Still in Pain After Injections? When to Get a Surgical Opinion - Spinal DISC Center | Kris Radcliff, MD | New Jersey

Dr. Kris Radcliff specializes in simplifying the management of complex spine conditions and traumatic spine injuries, focusing exclusively on spine surgery, with particular expertise in the area of artificial disc replacement. Dr. Radcliff is highly experienced, having performed more than 10,000 spine surgeries. He combines conservative decision-making judgment with state-of-the-art and minimally invasive surgical techniques, endoscopic spine surgery, and artificial disc replacement.

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Still in Pain After Injections? When to Get a Surgical Opinion

Had injections, ablations, or months of therapy and still hurting? Pain management helps a great many people, and it is often the right first step. But if your relief keeps wearing off, it may be time to ask a different question: is there a problem that can be fixed?

Dr. Kris Radcliff is a fellowship-trained spine surgeon, Professor of Orthopaedic Surgery and Neurological Surgery at Thomas Jefferson University, and part of Progressive Spine & Orthopaedics. He works alongside pain management physicians, not in place of them. A surgical consultation is simply a second set of eyes on your MRI and your options. It does not mean you need surgery.

How many epidural injections can I get?

There is no single number that applies to everyone. Many physicians limit steroid injections to a few per year in the same area, because repeated steroids can affect bone strength, blood sugar, and other parts of the body. Your pain management doctor sets the right limit for you.

A more useful question is how long each injection lasts. If injections give you months of relief, they may be doing their job. If the relief is shrinking to weeks, or you are getting injections more and more often, that is a good time to get a surgical opinion.

What if the ablation didn’t work, or the pain came back?

Radiofrequency ablation quiets the small nerves that carry pain from the facet joints, the small joints at the back of the spine. It can work well, but the nerves grow back over time, and it only helps if those joints are the true source of the pain.

If an ablation did not help at all, it can be a clue that the pain is coming from somewhere else, such as a disc, a pinched nerve, or an unstable segment. Finding the real pain generator is the most important step, and it may point to a treatment you have not tried.

What is the MILD procedure?

MILD (minimally invasive lumbar decompression) is an outpatient procedure for some patients with lumbar spinal stenosis caused mainly by a thickened ligament in the back of the spinal canal. Through a very small opening, part of that ligament is removed to give the nerves more room. It can be a good option for the right patient. For others, the narrowing comes from disc bulges, bone spurs, or a slipped vertebra, and a different approach, such as endoscopic decompression or a motion-preserving operation, may help more.

Signs it may be time for a surgical opinion

Leg or arm pain that keeps coming back after injections
Relief from each injection or ablation that lasts a shorter time than before
Numbness, tingling, or weakness in a leg or arm, such as tripping or a foot that slaps when you walk
You can walk or stand for shorter and shorter periods before you need to sit
Your MRI shows a disc herniation, stenosis, or a slipped vertebra pressing on nerves
You have been told you “just have to live with it”

Go to the emergency room if you have new loss of bladder or bowel control, numbness in the groin or inner thighs, or rapidly worsening weakness in your legs.

What a surgical opinion can offer

Many of the people Dr. Radcliff sees after pain management are good candidates for smaller, motion-preserving operations, not just fusion:

Endoscopic spine surgery through an incision under half an inch, usually with same-day discharge
Artificial disc replacement in the neck or low back
Minimally invasive decompression
Other alternatives to fusion, including TOPS facet replacement for some patients

And sometimes the best advice is to keep doing what you are doing. You will leave with a clear explanation either way.

Schedule a consultation or second opinion

Bring your MRI (the disc and the report), a list of the injections and procedures you have had, and how long each one helped.

Dr. Radcliff accepts most commercial insurance plans and is out of network with most of them. Many Pennsylvania and New Jersey plans have out-of-network benefits, and we can help review your benefits and explain them. Don’t worry. We are all about helping the patients.

Offices in Somers Point, Cherry Hill, and Brick, New Jersey, as part of Progressive Spine & Orthopaedics.
Call: 609-800-3472
Fax: 609-842-4040
newjerseyspinesurgeon.com

This page is general information, not medical advice. Your treatment should be based on an evaluation by your own physician.