needed cells to help repair damage.

PRP therapy is a bit different. In PRP therapy, your blood is processed through a centrifuge and then the PRP is re-injected into the injured area.

PRP is believed to have special proteins that promote cell growth. The PRP aids in the regrowth of healthy cells in your injured areas.

What’s the Process?

Now that you know a little about stem cell therapy and PRP therapy, you’re probably wondering how it works. Is it painful? How long does it take? How soon will I feel relief?

The process for both therapies is pretty simple and quick. Both are outpatient procedures, require no anesthesia, and allow you to return to normal activities relatively quickly after the treatment.

The first step in either process is an exam by a doctor to determine if you are a good candidate. The doctor also may want to do an x-ray or MRI.

Stem Cell Therapy

If you are undergoing stem-cell therapy, the procedure involves extracting bone marrow from your hip bone and separating the stem cells.

The process works like this: bone marrow is extracted from your hip bone and the stem cells are separated out in a centrifuge. The stem cells are then injected into your damaged disc using an x-ray as a guide. And….that’s it!

You can recover at home and could potentially experience total relief from your back pain.

PRP Therapy

Like stem cell therapy, PRP therapy is an outpatient procedure. After an exam, the process begins with a blood draw and then processed using a centrifuge. The platelet-rich plasma that is separated from your blood is then injected into the site of the pain or injury.

Some doctors may use a lidocaine injection or a local anesthetic to numb the site of the injection. And just like stem cell therapy, you’re able to go home to recover and can return to your normal activities quickly.

Can this Really Work to Decrease my Back Pain?

The short answer is, yes, stem cell therapy and PRP therapy can decrease your back pain. Professional athletes like golfer Tiger Woods and tennis player Rafael Nadal have used PRP therapy and touted its effectiveness.

The idea is that injecting stem cells and/or PRP into damaged tissues stimulates your body to grow new cells and promote healing. Since the injections include concentrated amounts of stem cells and PRP, it is believed that the tissue may heal faster as well.

Research has found that people who go through stem cell therapy are highly satisfied with their experience. Patients who have undergone stem cell therapy often report that they can exercise like normal, sleep better, and experience pain while completing every day activities. And, not only does stem cell therapy improve your daily life, it can also reduce the need for opioids and other painkillers.

Am I a Good Candidate for These Treatments?

Have you been diagnosed with a treatment such as a bulging or herniated disc? Sciatica or other spine conditions? Spinal stenosis?

Do you have trouble doing everyday activities, including sleeping, exercising, standing for long periods of time, and taking care of your home?

Have you tried other treatment, like visiting a chiropractor, doing physical therapy and stretching, or yoga? Have you had spinal surgery already with no success?

If you answered yes to any of these questions, these treatments may be right for you. To take the next step to eliminate your back pain once and for all, contact us for more information and your no-cost MRI review. What do you have to lose? Nothing. What do you have to gain? Potentially becoming pain-free for the rest of your life.

high-frequency stimulation

What is High-Frequency Stimulation for Back and Leg Pain?

Are you one of the quarter of people in the US who has experienced back pain in the past three months? Did you know that back pain is one of the most common medical problems in our country? Back pain, especially lower back pain, can commonly lead to leg pain as well.

High-frequency stimulation is a new treatment that can help alleviate both of these types of pain.

It’s vital to treat back and leg pain because back pain is one of the leading causes of missed work. Not to mention, back pain can impact the activities you do on a daily basis. It can affect your ability to engage in your hobbies, play with your kids or grandkids, and impact your ability even to do simple chores around the house.

You don’t have to live with this pain, though. Keep reading to learn more about high-frequency stimulation and how it can help treat your pain.

What Is High-Frequency Stimulation?

High-frequency stimulation is typically considered to be spinal cord stimulation (SCS). SCS uses a device placed under your skin to send mile electric currents to your spinal cord. This device stimulates the nerves in the location of your pain. The electric pulses than modify the feelings of pain and masks the pain signals before they reach your brain.

A new form of high-frequency stimulation, called HF10, has now been approved by the FDA as a way to treat chronic back and leg pain. HF10 therapy has received a superiority designation from the FDA for chronic back and leg pain. It also is able to give patients pain relief without any tingling or buzzing, which is known as paresthesia.

A lot of patients find these feelings to be uncomfortable are reluctant to do SCS because of it. HF10 therapy is a great alternative then since you don’t get any of those uncomfortable side effects. It’s also possible that SCS gives you an unexpected shock if you bend or twist wrong.

