If you are reading this, you should know that you are not alone. Back pain is the most common reason to seek treatment from an experienced and ACGME certified pain management specialist. At Integrated Pain Consultants, we recognize that either you or a loved one is in pain, which is why it is important to be properly diagnosed and have a comprehensive individual treatment plan developed.

You can find a list below of the most common back pain conditions that we treat at our office. For a detailed evaluation, please call (480) 626-2552to schedule your appointment today.



Common Back Pain Conditions

Lumbar Degenerative Disc Disease, Lumbar Radicular Pain, Lumbar Spinal Stenosis, Bulging Discs, Facet Arthropathy, Spondylosis

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Lumbar Degenerative Disc Disease
Lumbar degenerative disc disease is a condition that sometimes causes low back pain or radiating pain from damaged discs in the spine. A lumbar spinal disc acts as a shock absorber between vertebrae and allows the joints in the spine to move easily.

Lumbar Radicular Pain
Commonly referred to as Sciatica, this form of pain radiates from the lower back down through the leg. Lumbar Spinal Stenosis, which is a narrowing of the spinal canal in the lower back, usually happens when bone, tissue, or both, grow in the openings of the spinal bones. This growth can squeeze and irritate nerves that branch out from the spinal cord.

Bulging Disc
A bulging disc occurs when a weakened or deteriorated disc swells through a crevice in the spine and extends outside of its normal jurisdiction. This condition happens when a disc shifts out of its normal position, usually slowly and over a long period of time. As the disc moves, its inner liquid-like nucleus begins to balloon outward towards the weakest point in its hard outer casing.

Facet Arthropathy
Facet Arthropathy is a common cause of back pain and discomfort due to degeneration and arthritis of this part of the vertebrae. This condition causes pain in the back that does not radiate down the leg(s). Spondylosis, which is an umbrella term, describes symptoms related to degenerative changes in the spine and is not considered a medical diagnosis.

Treatment for back pain

Epidural Steroid Injection, Facet Injection, Medial Branch Blocks, Radiofrequency Ablation, Spinal Cord Stimulation, Kyphoplasty, Platelet Rich Plasma (PRP) Injections

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Epidural Steroid Injection
Epidural steroid injections in the lumbar spine help to reduce inflammation related to back pain. During this procedure, a small needle is inserted into the epidural space with X-ray guidance (fluoroscopy). After proper placement of the needle is confirmed, a corticosteroid, in combination with a local anesthetic pain medication, will be injected through the needle. The purpose of the corticosteroid is to minimize inflammation and swelling in the epidural space to minimize inflammation, which will take pressure off of the nerves and soft tissues to provide pain relief over time. The anesthetic pain medication provides immediate pain relief and flushes out inflammatory proteins that may exacerbate pain. For some individuals, an epidural steroid injection alone is sufficient enough for back pain relief. For others, epidural steroid injections are used in combination with rehabilitation, such as physical therapy. Pain relief from an epidural steroid injection can range from one week to one year or more.

List of conditions treated

  • Lower Back Pain
  • Compression Fractures
  • Lumbar Degenerative Disc Disease
  • Lumbar disc herniation
  • Lumbar spinal stenosis

Typical Benefits / Outcomes

  • Reduction of pain (primarily leg and back pain)
  • Improvement in function and mobility
  • Reduction in pain medication
  • Reduction of inflammatory proteins (chemicals contributing to pain exacerbation)
Facet Injection
Facet injections are a minimally-invasive procedure that are used as treatment for Facet Arthropathy, Axial Back Pain, and Spondylosis. The facet joint of the spine is a moveable connection that connects one vertebrae to another. A small needle will be inserted into the area of the facet joint and a long-lasting steroid and anesthetic medication, such as Bupivicaine or Lidocaine, will be injected. The steroid helps to reduce inflammation and irritation and the anesthetic medication numbs the area for a period of time. The entire procedure typically takes less than 15 minutes and is performed under X-ray guidance (fluoroscopy). The above medications will spread to other portions of the spine, further reducing inflammation and irritation. Facet injections and epidural steroid injections are similar, but differ in the location where the medication is injected. During an epidural steroid injection, the medication is injected into the epidural space, whereas during a facet injection, the medication is injected directly into the joint.

List of conditions treated

  • Axial back pain
  • Facet arthropathy
  • Spondylosis

Typical Benefits/Outcomes

  • Rapid relief in pain
  • Improvement in function and mobility
  • Diagnostic test to see if the pain is coming from the facet joints
  • Reduction in pain medication

Medial Branch Blocks
The facet joint connects one vertebra to another. A medial branch block interrupts the sensory nerve supply to the involved facet joint through the use of a precise administration of an anesthetic agent and a long-lasting steroid. The nerve targeted during this injection is the medial branch nerve, hence the term "medial branch block." The steroid helps to reduce inflammation and irritation, and the anesthetic works to numb the pain for a short period of time. The purpose of this procedure is to determine if the pain you are experiencing is caused by the medial branch nerve or the facet joint itself. If this procedure leads to a short term relief in pain of at least 70-80%, a radiofrequency ablation can be performed to provide long lasting relief of your back pain.

List of conditions treated

  • Axial back pain
  • Facet arthropathy

Typical Benefits/Outcomes

  • Rapid relief in pain
  • Improvement in function and mobility
  • Diagnostic test to see if the pain is coming from the facet joints
  • Reduction in pain medication

Radiofrequency Ablation
A radiofrequency ablation is a procedure that creates a nerve lesion produced by localized heat. This procedure will decrease the pain felt by the arthritic facet joint. Intravenous sedation is highly recommended for this procedure and the patient will be monitored by an Anesthesiologist or Certified Registered Nurse Anesthetist. Before the procedure begins, your physician starts by cleaning the skin over the injection site and injecting a local anesthetic to numb your skin.

