Frequently Asked Questions

What are the options?

Non-surgical options to relieve pain

Non-surgical options for pain relief include: acupuncture, chiropractic therapy, electric stimulation, epidural steroid injections, facet injections, heat, ice, massage therapy, physical therapy, shiatsu, traction, trigger point injections and ultrasound therapy.

Typically, our patients come to us after having tried other therapies that are no longer working.  Once their pain begins affecting their ability to live a normal life, they turn to us for a solution. We provide treatment of lumbar facet syndrome, facet arthopathy, sciatica and sciatic nerve pain. We also utilize  epidural steroid injections, epidural blocks, facet injections, sacroiliac joint and trigger point injections.

Surgical options to relieve pain

In addition to providing laser and non-laser surgery to repair bulging  discs, herniated discss, and disc tears, we also provide disc fusion, disc replacement, bone spur removals, and surgery for degenerative disc disease.  We also perform foraminotomy, laminotomy, percutaneous endoscopic discectomy, vertebroplasty, and laminectomy surgeries, as well as spinal fusion surgery to address spinal stenosis and surgery to repair compression fractures.

We will thoroughly diagnose the causes of your body pain, and we'll present all of your options in easy-to-understand terms.  We'll explore the pros and cons of surgery with you, as well as the techniques themselves.  We will help you discover the best path to relieving your pain and getting your life back.

How do I know if I need surgery?

The only way to know for certain if you require surgery is to come in and let us review your CT-Scans, MRIs and/or X-rays. We thoroughly diagnose your unique situation and then explain all of your options plainly. We will explain the pros and cons of each treatment option, and help you make the decision that is best for you, your situation and your family.

Is there one type of treatment or therapy that the Institute for Diagnosis and Treatment of Pain prefers?

Maybe you've found a back surgery center dedicated exclusively to laser surgery.  Or, perhaps you've found a web site claiming that some laser surgery centers are a scam.  At the Institute for Diagnosis and Treatment of Pain, we provide a wide range of pain relief treatments -- of which laser surgery and non-laser surgery are sometimes (but not always) a part.

Our focus is on the person, not the procedure. We are not “married” to any one treatment option; rather, we treat each patient as an individual with a unique cause of severe pain that needs relief.

What is the recovery time from surgery?

Your recovery time from surgery depends upon many variables.  First, every person’s body responds to surgery differently. Your recovery is affected by your age, your physical health and the extent of your condition.

Second, the complexity of the surgery will also affect your recovery time.   For simple surgeries, most people recover in a couple of days.   Patients with more complex issues take more time to recover. In most cases, patients can expect to return to less-strenuous work in 2-3 weeks.  Most of these patients can regain their full physical abilities in 6 weeks.  Please note that all surgical patients require physical therapy in order to maintain these recovery schedules.  

Do you take insurance? What about Medicare?

The Institute for Diagnosis and Treatment of Pain accepts all forms of health insurance (including Medicare), with the exception of HMOs and Medicaid.

If you do not have insurance, or if you need to investigate other payment options with us, please call us and speak with our office manager. She can assist you.

What are back sprain and back strain?

Back sprain and strain occur when tissues in the lumbar spine are over-stretched or torn. This is the most common -- but less severe -- cause of back pain. Strain applies to injury to the ligaments, while sprain applies to muscle injury.

Back sprain and strain are called musculo-ligamentous injuries. Clinically, these injuries are associated with muscle spasms and reduction in lumbar spine mobility. Patients feel acute and chronic pain or soreness in the lower back. The pain is aggravated by most physical activities like standing, bending and walking. Normally, these injuries are not accompanied by leg pain.

What are disc tears, disc bulges, disc degeneration, and disc herniation?

Definition according to Wikipedia

What are neuritis, radiculitis, radiculopathy, sciatica and cauda equina?

Definition according to Wikipedia

What is lumbar facet joint disease?

The facet joints are part of the connection between the vertebrae. When the spine wears and tears, the spinal discs become thinner, placing more of the burden of support onto the facet joints. The increased stress causes inflammation and the growth of bone spurs. Clinically, patients feel lower back pain, buttock pain, and upper leg pain. The pain usually worsens when bending backwards and to the side.

What are spinal stenosis and foraminal stenosis?

Definition according to Wikipedia

What is spondylolisthesis?

Definition according to Wikipedia

What is failed back surgery syndrome (FBSS)?

Definition according to Wikipedia

What are the risks of endoscopic laser spinal surgery (ELSS)?

Like any other surgery, endoscopic laser spinal surgery carries risks. However, these risks are very low. They include, but are not limited to, infections, bleeding, nerve and spinal cord injuries, and failure to relieve pain.

I'm coming in from out-of-town. How long should I plan to stay?

You will need to stay for 3-4 days.  The first day of your visit is for preoperative consultation and testing. The second day is for surgery, and the third and/or fourth day is for a postoperative follow-up visit.

Since we provide only outpatient surgery, we recommend that you book a room at a hotel in the area. We have negotiated discounted rates with nearby hotels. Please call our office for details.

After cervical surgery, how long should I wear a neck collar?

A neck collar should be worn for one week. It can be taken off during sleep and when taking a shower.

Will I be able to drive myself home after surgery?

We require that someone accompany you to and from our facility on the day of your surgery, and to do the driving for you. (When requested in advance, transportation from the hotels to our surgical center is available; however, you still must arrive for surgery accompanied by someone else.)

If endoscopic laser spinal surgery (ELSS) is so state-of-the-art, why don't many surgeons perform this type of procedure?

ELSS is getting more and more popular. We believe that eventually, it will be a standard technique, just as laparoscopic removal of the gall bladder and arthroscopic knee and shoulder surgery are today.

However, the technique is still in its infancy. Most medical residents in orthopedic spine surgery and neurosurgery graduate without having been exposed to this technique. Furthermore, the learning curve of ELSS is very steep. To be very good, a surgeon needs not only adequate training and experience, but also passion, skill, and total dedication to the patient's well-being.

Are these surgical procedures considered experimental?

"Experimental" is a relative term. Microdiscectomy is a standard surgical procedure for the treatment of lumbar disc herniations. However, in order to improve results and reduce surgical complications, research or experiments on microdiscectomy are ongoing.

Recent studies have compared endoscopic lumbar discectomy with microdiscectomy. Studies show that long-term (2 years) success after endoscopic lumbar discectomy and microdiscectomy are similar, and that endoscopic surgery has advantages such as faster recovery times and less postoperative pain.

Is my bulging disc or herniation going to be removed?

Yes, if your herniated or bulging disc is symptomatic and does not respond first to more conservative treatment.