How Does It Work?

To find out if HF10 therapy is going to work for you, you can actually participate in the temporary trial use of it. If you find that it works, you can make the commitment for the implanted device.

The HF10 trial consists of a simple procedure, performed at your doctor’s office or at an outpatient surgery facility, where thin wires are placed beneath your skin, next to your spine. A temporary device that you wear under your clothes or on a belt delivers the stimulation to the wires.

You can customize it based on your pain levels, and adjust daily based on how effective it is. If you think that it’s working, and 9 out of 10 patients do, you can have a permanent HF10 device implanted.

Implanting the permanent device is also minimally invasive. This procedure is definitely preferable to traditional SCS. In traditional SCS, the patient actually has to be woken up from the sedated state to allow the doctor to determine the best placement for the device.

That’s not necessary with HF10 therapy. In this procedure, a small device is implanted under your skin, above your belt line or in the buttocks area. The device is connected to thin, flexible wires (just like the ones in your trial HF10 therapy) that are placed near the spine.

Once it’s in, you most likely get to go home the same day, and you get to control the HF10 device and can turn it off and on as you wish using a remote. This allows you to leave the device on while you drive or sleep and you can even use it in conjunction with pain medications you may be prescribed. If it’s ever necessary, the device can be removed by your doctor too.

Does It Work?

Probably the most crucial question now is: does this actually work? Patients want to know, and insurance companies certainly want to know. To test the effectiveness, the creator of HF10 therapy conducted a randomized, controlled clinical trial to compare traditional SCS, which has been the most common type of high-frequency stimulation, and HF10 treatment.

Basically, this means that patients were randomly assigned to receive the traditional SCS and some patients were randomly assigned to receive HF10 therapy, and some patients received nothing. Then, all the groups were compared to see what worked.

The results showed that two times as many patients received significant pain relief from HF10 as did with traditional SCS. Almost 80% of those who had HF10 therapy for severe back and leg pain reported significant pain relief. The FDA found these results so strong that they designated HF10 therapy as superior to other SCS methods.

Two years after the study, patients who received HF10 therapy reported an average decrease in their back pain score (on a scale of 1-10) by 5 points and 60% said they were very satisfied with their treatment.

Am I A Good Candidate?

If HF10 sounds like the answer to your chronic leg and back pain, you need to find out if you’re a good candidate. Do any of the following apply to you?

  • You have chronic pain in your back and legs
  • You have tried other treatments, such as physical therapy or chiropractic care
  • You regularly have to use medication to manage your pain
  • You find that your pain keeps you from your everyday activities and work

If these describe you, you may be a good candidate for high-frequency stimulation in the form of HF10 therapy. Your doctor may also want to know more about your health history.

The Next Steps

Only a medical professional can determine if high-frequency stimulation, especially HF10 therapy, is right for you. At Executive Spine Surgery we have the right doctors to help you with your case. Once you choose us, we’ll determine the right treatment plan to help you recover from the pain.

Contact us today to take the next steps in deciding if HF10 therapy is the right choice to address your leg and back pain. Don’t go another day suffering from debilitating pain that keeps you from enjoying your life!

facet joints

How Does PRP Heal Damaged Facet Joints and Back Pain?

If you’re facing issues with your facet joints or general back pain, a study conducted by the National Institutes of Health (NIH) shows that platelet-rich plasma (PRP) injections could be the perfect remedy.

PRP injections are becoming a popular treatment option among professional athletes and others as a long-lasting solution that uses the body’s ability to heal itself.

Here’s how they work to ease or even eliminate pain in the facet joints.

What are Facet Joints?

Facet Joint Syndrome is thought to be a major source of lower back pain.

The facet is a joint that lies between each of your vertebrae, and the facets connect the vertebrae to each other. Facet joints and the ligaments that surround them can be damaged if you are injured in some way or if you develop a degenerative condition such as arthritis.

Damage to these joints and ligaments puts stress on the nerve endings in the joint capsules, which then causes pain.

Symptoms of Facet Joint Syndrome

  • Difficulty twisting or bending
  • It is more painful to bend backward than forward
  • Lower back pain, numbness, muscle weakness or tightening
  • Pain that worsens at night or with weather changes
  • Sound of bones grating on each other with movement
  • Abnormal curvatures of the spine

Risk Factors for Facet Joint Syndrome

Accidents that cause trauma to the vertebrae can be responsible for pain in the facet joints. So can repetitive behaviors such as improper lifting of heavy objects or bending the wrong way. These behaviors put stress on the spine.

