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Spinal Nerve Block Injections

Spinal pain is often caused by an inflammatory reaction in the body that produces swelling and damage to the spine, joints, disks, bones or ligaments. This reaction can be triggered by conditions such as a herniated disc, sciatica or spinal stenosis. Sciatica is a type of spinal pain where a ruptured disk pinches the sciatic nerve and triggers an inflammatory reaction that causes leg pain. The initial treatment for spinal pain is to reduce inflammation with steroid, analgesic and anti-inflammatory medications taken orally. Although these medicines can be very helpful under certain conditions, their diffuse and widespread effects in the body when taken by mouth are not concentrated enough to effectively relieve spinal pain.

What Are Spinal Nerve Block Injections?

At Executive Spine Surgery in Hackettstown, NJ, Dr. Carl Spivak treats spine pain with nerve block injections. These injections can effectively reduce spine pain without surgery. Spinal pain injections are performed with the help of x-ray guidance so that Dr. Spivak can deliver precise doses of steroidal, anti-inflammatory and analgesic medications in high concentrations directly AROUND (REMOVE into) the nerves or INTO trigger points where the inflammation exists.

Injecting these medications into an inflamed nerve in a highly concentrated form can reduce inflammation and swelling, relieve pain and flush irritants from the body. The relief that patients typically experience as a result of spinal nerve block injections in Hackettstown can last for one year or more. In the meantime, the body may be able to heal the nerve damage enough to eliminate discomfort.

What’s Involved In Trigger Point Injection Procedures In Hackettstown?

Trigger point injections are a noninvasive treatment for spinal discomfort. Injections are performed on an outpatient basis, so the risks involved in spine surgery are avoided. The treatment itself takes only 20 to 30 minutes. After the nerve block injection procedure is complete, the patient rests for 45 minutes while under observation.

How Long Do The Results Of Nerve Block Injections Last?

Just one trigger point injection can reduce or eliminate pain, swelling and inflammation so effectively that spine surgery is no longer necessary. Many patients require three injections to obtain optimal relief, whereas other patients experience great relief after only one or two treatments. Patients can receive up to three spinal nerve block injections two or three weeks apart over a six-month period. Just one spinal injection can deliver significant relief within a day or two after treatment. Spinal nerve block injections are even more effective when paired with physical therapy. Patients who combine these two treatments often go on to enjoy an active and pain-free life.

Are There Any Side Effects Associated With Spinal Pain Injections?

Many patients experience a mild tenderness at the injection site after a spinal pain injection. Dr. Spivak will consult with you about any possible side effects prior to giving you an injection.

Why Choose Executive Spine Surgery?

Dr. Carl Spivak takes a conservative approach to spine surgery and prefers minimally invasive treatments whenever possible. As the President of Executive Spine Surgery and a board-certified neurosurgeon, Dr. Spivak is well known for his innovative use of state-of-the-art endoscopic spinal techniques and other cutting-edge technologies.

Free Seminar on Lower Back Pain by Dr. Cal Spivak on April 16, 2016

The 32nd Annual Meeting of the Section on Disorders of the Spine and Peripheral Nerves. ‪#‎SpineSummit2016

Neck Pain Treatment

What Is Neck Pain?

Neck pain, also called cervical pain, is a common affliction that can be caused by conditions like degenerative disc disease, whiplash and other neck injuries, a pinched or inflamed nerve or a herniated disc. Neck pain can present as a dull ache in the neck, inability to move the head, shooting pains, tingling, numbness and dizziness, problems swallowing, enlarged lymph nodes and head, shoulder, back and facial pain.

How Is Neck Pain Treated?

Treatment for neck pain includes traction, muscle relaxants, a neck collar, massage, ultrasound treatments, antibiotics, exercise, physical therapy, pain medication, acupuncture and applications of heat and cold. If the neck pain is caused by an inflamed nerve in the epidural space, an epidural injection of anti-inflammatory and steroidal medications may reduce inflammation and relieve pain.

If these treatments don’t bring pain relief, the only other option is neck surgery. Until recently, the surgical treatment for neck pain was open neck surgery. Because of its highly invasive nature, open neck surgery is considered a last resort when less invasive treatments have been ineffective.

What’s Involved In Traditional Open Neck Surgery?

A common cause of neck pain is cervical disk herniation. In addition to neck pain, a cervical disk herniation may produce numbness, weakness and stiffness. Traditional open neck surgery involves making a large incision in the neck, moving the food tube and voice box, removing the herniated disk and performing fusion. Open neck surgery requires several days as a hospital inpatient, and healing can take up to one year. The recovery period could involve problems swallowing, hoarseness, stiffness at the site of the fusion and significant scarring. If the remaining disks don’t heal properly, the neck pain can continue, and additional neck surgery may be necessary.

Are There Less Invasive Surgical Treatments For Neck Pain?

