Minimally Invasive • Image-Guided
Relieve Lumbar Pain Without Surgery
Evidence-guided diagnostics and orthobiologic options before higher-risk surgery. Book in minutes or refer a patient now.
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Symptoms
Start here if you know how it feels but not what it is.
- Understanding Low Back Pain: Why It Happens and What You Can Do About It
- Sciatica: What That Shooting Leg Pain Really Means
- Pain Worse with Extension or Rotation: Understanding Facet Joint Pain
- Leg Numbness, Tingling, or Weakness: Signs Your Nerves Need Attention
- Buttock and Hip Pain: When It’s Really from the Sacroiliac (SI) Joint

Conditions & Diagnoses
Conditions we identify and confirm before treating.
- Bulging and Herniated Disc: When a Spinal Disc Presses on a Nerve
- Degenerative Disc Disease: Understanding the Aging Spine
- Lumbar Facet Arthropathy: Arthritis of the Spine’s Small Joints
- Lumbar Radiculopathy: When a Pinched Nerve Causes Leg Pain
- Lumbar Spondylosis: Understanding Spinal Arthritis and Aging
- Sacroiliitis: Inflammation of the Joint Connecting Your Spine and Pelvis
- Spinal Stenosis: When Narrowing of the Spine Causes Nerve Pressure

Treatments
Non-surgical options, from conservative care upward.
- Epidural Steroid Injection (ESI): Reducing Nerve Inflammation and Pain
- Medial Branch Nerve Block: A Targeted Test for Facet Joint Pain
- Radiofrequency Ablation (RFA): Lasting Relief for Facet Joint Pain
- Facet Joint Injection: Relieving Pain from Arthritis in the Spine
- Sacroiliac (SI) Joint Injection: Targeting Inflammation at the Base of the Spine
- PRP Spine Injection: Using Your Body’s Own Healing Potential
- Bone Marrow “Cell” Injection (BMAC): Harnessing Your Body’s Natural Healing Cells
- Spinal Cord Stimulator (SCS): A Modern Option for Chronic Nerve Pain
- Spinal Pain Pump: Targeted Medication Delivery for Chronic Pain
For referring clinicians
Same-week evaluations, image-guided diagnostics, and rapid feedback. Upload notes via our secure portal or send eFax. No PHI on this page.
Get urgent care for these
- New weakness in a leg or foot, or a foot that drags
- Loss of bladder or bowel control, or numbness around the groin
- Back pain with fever, chills or unexplained weight loss
- Severe pain immediately after a fall or collision
These need assessment now, not an appointment next week. Go to an emergency department or call 911.
Common questions
What is a facet ablation (RFA), and how is it different from diagnostic blocks?Blocks test the pain source; ablation stops the nerve signal.
A medial branch block temporarily numbs a spinal joint to confirm the pain generator. If it works, radiofrequency ablation (RFA) uses heat to deactivate that small nerve for 6–12 months. The joint stays stable, and pain often lessens dramatically.
How long does a radiofrequency ablation (RFA) last, and can it be repeated?Relief often lasts 6–12 months and the procedure can be repeated safely.
After an RFA, the tiny sensory nerves that send pain signals grow back slowly. Many patients enjoy meaningful relief for 6 months to a year. If the pain returns, a repeat ablation can usually be performed using the same approach. Regular stretching and strengthening help extend the benefit.
Why does my low back hurt after sitting or long drives?It’s usually from facet-joint stress or weak postural muscles.
Sitting flexes the lumbar spine and compresses facet joints and discs, especially if the core is de-conditioned. Over time, this posture leads to inflammation and stiffness. Supportive cushions, regular breaks, and targeted therapy for core and glute muscles often relieve symptoms.
What is a diagnostic discogram, and why is it rarely done now?It injects dye into spinal discs to find the pain source but carries risks.
Discography involves pressurizing discs with contrast dye while monitoring pain response. It was once common before spine surgery but is now less used because it can worsen disc damage and cause infection. Modern MRI and targeted nerve blocks provide safer diagnostic insight.
Why do some people have chronic back pain even after “successful” fusion surgery?Adjacent levels often wear out faster.
Spinal fusion stabilizes one level but transfers stress to the discs and joints above and below, leading to adjacent segment disease. Scar tissue, muscle atrophy, and nerve irritation can also persist. Nonsurgical options like PRP or radiofrequency treatment can help preserve the surrounding spine.
What are “adjacent segment disease” and “hardware failure” after spine surgery?They mean nearby levels or implants break down over time.
After fusion, joints next to the fused area compensate by moving more, sometimes developing arthritis or stress fractures. Hardware fatigue or loosening can also occur years later. Regular imaging helps detect changes early; pain-management injections or strengthening programs can often delay revision surgery.
How do you tell if leg pain is from the back or from a knee or hip problem?Back-related pain travels below the knee; joint pain usually stays local.
Nerve compression in the spine typically causes sharp, shooting pain that radiates past the knee or into the foot. Hip or knee arthritis usually creates aching localized pain or stiffness without tingling. Imaging and physical-exam maneuvers help determine whether the source is spinal, joint, or both.
What is an epidural steroid injection and what does it do?It delivers anti-inflammatory medicine around pinched nerves.
Guided by X-ray, a thin needle places medication into the epidural space of the spine. The steroid reduces swelling around irritated nerves from a herniated disc or arthritis. Relief may last weeks to months and can allow better participation in physical therapy.
What are red-flag symptoms that spine pain is not just mechanical?Fever, unexplained weight loss, numbness, or bladder issues.
Warning signs include constant pain at rest, night sweats, progressive weakness, loss of control of urine or stool, or recent infection. These could signal infection, tumor, or severe nerve compression and need emergency evaluation.
How long should I wait before considering spine surgery?Only after conservative care has clearly failed and red flags are excluded.
Most mechanical back or neck pain improves with guided injections, therapy, or biologic repair within 3–6 months. Surgery is reserved for progressive weakness, structural instability, or nerve compression causing loss of function. A second opinion is always appropriate before proceeding.
What is a “facet joint,” and why can it cause back or neck pain?It’s a small stabilizing joint behind each vertebra that can become arthritic.
Facet joints allow bending and twisting. With aging or injury, they may develop arthritis and inflammation that causes sharp localized pain, often worse when leaning backward or standing long periods. Facet injections or RFA can calm these joints for months at a time.
When should I seek emergency care after a neck or back injury?Sudden weakness, numbness, fever, or bladder/bowel changes.
Go to the ER immediately for severe pain with loss of strength, incontinence, high fever, or trauma with head injury. These could indicate nerve or spinal-cord compression, infection, or fracture. Early treatment prevents permanent damage.
What is a “nerve root block,” and how is it different from an epidural?A nerve-root block targets one specific nerve, while an epidural bathes several.
A selective nerve-root block (SNRB) uses live X-ray to deliver medication directly around one irritated spinal nerve. It helps confirm which nerve causes the pain and can calm inflammation at that precise level. Epidural injections are broader, covering multiple nerves at once.
How can I tell if my hip pain is coming from the joint or my back?Hip arthritis hurts in the groin; back problems radiate to the leg.
Hip joint disease often causes deep aching in the groin or front thigh, worse with walking or stairs. Lumbar nerve compression tends to cause burning or tingling down the leg. Diagnostic injections into the hip or spine can confirm the true source.
Can regenerative medicine help spine patients who already have hardware or fusions?Yes, but injections are placed around not into the fused levels.
PRP and bone-marrow concentrate can reduce inflammation in joints and ligaments next to a fusion where new pain develops. These procedures don’t interact with the hardware itself. Most patients benefit from improved flexibility and less reliance on pain medication.
