6. What Are My Treatment Options?
In theory, there are three basic forms of treatment for the spine. Not all forms of treatment are appropriate for all patients:
  1. Conservative Management
    This includes non-invasive treatments such as physical therapy, massage/deep tissue release, stretching, regular exercise, and various medications. Other options may also be incorporated depending on the diagnosis: chiropractic modalities, acupuncture, holistic medicine, among others. Regular exercise and stretching can help patients avoid surgery, and prevent reinjury.
  2. Spinal Injections
    Spinal injections can be directed toward neck or back pain, or radiating pain, depending on the diagnosis. Typically, a short acting anesthetic, or strong anti-inflammatory (cortisone) is used. The goals are usually two-fold:
    1. To make you feel better!
    2. To help diagnose your pain generators.
      Remember that there can be a delay between when the injection is given, and when the pain goes away. It is important to keep track of your symptoms over time, and speak to your physician about them. No one understands your body better than you do.
  3. Surgery
    Surgery is only necessary in a small percentage of patients that visit a spine specialist, but it is important your care provider has a strong sense of all your options. Surgery is typically recommended in the following conditions:
    1. When we understand the pain generators, and all other treatment options are not adequately controlling the pain.
    2. When there is progressive pain or weakness that does not improve with conservative management.
    3. In scoliosis, when curves progress beyond a certain size, depending on the age and symptoms of the patient.
      The most important component is understanding the pain generators, and setting your expectations for surgery. Some surgeons only recommend conservative management or injections if you refuse surgery, or try to scare you with threats of future paralysis. Beware! In other cases, surgery cannot help at all, or may make you worse. Therefore, it is important to see a specialist with a strong commitment to avoiding surgery unless it is absolutely necessary.

As a leading spinal revision specialist, Dr. Rinella takes pride in avoiding the problems that may lead to additional surgery down the road. He may be able to help you, even in situations where others told you there were no other options.