Palomar Spine & Pain offers spinal care for patients with traumatic, degenerative or inflammatory spinal diseases. It is a multi-disciplinary spinal diagnostic and treatment center dedicated to the evaluation, diagnosis, and treatment of spinal conditions, including but not limited to the back and neck.
Well informed patients have less anxiety and better outcomes. The information provided helps you understand your diagnosis and proposed treatment to pave the way for your full recovery. We hope this information gives you a greater understanding of your spinal pain and allows you to make a better-informed decision about your treatment. To learn more about the services, follow the links below under conditions and treatments.
- Anatomy of the Spine
- Back Exercises
- Cervical Radiculopathy
- Degenerative Disc Disease
- Facet Joint Syndrome
- Herniated Discs
- Lower Back Pain
- Lumbar Radiculopathy
- Myofascial Pain Syndrome
- Neck Pain
- Piriformis Syndrome
- Post Laminectomy Syndrome
- Sacroiliac Joint Pain
- Spinal Infection
- Spinal Stenosis
- Where Back Pain Begins
- Whiplash (CAD Syndrome)
Neck pain and back pain are the most common physical complaints in the United States, equally affecting men and women. All income levels or occupations are equally affected. Most episodes of back pain and neck pain are single incident events, but occasionally they become chronic and repetitive. Fortunately, a wide range of treatments is available for individuals experiencing back pain and neck pain.
- Medical Acupuncture
- Cervical Epidural Steroid Injection
- Cervical Facet Radiofrequency Neurotomy
- Cervical Selective Nerve Root Block
- About Chiropractic
- Cold Laser Therapy
- Costovertebral Block
- Dekompressor Discectomy
- Epidural Nerve Block
- Facet Joint injections
- Intrathecal Pump Implant (Medtronic)
- Lumbar Epidural Steroid Injection
- Lumbar Radiofrequency Neurotomy
- Lumbar Sympathetic Block
- Lumbar Transforaminal Epidural Steroid Injection
- Medial Branch Block
- Pain Management
- Percutaneous Discectomy
- Physical Therapy
- Platelet Rich Plasma (PRP) Injection Treatment for Chronic Back Pain
- Platelet Rich Plasma (PRP) Injection Treatment for Whiplash
- Prolotherapy Treatment for Chronic Lower Back Pain
- RACZ Caudal Neurolysis
- Radiofrequency Ablation
- Sacroiliac Joint Steroid Injection
- Spinal Cord Stimulation
- Spinal Cord Stimulator Implant (Trial Procedure)
- Spinal Cord Stimulator Implant
- SpineMED Decompression
- Stem Cell Prolotherapy
- Thoracic Epidural Steroid Injection
- Thoracic Transforaminal Epidural Steroid Injection
- Trigger Point Injections
At Palomar Spine & Pain, non-operative care is the treatment of choice for those suffering back pain and neck pain. A combination of non-invasive treatment measures including physical therapy, decompression, and alternative medicine is used to reduce pain, increase mobility and improve functionality. This approach is also used to assist in managing issues frequently associated with spinal pain, such as insomnia or depression.
The early use of non-operative care will speed the healing process. The time that non-operative treatment is necessary varies greatly from patient to patient. Each patient is carefully monitored throughout their course of treatment.
Spinal-related services are provided in one convenient location. Physician office visits, x-rays, MRI imaging, CT scan imaging, physical therapy, decompression, alternative medicine, and interventional pain management procedures are all centralized at the Palomar Spine & Pain’s Escondido location for patient convenience and ease of treatment.
Spinal Injections Diagnose and Reduce Pain
Spinal injections can serve numerous roles:
- Diagnose or confirm the cause of pain.
- Reduce or eliminate inflammation and pain.
- Promote repair or replacement of pathologic tissues through the augmentation of natural processes.
Description of Injection Procedure
An interventional spinal pain injection is performed for either diagnostic or therapeutic purposes:
- Diagnostic injections with low dose local anesthetics are those performed with precision to determine the exact cause of pain (pain generator).
