Spine Medicine
Spine Health and Pain Management
Spine medicine is a multidisciplinary field that integrates cutting-edge medical technologies, holistic therapies, physical rehabilitation, and psychological support. Whether you are managing chronic back pain or recovering from a spine injury, this comprehensive guide outlines everything from conservative care to advanced interventions.
Understanding Spine Conditions
Degenerative Spine Disorders:
Lumbar and Cervical Disc Herniation: Nerve root compression may cause radiculopathy. Treatments include physical therapy, epidural steroid injections, or surgery like microdiscectomy.
Spinal Stenosis: Narrowing of spinal canal causing pain and weakness. May require decompression or laminoplasty.
Facet-Mediated Pain: Often treated with medial branch blocks (MBB) and radiofrequency ablation (RFA).
Spondylolisthesis: Forward slippage of vertebra; can be managed with therapy or fusion procedures.
Spinal Deformities and Instability:
Adult and Pediatric Scoliosis: Options range from observation and physical therapy to long or short fusion surgeries.
Schuermann's Kyphosis and DISH: Managed conservatively or surgically depending on severity.
Inflammatory and Infectious Conditions:
Inflammatory Spine Disorders and Spine Infections: Require diagnostic imaging and often systemic treatment.
Neoplastic Spine Conditions:
Spine Tumors and Cancer-Related Pain: May necessitate radiation, vertebral augmentation, or surgical stabilization.
Diagnostic Tools and Imaging Guidance
Electrodiagnostics: To evaluate radiculopathy and neuropathy.
Imaging: Use of X-ray, ultrasound, CT, MRI, and bone density scans.
Conservative Management
Rehabilitation Therapies:
Physical Therapy (PT)
Occupational Therapy (OT)
Home Exercise Programs (HEP)
Osteopathic Manipulative Treatment (OMT)
Yoga and Pilates
Medications and Supplements:
NSAIDs, Acetaminophen (APAP), Muscle Relaxants, Neuropathic Pain Agents
Opioids - used cautiously in acute fractures and cancer pain.
Psychological Considerations:
Addressing Anxiety, Depression, Fear Avoidance, and Chronic Pain Syndrome with integrated behavioral therapy.
Interventional Pain Procedures
Epidural Steroid Injections (ESI) for acute radiculopathy
Facet Joint Injections and MBB/RFA for chronic facet pain
Trigger Point Injections, Peripheral Nerve Blocks, Sympathetic Blocks
SI Joint Injections, Disc Injections, and Intravertebral RFA
Advanced Minimally Invasive Procedures:
Vertebral Augmentation for osteoporotic fractures
MILD Procedure for lumbar stenosis
Disc Regenerative Therapies (PRP, Stem Cells)
Spinal Cord Stimulation (SCS) for refractory neuropathic pain
Endoscopic Procedures for disc pathology
Surgical Considerations
Short vs. Long Fusion based on pathology severity
Scoliosis Surgery: Traditional fusion vs. vertebral body tethering
Sacroiliac Joint Fusion: For intractable SI joint pain
Decompression Surgeries for stenosis and myelopathy
Patient Education & Safety
Nonspecific Low Back Pain (LBP) Guidelines: Promote conservative management first
Work-related and Traumatic Spine Injuries: Often treated with a combination of conservative and procedural interventions
Spine Orthoses: May be prescribed for structural support
Conclusion
Spine medicine requires a comprehensive and integrative approach. From conservative modalities to complex surgeries, a personalized plan based on diagnosis, function, and goals leads to the best outcomes. Dr. Amir Mahajer has led the development of multiple Spine and Musculoskeletal Centers of Excellence and is committed to delivering individualized care rooted in the highest standards of clinical excellence.
To learn more, visit www.osso.health or schedule a consultation today.
