You’ll find the most advanced multidisciplinary treatments for spine-related disorders and injuries at New York City Spine Surgery, PLLC. Our doctors offer a complete armamentarium of treatment options – everything from alternative therapies to spinal injections.
Our doctors do not fully subscribe to the theory and beliefs associated with some of the therapies listed below. They do however, recognize that there are certain alternative therapies you might elect to try in addition to conventional treatment. Some of these therapies lack scientific validation. Yet, many patients experience considerable pain relief from acupuncture, so our doctors support acupuncture treatment in certain cases. You might consider the following alternatives.
Acupuncture is the ancient Chinese healing technique considered part of Traditional Chinese Medicine (TCM). Acupuncture is the insertion of fine needles into acupuncture points called meridians. There are 365 mapped acupuncture points along 12 major channels. More than 1,000 extra points are found on the hand, ear and scalp.
Trauma, aging, stress from poor body mechanics, normal wear and tear, and injury can affect muscles, tendons, ligaments, discs or vertebrae in the spine. Pain associated with certain spinal disorders may effectively be treated using acupuncture. Acupuncture stimulates the secretion of endorphins, the body’s natural pain fighters, enhances circulation and helps the body heal.
Massage therapy is performed by a licensed therapist and has been shown to have positive benefits. By manipulating the soft tissues, muscle tension is often relieved and circulation enhanced. Although not advisable for individuals with recent fracture, massage can be beneficial overall.
Proponents of biofeedback believe that chronic pain may be affected by your mental health. During a session, electrodes/sensors are applied to your body and attached to machines that provide “feedback” on heart rate, muscle tension, respiratory rate, etc. The therapist works with you to control vital signs and tension, with the goal of you learning how to perform these control measures unassisted, thus “controlling” your pain.
Practicing yoga – gentle stretching and controlled breathing – has been shown to benefit patients with chronic pain. Regular practice of yoga can enhance overall fitness and relieve pain.
Applying sudden force to the joints of the spine, when done by a trained therapist, can restore spinal alignment, relieve pain and restore mobility.
Alternative or complementary therapies cannot always be viewed in terms of conventional medicine. Many patients find relief, despite the lack of scientific validation of some of the therapies listed above. A balanced approach to treatment of your spine disorder is probably the most reasonable and effective means of managing your condition.
When you visit our practice for treatment, our doctors may recommend that you wear a brace. Some patients find braces uncomfortable or inconvenient, but they serve a very important purpose. Braces are used to immobilize and support the spine. Sometimes they are also used to correct spinal deformity. We want you to understand how valuable spinal bracing can be to your recovery.
Braces are external devices that support the spine’s muscular and bony structures. Braces are categorized as rigid or soft. Rigid braces are used to restrict movement, while soft, elastic-type braces provide muscular support while allowing movement. Commonly used braces include:
Endoscopic laser spine surgery is the latest alternative to traditional open spine surgery. It cannot be used in every case, yet provides an excellent option for many spinal decompression procedures. It is a minimally invasive procedure. This means less tissue damage, shorter recovery times and fewer complications.
Patients can have the procedure done on an outpatient basis, leaving the hospital the same day. We perform the procedure under local anesthesia through little more than a small skin incision. Be sure to ask our doctors if you are a candidate for this revolutionary procedure. If you are not a candidate, there are still many other less invasive procedures that our doctors specializes in. They will work with you to find the best, least invasive manner to return you to health.
Back and neck pain can be miserable! Injury, herniated disc, spinal stenosis lumbar, osteoarthritis, vertebral compression fracture… Even a simple back strain can cause considerable pain. Back pain is one of the most common reasons people seek medical care.
In our practice, our doctors recommend and prescribe medication to patients. Our doctors understand spinal disorders can be painful and want to help you manage your pain while you are in our care. Here are common types of drugs recommended, prescribed or available over-the-counter (OTC) to treat symptoms. Some drugs work better in combination, such as an NSAID and muscle relaxant. Our doctors and their staff will explain which drugs can and cannot be combined and answer all of your questions about your treatment.
*Nonsteroidal anti-inflammatory drugs
Whether your medication is prescribed (Rx) or over-the-counter (OTC), there are risks – side effects, drug interactions and possible liver damage. Be sure to tell your doctor about your allergies, current medications (Rx and OTC) and use of vitamins and herbs. When you obtain a new medication, read the information provided by your pharmacist or on the label. Report these side effects immediately to our office:
With minimally invasive spine surgery (MIS), our doctors can effectively treat spine disorders without the disruption of spine anatomy normally associated with traditional, open surgery. The technology is so advanced that MIS can be accomplished through one-inch incisions, offering patients greater possibility of reduced blood loss, scar tissue formation and faster return to normal activity.
An endoscope is a thin telescope-like instrument with a lighted tube and camera attachment. We operate by passing instruments through the endoscope to the operative field. The light illuminates the field and the camera transmits images to a monitor in the operating room.