- Therapeutic injections often involve placing a low dose corticosteroid, prolotherapy proliferant (dextrose, PRP or stem cells), stabilizing material or radiofrequency energy at the source or cause of pain.
Following an injection, there may be no spinal pain relief, short-term spinal pain relief, or long-term spinal pain relief. The result assists in identifying the main cause of spinal pain, such as a facet joint, nerve root, disc, muscle, ligament, tendon, bone, etc. When spinal pain is relieved, the benefits of physical therapy are enhanced. Continuing symptoms may represent the need for additional or alternative spinal pain treatments. When surgery is recommended, the surgeon may request specific diagnostic injections to confirm their recommendations. Palomar Spine & Pain retains a medical record of each needle placement.
Spinal Pain Relief
Spinal pain relief varies among patients. For some therapeutic injections, only one is indicated. For others, the need for a repeat therapeutic injection depends on your body’s ability to correct the underlying spinal disorder, on the severity of your spinal condition, and on your subjective response to the injection. For diagnostic injections, the procedure is performed with a local anesthetic as a precursor to another procedure intended to provide long-term relief. Maintaining a healthy weight, using proper posture, and strengthening your core and joint musculature is of paramount importance in achieving the best result from your spinal treatment.
Pain can cause sleeplessness, depression, and limitations of movement, all of which can delay recovery. It is important to manage your spinal pain before it becomes overwhelming. Inform your doctor when you have pain so he or she can develop a multi-disciplinary strategy to reduce the pain with realistic goals. Usually, back pain and neck pain improve within two weeks to twelve weeks. Spinal pain is less likely to worsen or lead to other complications if treated early on.
Opiates or narcotics should be avoided because they commonly lead to dependence. Long-term use of opiates leads to a paradoxical increase in pain sensitivity (opioid hyperalgesia). Other negative effects of opiate use include decreased testosterone, decreased estrogen, osteoporosis, immune dysfunction, depression, weight gain, constipation, memory loss, mood changes, and respiratory depression. Numerous non-opioid medications are effective in reducing spinal pain without creating physiological and psychological dependence.
Spinal Pain Duration
Back pain and neck pain can be acute, usually the result of an injury or condition such as osteoarthritis and lasting up to six months or less. This spinal pain can range from a muscle ache to shooting or stabbing nerve pain. Occasionally, the range of motion is limited which can impede the ability to perform activities of daily living. Back pain and neck pain can also be recurrent, a repeat episode of acute symptoms. Last, back and neck pain can be chronic, lasting longer than six months. This pain often worsens with time and its cause can be difficult to identify. Often, the symptoms are out of proportion to diagnostic studies and physical examination findings.
Number of Spinal Pain Procedures Performed
Our medical director, Dr. Jose Veliz, has performed thousands of outpatient procedures for spinal pain. Studies suggest that for many spinal pain procedures, centers that perform high volumes have better quality outcomes with lower morbidity. Volume is an indicator of experience, which affects outcomes in a multitude of ways. Commitment to quality standards throughout the center is also an important determinant of positive outcomes.
Patient Care and Outcomes
At Palomar Spine & Pain, several aspects of patient care are monitored for patients undergoing spinal pain treatments. These include the Oswestry Disability Index and spinal pain level measurements. The Oswestry Disability Index (ODI) is one of the principal condition-specific outcome measures used in the management of spinal pain disorders. The ODI is the most commonly utilized tool for outcome measure in patients who experience low back pain. It has been rigorously tested, demonstrating excellent psychometric properties and applying to many clinical settings. The ODI gives a subjective percentage score for level of function (disability) in activities of daily living for individuals recovering from spinal pain. Palomar Spine & Pain also measures a patient’s level of spinal pain at every follow-up visit. Patients are asked to rate their pain which may range from “no pain” to “worst possible pain.”
Jose Veliz MD is the medical director of Palomar Spine & Pain, in Escondido, CA (North San Diego County).