Another needle is placed through the numb tissue, and the entire procedure is performed using fluoroscopic (X-ray) guidance. When proper needle placement is confirmed, an electrode is introduced into the center of the needle. Stimulation is initiated first with sensory stimulation and then with motor stimulation. After the ablation has been performed, a local anesthetic and a steroid medication, unless not indicated, are injected to help aide in post procedural pain.


Radiofrequency Thermo-Coagulation
The electrode is heated to 80°C and kept at that temperature for several minutes. Electro-thermal heat is generated, which allows for destruction of surrounding pain fibers, thereby decreasing your pain.


Pulsed Radiofrequency Technique
This technique is similar to thermo-coagulation RFA, but differs by a lower level of heat produced. This does not destroy the nerve tissue, but instead stuns the nerve. This method is less uncomfortable and in general only a mild pulsating sensation is felt. After a brief recovery period, you can go home after the procedure. You may have some discomfort when the local anesthetic wears off.

List of conditions treated

  • Arthritis Pain
  • Chronic Lower Back Pain
  • Chronic Neck Pain
  • Facet Joint Pain

Typical Benefits/Outcomes

  • Reduction or relief of pain
  • Improved range of motion
  • Short recovery time
  • Reduction in pain medication
  • Longer lasting pain relief in comparison to steroid injections

Spinal Cord Stimulation
A spinal cord stimulator uses groundbreaking technology that works by introducing an electrical current into the epidural space near the source of chronic pain impulses. Under a local anesthetic and minimal sedation, your doctor will first place the trial SCS leads into the epidural space. The spinal stimulator lead is a soft, thin wire with electrical leads on its tip and is placed through a needle in the back into the epidural space. The trial stimulator is typically worn for five to seven days as the lead is taped to your back and connected to a stimulating device. If the trial successfully relieves your pain, you can undergo a permanent SCS if desired.

List of conditions treated

  • Nerve Root Compression
  • Failed Back Surgery Syndrome
  • Spinal Stenosis
  • Degenerative Disc Disease
  • Sciatica or Lumbar Radiculitis
  • Complex Regional Pain Syndrome
  • Peripheral Neuropathy
  • Central Sensitization

Typical Benefits/Outcomes

  • Improves lumbar back, neck, joint, and nerve pain in patients with many different conditions
  • Effective in patients with failed back surgery syndrome
  • Reduction in pain medication

Kyphoplasty
Kyphoplasty, also referred to as balloon-assisted vertebroplasty, is a procedure that involves reinforcing a fractured vertebra with a medical grade acrylic cement. A large needle is advanced directly into the fractured vertebra and a strong balloon is inserted, creating a space for injection of the acrylic cement. The technique is similar to a standard vertebroplasty, but instead, the inflation of the balloon may result in an increase in the vertebral body height. This procedure is typically completed in less than 30 minutes with the assistance of intravenous anesthesia. The benefit of this procedure is it is performed in an outpatient setting and helps to decrease fractured vertebra pain instantly.

List of conditions treated

  • Osteoporosis
  • Bone cancer metastasis
  • Trauma
  • Vertebral/spine fracture

Typical Benefits/Outcomes

  • Restore vertebral height & alignment that was damaged by the collapse of the vertebrae
  • Rapid relief in pain
  • Improvement in function and mobility

latelet Rich Plasma (PRP) Injections
This non-surgical therapy is an injection of a concentrated mixture of the patient’s own blood. For the PRP procedure, a small volume (30 mL) of blood is drawn from the patient’s vein, placed within a sterile tube and spun within a centrifuge to allow gravity to separate individual components of the blood by weight. This procedure is called blood fractionation. Once spun, the bottom of the tube will contain the heaviest cells, the red blood cells, while the top will contain fluid plasma with platelets. Separating these two layers is a small white, “buffy coat” layer, which contains the white blood cells and some platelets. The top plasma layer is then separated from the rest of the blood product and spun down more aggressively within a centrifuge to force the platelets to the bottom which is then extracted as a smaller volume of PRP (3-6mL, or cc).

Once the PRP solution is prepared, the patient will be positioned to a comfortable position on a procedural table. The site of injection is then cleaned and sterilized before a local numbing agent, such as lidocaine, is injected superficially to provide local anesthesia during the procedure. A needle is then guided to the intended injection target site, where the physician will administer the PRP. The physician may inject additional medications along with the PRP to ensure proper PRP adherence to the target site.

In preparation for a PRP procedure, the pain specialist may elect to utilize ultrasound guidance to assist in guiding the needle to the correct location, as well as confirm that the PRP solution was properly placed in the targeted location (Barkdull, O’Connor, & McShane, 2010). Ultrasound can increase the accuracy of the PRP procedure, and potentially reduce post-procedural pain. If ultrasonography is used in conjunction with PRP injection, the patient and physician will review the imaging results during the procedure.

There are certain contraindications to PRP injection therapy, in which a patient may not be immediately eligible for treatment. Infection or broken skin at the injection site, blood clotting disorders, concurrent anti-coagulant therapy, multiple prior injections, pregnancy, or unstable/inaccessible joints may preclude use of the procedure to treat chronic pain (Barkdull, O’Connor, & McShane, 2010).Patients should discuss any of these conditions with their physician before undergoing a PRP procedure.

The entire procedure typically takes between 1-2 hours.

List of conditions treated

  • Osteoporosis
  • Bone cancer metastasis
  • Trauma
  • Ligament injury
  • Joint pain – knee, hip, elbow, shoulder, etc
  • Facet joint/arthritic pain

Typical Benefits/Outcomes

  • Relief from acute and chronic pain
  • Accelerate healing of injured tissues and joints
  • Stimulate the clearance of unhealthy tissue and natural healing processes