Evaluation of chronic back pain, neck pain, and headaches is often not straight forward for the following reasons:

Pitfalls with conventional evaluation of low back pain

"Specific anatomic etiology is clearly and objectively identified in only 10% to 20%."
  1. Radiographic "abnormalties" are frequently clinically irrelevant.True sciatica occurs in only 1% to 2% of the patients.No universal criteria are established for for scoring the presence, absence or importance of particular signs.Quantification of the degree of disability and the association to treatment outcomes is difficult.Interpretation of biomedical findings relies on "clinical judgements," "physician's experience," and "quasi-standardized criteria."Routine clinical assessment is frequently subjective and unreliable.Physical examination and diagnostic findings are subjective.The discriminative power of common objective signs has been questioned.Reliance on general "clinical impression" to detect gross psychological disturbances is "hopelessly inaccurate."
  2. It is usually not possible to make a precise diagnosis or identify anatomic origin of the pain by routine clinical assessment.

Adapted and modified from Manchikanti(41).

Often, patients have a nonspecific diagnosis of chronic low back pain or neck pain without a specific knowledge of the cause. This can lead to missed opportunities for treatments which would afford the patient more comfort and a better quality of life.

We practice advanced interventional pain management aimed at making a specific diagnosis and creating an appropriate treatment plan using an algorithmic approach. Our approach is based on algorithms from the International Spine Intervention Society and the International Society for the Study of Pain, as well as the American Society of Interventional Pain Physicians. This approach is based on the best and most current Evidenced Based Practice Guidelines available.

Please browse through our PHYSICIAN INFORMATION section for descriptions of some of the most common pain problems that you will encounter in your practice. They are not meant to be an exhaustive treatise on each condition, but rather information you can easily use every day. The treatments covered are all non-surgical. There may be occasions when surgical treatments are the best option. If you would like more detailed information on these entities or any other pain problems or treatment options, please feel free to contact us directly.