In people over 50, chronic facet joint pain is usually caused by degeneration due to aging.

Some degeneration of cartilage is part of the aging process.

But several risks factors other than age or repetitive behaviors that stress the spine can also make you more likely to develop trouble with your facet joints. These factors include genetics, obesity, and poor posture.

Traditional Treatment Options

Chronic facet joint pain has traditionally been treated with measures designed to alleviate symptoms. These measures include anti-inflammatory medications or muscle relaxers, which can help. But they are generally only a temporary solution.

More permanent solutions include a variety of facet joint surgical procedures.

The PRP Way

There is another way, though.

The PRP technique uses platelets, the small cell fragments that circulate in your blood along with red blood cells, white blood cells, and plasma. Platelets have growth factors inside them that help heal damaged tissue.

These platelets cannot normally reach injured areas inside joint cavities because there are no blood vessels there.

PRP injections put a concentrated level of these healing platelets into the space surrounding damaged joints, stimulating the body’s natural repair process.

Once blood is drawn from the patient, it is centrifuged (spun at high speeds) to separate red blood cells, white blood cells and platelets, leaving a layer of plasma at the top.

The platelets are then combined with the plasma to form platelet-rich plasma.

Many clinical trials are underway to find out all the ways the unique properties of PRP injections can be used to relieve pain and bring about permanent healing.

In spine practices, doctors have noted promising results from PRP in the treatment of facet joints and other spine disorders when traditional treatments have not worked.

Another NIH study that compared PRP injections to steroid shots for the treatment of lumbar facet joint syndrome found that while both treatments were effective, easy and safe, PRP injections were a superior option because they offered a long-lasting solution.

What to Expect During the PRP Procedure

The PRP procedure can be done on an outpatient basis. The whole thing takes about an hour.

Once your blood is drawn (about the same amount as during a routine blood test), it is put through a centrifuge. The resulting PRP is then injected directly into the facet joints.

An imaging technique called fluoroscopy will be used to ensure precise placement of the injections.

You may have mild discomfort during the injection, and your doctor may use a topical anesthetic to help with this.

After injection, the needle will be removed, and you will rest for a short period of time before going home.

The number of PRP injections you receive will vary based on your condition, but they usually range from two to six injections, with four to six weeks of healing time in between.

When Will I Feel Better?

Most patients get a significant reduction in their pain or better movement after the first or second injection.

You may need to also continue physical therapy and avoid overdoing it with physical activity for a few weeks to maximize the healing process and allow your damaged tissues to heal.

Sometimes, there is minor pain after the procedures. This pain typically does not last more than a few days, and you can minimize it with over-the-counter Tylenol.

It is crucial that you avoid anti-inflammatory medications such as Aleve, Motrin, Celebrex, Naprosyn, or Mobic. These drugs may interfere with your healing process.

Are There Any Risks?

Overall, PRP is considered a safe treatment option for pain in the facet joints.

Because your own blood is being used, there is no chance of rejection or an allergic reaction.

Any time a needle is placed in the body, though, there is a risk of infection, bleeding or nerve damage. These risks are very low with this procedure.

If you are unsure of the risks of your specific condition, you should talk to your doctor about it.

Harness Your Own Healing Power

PRP injections are an intriguing new option for harnessing the power of your own body’s healing process when more traditional treatments have not worked.

Your spine specialist may recommend platelet-rich plasma as a treatment for your chronic facet joint pain, giving you a convenient, minimally-invasive solution to alleviate your pain and use your own blood to heal your damaged tissue.

Let Us Help You

We’ve got lots more science-based information available to help you find the right treatment for your back pain.

Contact us with any questions or comments. We look forward to helping you!

PRP

What Is the Role of PRP in Sacroiliitis?

Are you struggling with lower back pain? Do you deal with constant sciatic nerve pain? Does climbing stairs make your back hurt?

You’re not alone. You might be among the 40% of Americans who will suffer from this pain at some point in their lives.

Luckily, there’s a solution. It comes in the form of PRP, or Platelet Rich Plasma, injections.

Keep reading to find out everything you need to know about Sacroiliitis and PRP.

What Is Sacroiliitis?

First of all, let’s define Sacroiliitis. Sacroiliitis is the inflammation of both or one of the sacroiliac joints. These joints are situated in the spot where your pelvis connects to your lower spine– your lower back.

These joints are vertical and about 6 or 7 inches long. They’re held together by ligaments that contain tons of nerve receptors.