Not every patient is a candidate for MIS, and there are certain disorders that still require open surgery. Treatment options depend largely on our judgment, your diagnosis and overall state of health. Our doctors perform both MIS and open surgery and will recommend the treatment best suited for your needs.
Minimally invasive spine surgery is appropriate for the treatment of degenerative disc disease, treatment for herniated discs, vertebral fracture treatment, spinal stenosis surgery and some spinal deformities. In addition, tumors and infections can be treated with MIS.
Many MIS procedures are performed on an outpatient basis. Perhaps the greatest advantage is that procedures once requiring open surgery and a lengthy recovery can now be done with MIS. The outcomes associated with MIS are as good, if not better, than those obtained with open surgery. The advantages of MIS include:
Our doctors have trained extensively and are considered an expert in their field. They routinely performs MIS, including, but not limited to, the following procedures:
Pain management is a growing medical specialty dedicated to treating acute, subacute and chronic pain. The goal is to improve your quality of life and help you return to everyday activities without surgery. A pain management physician is often part of a team of medical professionals, such as the patient’s referring physician, physical and occupational therapists, oncologist, psychiatrist or psychologist.
Pain is generally classified as being acute or chronic. Acute pain begins quickly or suddenly and may be severe. Postoperative pain is an example of acute pain. Subacute pain is defined as being between acute and chronic. Depending on the cause, acute pain may last three to six months. Chronic pain may be mild or severe and lasts longer than six months.
An accurate diagnosis is imperative for an effective pain management plan. Our doctors combine your medical history and physical and neurological examination results with a thorough review of lab and imaging results. If you have kept a pain diary, this information is of significant value.
Depending on many factors, such as your type of pain and general health, our doctors may combine treatments. Some patients are surprised to learn that a failed treatment is effective when combined with one or more therapies. Our doctors may combine medications for maximum relief.
*Nonsteroidal anti-inflammatory drugs
Spinal injections serve two purposes:
(1) Diagnose or confirm the cause of pain
(2) Reduce or relieve inflammation and pain
A spinal injection for diagnostic or pain treatment involves injecting a local anesthetic and corticosteroid into an area of the spine. A corticosteroid is a powerful, slow-releasing, long-lasting anti-inflammatory medication effective at reducing inflammation. Our doctors sometimes we inject a narcotic to increase pain relief.
Diagnostically, when the patient’s symptoms are relieved, the injection provides evidence that a particular nerve root is a pain generator.
RF rhizotomy or RF neurotomy reduces or eliminates facet joint pain and related symptoms in the neck (cervical spine) or low back (lumbar spine). The goal is to interrupt pain communication between a specific medial nerve root and the brain. Relief from pain and related symptoms may last a year or longer. This is a treatment for low back pain, neck pain and degenerative disc disease.
The medial nerve roots innervate the spine’s facet joints. Before we perform RF rhizotomy, we identify the pain-generating facet joint nerve(s) (medial branch nerves) is identified by means of a diagnostic injection, such as a facet joint or medial branch nerve block. Other tests may include MRI. Since the medial branch nerves do not control neck or low back muscles, it is not harmful to disrupt or turn off their ability to send signals to the brain conceived as pain.
SCS provides therapeutic treatment of chronic neck, back and extremity pain and is also used for sciatica pain relief and low back pain treatments. Although the science of SCS has been around for a long time, advances have improved this technology by prolonging battery life, making device components smaller and improving pain control to multiple areas. Many chronic pain patients have regained life and vitality using SCS.
SCS works by producing electrical impulses that block pain from being perceived in the brain. Pain is replaced by a mild tingling sensation. The success of SCS depends on (1) careful patient selection and (2) a successful SCS trial. The device resembles a pacemaker and includes a generator, thin leads and remote control. The remote control enables you to turn impulses on, off or adjust their intensity.
A spinal or intrathecal pump can help provide chronic pain patients round-the-clock pain relief. Spinal pumps are programmable devices that deliver a measured and safe drug dose to meet the patient’s daily needs for pain management. Unlike oral pain medication that takes time to take effect, an intrathecal drug pump bypasses the gastrointestinal system and delivers medication into the cerebrospinal fluid. Patients may benefit four ways:
(1) Less pain medication is needed
(2) Pain relief is sustained and better controlled
(3) Side effects are reduced (i.e. constipation, nausea)
(4) Increased quality of life
Physical Therapy (PT), or functional rehabilitation, helps patients improve and maintain functional abilities needed for activities of daily living. PT includes passive therapies, treatment that does not require patient participation, such as spinal manipulation, myofascial release or ultrasound, and active therapies, including therapeutic exercise to increase flexibility, build strength and endurance, and biomechanics for posture correction and proper, safe movement.