Yes. The Cervical Endoscopic Surgical System (CESSYS), for example, is a new, non-invasive and cutting edge technology that can be used to perform neck surgery and relieve pain without the risks, discomfort and long recovery time associated with open neck surgery.

How Does The Cervical Endoscopic Surgical System Work?

With CESSYS, a video camera is inserted into the spine so the surgeon can easily find and extract the herniated part of a disk. This procedure is performed using very small instruments and guided by x-ray. The surgery requires only a small incision, so the surrounding tissues are not damaged. There is minimal pain, a much shorter recovery time and no overnight hospital stay.

If you suffer from neck pain that has not been relieved by nonsurgical treatments, schedule a consultation with Dr. Carl Spivak at Executive Spine Surgery to see if the Cervical Endoscopic Surgical System would be an appropriate treatment for your case.

What Is Lower Back Pain?

Most of us have had lower back pain at one time or another. It can be anything from a sharp pain that appears quickly and inhibits movement to a dull pain that develops slowly and gets worse over time. Acute lower back pain is quite common. It’s often caused by an injury, and it tends to clear up in a few weeks with or without treatment. Chronic lower back pain is less common. The cause may not be known, and the pain can last for months or even years.

What Causes Lower Back Pain?

Lower back pain can be caused by anything from chronic stress to poor posture. Other reasons for back pain include:

Aging. The older you get, the more likely you are to have back pain.

Other conditions. Arthritis, scoliosis, cancer, kidney stones and infections can all cause back pain.

Weight gain. Being overweight can cause back pain when the extra pounds are excessively straining the back.

Work. If your job involves lifting, pushing, pulling and twisting, it can cause back pain or back injury.

Lack of fitness. Those who are out of shape are more likely to experience lower back pain.

Genes. In some cases, back pain may be hereditary.

Injuries. Sprains, falls, accidents and fractures can all cause back pain.

Osteoporosis. Thinning and weakening bones can cause stress fractures and back pain, especially for women.

Spinal degeneration, muscle knots, spasms, inflamed nerves and deterioration of the back joints and disks can also cause lower back pain.

How Is Lower Back Pain Treated?

Acute lower back pain can be treated with hot and cold packs, ibuprofen, acetaminophen, aspirin and topical analgesics. Chronic back pain may be treated with massage, manipulation, physical therapy, stretching exercises, acupuncture and acupressure. Spinal injections of steroids, anti-inflammatory medications and painkillers can relieve lower back pain for up to 12 months. During this time, the condition causing the back pain may be able to heal itself.

I Have Lower Back Pain. Will I Need Back Surgery?

Most of the time, people with lower back pain do not require surgery. Back surgery is considered only after less invasive treatments have failed to provide relief. When back surgery is indicated, it is usually associated with conditions like:

Spinal stenosis

Degenerative disk disease

Herniated disk

Spondylolisthesis

Fractured vertebrae

If you live in the Hackettstown, NJ, area, and you’re suffering from lower back pain, it’s time to get relief. Dr. Carl Spivak, President of Executive Spine Surgery and a board certified neurosurgeon, specializes in minimally invasive treatments and cutting edge endoscopic spinal techniques to provide effective and lasting relief from chronic lower back pain.

What Is Sciatica?

Sciatica is a condition where there is radiating pain in the sciatic nerve. The sciatic nerve goes from the lower back to the hips, buttocks and down the side of the leg. The condition can develop because of a herniated disk. It can also occur when a bone spur on the spine or a narrowing of the spine compresses the root of the nerve. The result is shooting pain and inflammation along the sciatic nerve pathway. There can also be numbness in the leg. Sciatica usually occurs on only one side of the body. Without treatment, it can easily get worse.

As a board certified neurosurgeon and President of Executive Spine Surgery in Hackettstown, NJ, Dr. Carl Spivak is well known for combining innovative and state-of-the-art technology with a minimally invasive approach. Sciatica pain can be severe, but when treated promptly, it usually improves over time without surgical intervention. In cases where there is chronic discomfort or recurring pain with weakness in the leg, a surgical procedure may be considered.

How Is Sciatica Treated?

Physical Exercise. Exercise can control or eliminate sciatica. In combination with anti-inflammatory agents, steroids and pain relievers, physical therapy that supports the spine and protects the back can significantly reduce discomfort and restore mobility.

Massage Therapy. Back problems are often associated with cramped back muscles, tight hamstrings and weak abdominal muscles. Gentle massage can reduce the muscle spasms and muscle stiffness caused by back injury.

Transcutaneous Electrical Nerve Stimulation (TENS). Combining stretching exercises that strengthen the back and the abdomen with massage or (TENS) can effectively reduce sciatica pain and help to restore range of motion. Pilates and weight training can also be used to supplement stretching and massage.

Steroidal, Anti-Inflammatory and Pain Relieving Medications. Pain medications can reduce discomfort and relieve inflammation so that the body can be rehabilitated. Combining medications with the nonsurgical treatments described above can postpone or even eliminate the need for surgery.