Since the sacrum is often subject to lots of stress as you go through your daily motions, the sacroiliac joints can become inflamed. This is what leads to Sacroiliitis. The many nerve receptors in the surrounding ligaments are responsible for the pangs of back pain that you may feel.

Sacroiliitis can cause pain in your back, buttocks, and can even extend all the way down your legs. It can also be hard to diagnose. Back pain is finicky, and the pain symptom is really the only telling symptom for sacroiliitis diagnosis.

Oftentimes, patients will come back with normal EMG studies, MRI scans, and lumbar spine scans. Yet they’ll still experience pain. Your doctor needs to be looking for Sacroiliitis to find it.

This is why it often takes time to diagnose. Usually, it’s a last resort diagnosis, after other scans have come back normal.

If your lower back pain gets worse when you climb stairs, stand for a prolonged period of time, or go for a run, you may have Sacroiliitis.

How Is It Caused?

There are five potential causes of sacroiliitis.

Traumatic injury is the first. This includes injuring your sacroiliac joints while lifting heavy items. It also includes injury from falling or getting into a car or bike accident.

A biomechanical injury is the second. This includes sacroiliac joint dysfunction manifesting from a previous lumbar infusion, or a discrepancy in leg length.

Hormonal imbalances or changes are the third. This includes hormonal changes due to medication, or natural hormonal changes due to pregnancy or childbirth.

Inflammation is the fourth. This is when your tissues become swollen, red, and painful.

The fifth is normal age-related degeneration, usually brought on by normal wear and tear over the years.

How Is It Diagnosed?

To diagnose sacroiliitis, you’ll need to first schedule doctor’s appointment. They’ll probably press on points of your lower back, including your buttocks, to try to put a finger on the location of the pain. Your doctor may order x-rays or an MRI of your back and sacroiliac joints to show if your sacroiliac joint is injured and to make sure the low back is not the cause of the pain. Another method your doctor will confirm the diagnose Sacroiliitis is anesthetic injections. This involves your doctor injecting the affected area with a numbing injection. If the pain stops, it’s likely that your sacroiliac joint is the problem.
The one caveat with this method of diagnosis is The anesthetic injection can leak into a surrounding area, making it unclear whether or not your sacroiliac joint is really the problem.

What Can You Do?

Physical therapy is an option. It’ll include plenty of strengthening and stretching exercises. If physical therapy doesn’t alleviate your symptoms, you might be a candidate for PRP, or Platelet Rich Plasma, injections.

How Does It Work?

Spinal injections are an effective pain management tool. PRP injections work to aid your boby in its natural healing process.

Platelets begin repairing your tissue by releasing growth factors. Growth factors are a substance, such as a hormone or a vitamin, that’s necessary to stimulate the growth of living cells.

The growth factors initiate the process of healing by attracting reparative cells, especially critical stem cells. Without PRP injections, your body would have far fewer platelets, meaning a slower healing time.

Once the platelets have been injected into your bloodstream, a sample of your blood will be taken and put into a centrifuge. The centrifuge will then separate the added platelets from the rest of your blood. Then, that concentration of PRP is re-injected into your body, specifically into your lower back.

Now, your lower back has tons of tools to begin healing– all naturally. After the injection, it takes around six weeks for your body to reduce inflammation and rebuild tissue within your sacroiliac joints. After six weeks, you’ll feel good as new.

When PRP Injections Aren’t Enough

You might get the PRP injections and find that your Sacroiliitis is just too far gone. While PRP injections are certainly effective for pain management, they can’t reverse degeneration or injury.

If this sounds like you, you might be a candidate for spinal surgery. If so, you should opt for a minimally invasive one.

Why? Because traditional surgery requires a very large incision. That means extensive tissue damage, and a subsequent long time recovering.

Why go the traditional route when a minimally invasive option is available?

Today, the minimally invasive procedure is as simple as placing three titanium implants on your sacroiliac joint. These implants will fuse and therefore stabilize the connection between the joints, your spine, and your pelvis.

It only takes around an hour, and you might even be discharged to go home the same day. That’s far preferable to weeks recovering in the hospital.

Are You a Candidate?

If you’re experiencing lower back pain, you could be struggling with Sacroiliitis and not know it yet. Oftentimes, sciatic nerve pain can go untreated for too long, and improperly diagnosed once you find the time to visit the doctor.

Don’t let this be you. If you’re in Hackettstown, Cedar Knolls, or Whiting, New Jersey, get in touch. We would love to get you on the road to recovery.