9 Chronic Pain Treatments Before Invasive Spine Surgery


Before considering more invasive surgery that requires a longer road to recovery, talk to your physician or pain specialist about these treatment options:

Epidural Steroid Injections

An epidural steroid injection is delivered directly into the lower back, mid spine, or neck region. The injection contains a local anesthetic as well as a steroid. Epidural steroid injections can help reduce inflammation and pain but it does not cure the pre-existing cause of the pain.

Lumbar Sympathetic Block

A lumbar sympathetic block is an injection that is delivered directly in or around the sympathetic nerves, which are located in the lower back region. The injection of local anesthetic and steroids helps to block pain signals coming from the sympathetic nerves while reducing swelling.

Facet and Medical Branch Blocks

A facet block and a medical branch are both injections of a of local anesthetic and steroid. The difference is that a facet block is placed into a joint in the spine whereas a medial branch block is delivered near the nerve just outside of the joint space. Ideal for patients suffering from arthritis or mechanical lower back pain.

Therapeutic Peripheral Joint Injections

Used only for peripheral joints, Therapeutic Peripheral Joint Injections involve a steroid-based medication that will help alleviate swelling and improve mobility. The benefits of the injection may last a few weeks to several months, depending on your condition and how your body responds to it. Here is a list of common peripheral joint locations: hips, shoulders, ankles, wrists, elbows.

Stellate Ganglion Block

Also referred to as a sympathetic block, this is an injection of a local anesthetic that is delivered into the front of the neck. It is ideal for pain located in the chest, arms, and head. Most patients receiving this treatment have a history of nerve injury or circulation problems.

Nerve Root Blocks

A nerve root block is a very precise injection that is guided via x-ray to deliver a combination of a local anesthetic and a steroid. The injection happens where a nerve exits the spinal column and it is ideal for a single nerve.

Spinal Cord Stimulation

This minimally invasive surgical procedure involves a simple proven method and a quick recovery time. A pulse generator is placed underneath the skin where it is connected to a lead. This lead sends out electrical pulses to help stop pain signals from reaching the brain.

Radiofrequency Neurotomy

Similar to Spinal Cord Stimulation, the method of radiofrequency neurotomy is used to disrupt signals coming from the site of the pain. Unlike SCS; however, thermal denervation is used to deaden nerves that are connected to the site of the pain. Your doctor will place radiofrequency needles along the spine then feed thermal energy through until the nerve is deadened.


Discography itself is not a long-term solution; rather, it is used by your surgeon to provide relief and discover which areas are causing you the most trouble. A minimum of two discs in the spine will be injected with a combination of local anesthetic and dye. Once the surgeon studies the x-ray, he or she will make the decision for further treatment.

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