Epidural Steroid Injections. Epidural injections for sciatica can effectively reduce inflammation and relieve pain. Injections are more effective than oral medications because they are injected directly into the area where the pain is located. Epidural steroid injections are more effective for some people than others. Pain relief can last anywhere from one week to one year. A significant benefit of epidural injections for sciatica is that while the pain is relieved, a patient can begin an exercise program and take other actions that support a positive outcome and a long term solution.

Surgery. When surgery is indicated, Dr. Spivak will suggest the least invasive option followed by the treatments described above. Microdiscectomy, discectomy, laminectomy and laminotomy are all minimally invasive procedures that require no hospital stay and minimal anesthesia. There is less trauma to the tissues surrounding the compressed nerve, and recovery time is faster than it would be with traditional back surgery. A program of physical therapy and massage can be started shortly after the surgery. This approach often brings about a positive outcome.

Can I Do Yoga After Back Surgery?

August 23, 2014

Yoga can be an excellent way to improve flexibility and mobility of the spine, as well as core strength. It is also an excellent tool for opening up the chest and relieving an over-stretched back and shoulders, as well as strengthening the core. Core strength is an important part of a healthy back. A strong core supports the spine from the front.

Over-stretched muscles are weak muscles. Working on a computer, driving, texting and many other aspects of the modern lifestyle all cause the shoulders to come forward by shortening the muscles of the chest. This leads to the muscles of the back becoming over-stretched and weak. Many yoga poses focus on opening the shoulders and chest, which relieves the over-stretched back and can allow the muscles to begin to return to their normal position.

Since yoga is full of isometric exercises, it can also strengthen weakened back muscles, which can often be a problem for people who have had chronic back issues. Building strength in back muscles help support the spine, which can sometimes improve lingering back issues that persist after surgery. Sometimes these issues come from muscular imbalances due to compensating for the injured spine. Yoga can help to reverse these imbalances and restore muscle tone.

Nonetheless, some yoga poses could cause injury after surgery, depending on the type of surgery and the area affected. It is important to speak to your surgeon or physical therapist about movements or positions you should avoid before taking a yoga class. When you take a class, make sure to arrive early so that you can speak to the instructor and inform him or her about your condition and your specific needs. Restorative yoga is probably a good place for most spine patients to start, especially if they have never done yoga before. It is important to defer to your physician or physical therapist’s advice.

Is It Safe to Get a Massage After Back Surgery?

August 10, 2014

Many of my patients ask me if they can receive a massage after the spine surgery. I always encourage them to see a licensed massage therapist after their incision site or sites have healed fully. It is important for the spine patient to tell the massage therapist where and what kind of spine surgery they received. Some massage therapists may ask for a doctor’s note or clearance before massaging a client who has received spine surgery recently.

I am happy to clear my patients for massage, as it can help improve circulation to ischemic muscles and help muscles that are both too tight and overstretched. Chronic back pain can lead to postural compensation patterns which can continue even after the back injury is repaired. When paired with physical therapy or exercise, regular massage can help stimulate the muscles to return to their proper postural alignment. Massage therapists can also sometimes help patients stretch and work on improving patients’ active and passive ranges of motion.

Massage also relaxes the patient, which allows the body to rest and heal. A relaxed patient has a better overall prognosis than a stressed patient. Massage is becoming a part of a more integrated, holistic way of looking at modern medicine. Though I work principally on the spine, I make sure that my patients also try to take care of their muscle. It is unfortunately quite common that patients experience back pain after spine surgery. This is often caused by tight or overstretched muscles rather than a dysfunction of the spine. Unfortunately muscles don’t just snap right back into place on their own after spine surgery, but through a combination of physical therapy and massage, the spine patient can restore his or her body to a strong, healthy, comfortable postural alignment.

Core Strength for the Reduction of Back Pain

August 6, 2014

The spine is supported by many muscles in the back, but it is also protected and supported by the muscles of the abdomen or core. Many people do not realize how important it is for the spine to be supported in both the front and back. It is especially important for those with a weakened spine or back muscles to develop strength in the abdominal muscles.

Core strength can be built with exercises that do not strain the back. Many people find that standard crunches, sit-ups and other abdominal exercises are painful, especially if they have a tight or injured lower back. Instead of doing these back straining workouts, which could ultimately do more harm than good, simply increasing one’s time in the plank and side plank positions is very beneficial for strengthening the core. If you have trouble with the standard plank at first, you can modify it by lowering your knees and work up to standard form. Both of these exercises are simple ways to build core strength without hurting or straining the back. Many back patients are found to have a weak core, which can increase their pain and suffering, as their spine lacks frontal support.

If you can hold both plank and side plank poses for at least a minute each, work on increasing to three minutes. Once your core is strong enough to hold both poses for at least three minutes, you might want to ask your doctor or physical therapist if pilates or yoga might be good methods for continuing to build core strength.

Images courtesy of YogaOutlet.com