Manual Therapy – Manipulation and Mobilization
Manual therapy involves restoring and increasing mobility, such as range of motion to stiff joints and alleviating pain. Manipulation is a specific and controlled quick movement to release a joint so it returns to correct position. Manipulation and mobilization may help reduce muscle spasm contributing to spinal nerve irritation.
Prior to manual therapy, a passive therapy may be administered. Passive therapy may include application of heat, ultrasound, and/or electrical stimulation. These therapies warm and relax soft tissue and allow joints to be more easily manipulated.
Electrical Stimulation – Transcutaneous Electrical Nerve Stimulation (TENS)
Electrical stimulation or TENS delivers a painless electrical current through the skin to specific nerves. The current produces mild heat to relieve stiffness and pain and may improve range of motion. This treatment is noninvasive, with no known side effects. It may be used to control acute pain and chronic pain.
Fasciae are sheaths of connective tissue that support muscles, bones and organs. Spinal stress from poor posture or injury may cause fascia to constrict or tighten. As the fascia constricts, muscles and bones may be pulled out of place and cause pain. Using their fingers, palms, elbows and forearms, physical therapists firmly and gently stretch the fascia. It is used as treatment for herniated discs, sciatica pain treatment, degenerative disc disease and other conditions.
Ultrasound is a common noninvasive therapy used to treat back and neck pain, tendon and ligament injury, muscle spasms, joint problems and other spine-related conditions, such as cervical radiculopathy, cervical herniated disc and nerve pain in leg. Ultrasound uses high-frequency sound waves to deliver heat deep into tissues, such as muscles. Ultrasound promotes circulation and healing, relaxes muscle spasm, decreases inflammation and helps alleviate pain.
Cold treatments are never applied directly to skin because excessive cold can injure skin tissue. A barrier, such as a towel, is placed between the skin and the cold source. Ice helps to reduce blood flow, thereby decreasing swelling, inflammation and pain. Heat therapy may include a moist heat pack with a protective skin barrier and ultrasound. Moist heat increases circulation – the body’s system for delivering healing nutrients and removing waste. Heat helps to relax stiff and sore muscles.
Aquatic Therapy (Hydrotherapy)
Patients with osteoarthritis, rheumatoid arthritis, back and neck pain and other spinal disorders may benefit from aquatic therapy. It can also be used as treatment of spinal stenosis and relief from sciatica, among others. Treatment often occurs in a heated tub or pool and addresses impaired flexibility, mobility, coordination, weakness, weight-bearing intolerance and pain. Warm water relaxes muscles. The buoyancy of water enables joints to be moved without excessive stress. Often, what a patient is unable to do on land can be done in water.
Everyone can benefit from therapeutic exercise. The physical therapist develops an individual program to meet the patient’s special needs. Benefits often include:
Prior to therapeutic exercise, a passive modality is often administered followed by a period of pre-exercise warm-up activities. Warm-up may include walking on a treadmill or stationary cycling. Therapeutiic exercise can be used for treatment of spinal stenooisis, degenerative disc disease, cervical herniated disc, relief for sciatica and spondylolisthesis, among others.
Physical therapists teach patients how to attain and maintain good posture to protect the spine from unnecessary stress and strain. Patients learn practical skills such as how to lift, reach, carry, stand, sit and get in and out of a car.
Our practice is committed to improving your health and well-being. We believe a critical part of every patient’s return to health and activity is a personalized rehab program that provides him/her with tools to prevent a future spine problem.
Spinal injections serve two purposes. They diagnose or confirm the cause of pain and they reduce or relieve inflammation and pain. A spinal injection, whether it is performed for diagnostic purposes or pain relief, involves injecting a local anesthetic and corticosteroid into an area of the spine. In the case of an epidural injection, the medications are injected into the epidural space. The epidural space is between the protective membrane (dura mater) containing the spinal cord and the bony spinal canal. When our doctors perform a nerve root block, our doctors inject the medication into the nerve root sheath. A protective membrane (pia mater) covers each nerve root. Our doctors perform the procedure using fluoroscopic guidance (real-time X-ray). Patients can expect one of three outcomes from a spinal injection:
Patients whose pain is adequately relieved or reduced may undergo additional injections at specific time periods. Some patients become so attuned to their pain cycle that they know when to call to schedule their next injection. Spinal injection therapy can be used as treatment of spinal stenosis, degenerative disc disease, nerve pain in leg and cervical radiculopathy, among others.
Learn how New York City Spine Surgery, PLLC can help you with your back pain and dysfunction. Call (212) 506-0240 or use our convenient Request an Appointment form. Our service area includes Jamaica Estate, Queens, NY, New York City, NY, Westchester, NY, Manhattan, NY, Denville, NJ, Morristown, NJ and surrounding areas.
Saint Barnabas Medical Center
Formerly St. Luke’s-Roosevelt
Hospital in Manhattan
Formerly Lenox Hill Hospital