A rigorous round of golf leads to back pain. A muscle is strained. Sure, there are nerves in the area, but there’s nothing wrong with them. It’s just the muscle needs time to relax. Or maybe there is nerve damage. Or injury to a facet joint in the spine.
Without proper diagnosis, the proper treatment can’t be dispensed. That’s one reason that every new patient meets with Dr. Pierce Waychoff, DC, clinic director and owner of Pain Stop North Phoenix, not only the first time, but every time. Among other things, he determines what advanced diagnostic testing might be necessary to pinpoint what’s going on.
Then the correct back pain treatment can begin. And to ensure patients are receiving the latest – and safest – options available Dr. Waychoff, DC and his wife, Erin Waychoff, DC, also an owner, go through a lengthy process that includes multiple meetings and research whenever they’re approached about new technology.
A higher-level standard of care for their patients drives their decisions about what equipment to purchase.
All diagnostic testing is done on site. Only testing that is warranted based on exam results is performed. Facet joints, each about the size of a thumbnail, are found on both sides of the spine. A facet joint injury can involve the cartilage inside the joint or just the connecting ligaments.
- X-rays reveal bone and joint integrity. Is there a stress fracture of the spine, for example? Bone spurs?
- MRIs play a role in assessing ligamentous and disc injuries.
- Fluoroscopy is like an X-ray “movie” that studies moving body structures. A continuous X-ray beam is passed through the body part being examined and transmitted to a TV-like monitor for viewing. Fluoroscopy, as an imaging tool, can help evaluate specific areas of the body, including bones, muscles and joints. “This live-time imaging is a step up from an ultrasound,” says Dr. Waychoff, DC.
- A medial branch block will help hone in on which of the many nerves feeding out from the facet joints are carrying pain signals to the brain. If temporary relief is gained from the injection of an anesthetic and steroid into a specific nerve – and the procedure is repeated twice – then the offending nerve is accurately identified.
Cool Tools to Aid Treatment
Treatment for back pain always begins with the most conservative approach, says Dr. Waychoff, DC, who discusses each patient with the medical providers.
If physical therapy, assisted stretching, trigger point injections and trigger point therapy are not effective, and depending upon what the diagnostics have revealed, epidurals, nerve blocks and radiofrequency neuroablation (RFN) might next be considered.
- RFN should never be the first line of treatment. “And it would be a big mistake to perform RFN without doing a diagnostic medial branch block,” says Dr. Waychoff. “There are so many nerves coming out of the facet joints, and it’s a semi-permanent procedure. You want to be accurate.”
- A fluoroscopy unit enables the pain doctor to see exactly where the needle is going while administering an injection that targets a tiny nerve.
- Intraoperative neurophysiological monitoring (IONM):
- Common in hospitals; used less frequently in pain clinics.
- Available at Pain Stop North Phoenix for the past five or six months
- Used in conjunction with fluoroscopy to target the precise tiny nerve
- Live-time messages are fired to a radiologist monitoring the procedure via the Internet.
- If the pain doctor is getting too close to the wrong nerve, a warning is immediately sent by the radiologist to the pain doctor.
Isn’t it time to hand your back pain over to Pain Stop North Phoenix where cutting-edge technology meets individual care and concern? Call today for your free consultation with Dr. Waychoff, DC.