Spine and Disc Pain Management

Palomar Spine & Pain is devoted to the latest Spinal Pain expertise and treatment.  As medical director, Dr Jose Veliz MD has created a comprehensive and advanced Spinal Pain Management program dedicated to the evaluation, diagnosis and treatment of back pain, neck pain and Spinal Pain conditions. It is a multi-disciplinary Spinal Pain diagnostic and treatment center.

Palomar Spine & Pain is dedicated to providing you with the best care possible. Dr Jose Veliz MD believes that patients who are well informed have less anxiety and better outcomes. The information provided here is designed to help you understand your diagnosis and proposed treatment and to pave the way for your full recovery. It is our hope that this information gives you a greater understanding of your Spinal Pain and allow you to make a more informed decision about your treatment.

At Palomar Spine & Pain, Dr Jose Veliz MD diagnoses and treats a wide variety of Spinal Pain conditions.  To learn more about the services offered, follow the links below under conditions and treatments.

Spinal Pain Conditions

Palomar Spine & Pain provides diagnostic and treatment services for a broad range of Spinal Pain conditions. These include but are not limited to:

Spinal Pain Treatments

Neck pain and back pain are the most common physical complaints in the United States today equally affecting men and women. All income levels or occupations are also equally affected. Most episodes of back pain and neck pain are single incident events, but occasionally they become chronic and repetitive problems. Fortunately, a wide range of treatments are available for individuals who are experiencing back pain and neck pain.

The following information will give you an overview of treatments offered to patients at  Palomar Spine & Pain. These include but are not limited to:

Dr Jose Veliz MD is also dedicated to developing new techniques through participation in continuing medical education related to Spinal Pain. This ongoing and never ending continuing medical education leads to effective approaches to alleviate neck pain and back pain for our patients.

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, chiropractic care 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. Early use of non-operative care will speed the healing process. The length of time that non-operative treatment is necessary varies greatly from patient to patient. For this reason, each patient is carefully monitored throughout their course of treatment.

Spinal Pain-related services are provided in one convenient location. Physician office visits, X-rays and MRI imaging, physical therapy, and pain management procedures are all centralized at 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; and
  • 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 in order 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.

Information Obtained From Results

One of three results can occur following an injection: no Spinal Pain relief, short term Spinal Pain relief, or longer term Spinal Pain relief.

  • The result assists in identifying the main cause of Spinal Pain, such as a cervical facet joint, lumbar nerve root, cervical disc, muscle, ligament, tendon, bone etc.
  • When Spinal Pain is relieved, the benefits of physical therapy and chiropractic therapy are enhanced.
  • Continuing symptoms may represent the need for additional or alternative Spinal Pain treatments.
  • When surgery is recommended, the surgeon may request target specific diagnostic injections to confirm his or her 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/or joint musculature is of paramount importance in order to achieve the best result from your Spinal Pain treatment.

Pain can cause sleeplessness, depression and limitations with movement - all of which can delay recovery. It is important to manage your Spinal Pain before it becomes overwhelming. Be sure to inform your doctor when you have pain and develop a multi-disciplinary strategy to reduce the pain with realistic goals. Usually back pain and neck pain tend to improve within two weeks to twelve weeks. However, Spinal Pain is less likely to worsen or lead to other complications if treated early on.

Dr Jose Veliz MD recommends that opiates be avoided or used as a last resort because they commonly lead to opiate 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, respiratory depression etc. There are numerous non-opioid medications which are effective in reducing Spinal Pain without creating physiological and psychological dependence.

Spinal Pain Duration

Back pain and neck pain can be:

  • Acute which is usually the result of an injury or condition such as osteoarthritis lasting up to six months or less. This type of Spinal Pain can range from a muscle ache to shooting or stabbing nerve pain. Occasionally, range of motion is limited which can impede the ability to perform activities of daily living.
  • Recurrent, a repeat episode of acute symptoms.
  • Chronic, lasting longer than six months. This type of 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

In 2012, Dr Jose Veliz MD performed over 2,000 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, a number of 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, demonstrated excellent psychometric properties, and is applicable in many clinical settings. The ODI gives a subjective percentage score for level of function (disability) in activities of daily living for those 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”.  


Dr Jose Veliz MD treats a full range of spinal disorders that cause pain and disability. He dedicates a large part of his practice to the care of patients with neck and back pain. The Spinal Pain Management program offers interventional pain management treatments, diagnostic blocks and a full range of treatment options, from Spinal Pain consultations, chiropractic care, SpineMED decompression, and alternative medicine. In addition, the Spinal Pain Management program offers Regenerative Pain Management of the spine including dextrose prolotherapy, platelet rich plasma (PRP) prolotherapy and stem cell prolotherapy.

To Learn More

If you are interested in learning how a Spinal Pain procedure may help manage your pain, please contact Palomar Spine & Pain in San Diego County with convenient locations in Escondido, CA and Vista, CA. We would be glad to schedule you for a consultation and provide additional information about other Spinal Pain treatment options.



Spinal Cord Stimulation

spinal stimulator

Facet Joint Injections

facet joint injection

Epidural Nerve Block

epidural nerve block