Just like there are many different causes of back pain, there are many different methods for treating it. Novant Health physicians work to personalize treatment plans and help patients understand their spectrum of options.
“We help the patient figure out the best way to manage that back pain,” said Jeff Peacock, MD, anesthesiologist and director of pain services. “In general we start simple, and work our way up to more aggressive approaches.”
Step 1: Determine the cause of the back pain.
“Pain can be a powerful subjective experience and it can, at times, be difficult to pinpoint the etiology,” said Jugal Dalal, MD, anesthesiologist who specializes in interventional pain management. “We can use treatments like targeted injections to be diagnostic as well as therapeutic. For example, targeted injections into the lower back that have a good response can indicate that the target is a likely pain generator.”
Step 2: Consider multimodal, noninvasive treatments for that pain.
“When a patient has pain, there’s not just one plan that everyone fits into and gets better with,” Dr. Peacock said. “A lot of times, it involves a little bit of a lot of the options.”
Those options include:
- Physical therapy
- Massage therapy
- Acupuncture
- Yoga
- Chiropractic care
- Inflammation-reducing injections and medications
- Neurostimulators
- Stimulators for diabetic neuropathy
- Surgery
Overall, there’s a shift toward more minimally invasive treatments that showcase innovative techniques.
“We offer a wide range of treatments from steroid injections to biologic injections,” Dr. Peacock said. “We do a procedure to put cement in a patient’s back for a compression fracture, or radiofrequency ablation to burn nerves to try to give people long-term relief. We’re doing some newer treatments to burn nerves around the disc, spinal cord stimulation using electrodes and minimally invasive treatments to prop open the spine.”
“Research is exploding.” said Dr. Dalal. “There are novel techniques constantly coming out so we can offer patients even more options. It’s constantly evolving and we’re trying to stay ahead of the curve.”
Step 3: Consider surgery if necessary.
“We usually give most conditions two or three months of nonoperative care to go over pros and cons of surgery,” said Chase Bennett, MD, orthopedic spine surgeon. “At some point it can
become a personal question for patients, if pain is preventing them from working or from interacting with their kids or grandkids.”
Surgery can be an option if less invasive treatments aren’t working to manage a patient’s pain. Surgery can also be an option early on in a patient’s care plan when there are concerns such as neurological deterioration, pressure on the spinal cord, and progressive numbness in the hands and feet. “We consider the rate at which symptoms are progressing, and how worrisome those symptoms are,” Dr. Bennett said.
Novant Health offers seamless care that employs advanced technology.
“We have a comprehensive program so we can be all-inclusive in the way we care for our patients,” Bennett said. “That ranges from physical therapy, to pain management, to surgery, to the team in the hospital that supports our patients.”
That also includes collaboration with the patients themselves, as well as with their primary care clinician. Plus, Novant Health’s investment in operating room equipment has expanded those comprehensive care capabilities. The seamless partnership between primary care clinicians,
spine clinics and the hospital means patients experience coordinated care across their diagnosis, treatment and recovery journey.
“We use modern tables that flex and bend to maximize the position of the patient,” Dr. Bennett said. “And our techniques offer minimally invasive surgical options whether we’re using microscopes, or tubes, or CT scans to guide surgical instruments. There’s also a new system called Pulse that dramatically reduces radiation exposure. Lastly, we have the ability to take X-rays of certain aspects of the spine. We can image the whole spine in one continuous image, which is helpful for scoliosis and any type of reconstruction or revision surgery, offering significantly more accuracy to ensure well-balanced positioning.”
Ultimately, comprehensive care can support better quality of life.
“Our goal is not just a reduction in pain scores but tangible improvements in quality of life and activities that patients are able to do,” Dr. Dalal said. “Whether it’s about walking longer distances, traveling the world or just playing with grandchildren, we want to help patients to live life at their very best.”
To make a referral to the Novant Health pain management program or Novant Health spine, neck and back specialists in Winston-Salem, call 336-277-2225.
Novant Health offers spine care across the Triad, with experts in Greensboro, High Point, Kernersville, Thomasville, Lexington, Winston-Salem, Mount Airy and Bermuda Run.
