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Pain Management

Pain Management Procedures

Our doctors will initially treat back pain with conservative procedures first and if these don't work move to medication, then minimally invasive techniques and finally surgery, using this scale below.

Treatment Scale

  1. Conservative
  2. Medication
  3. Minimally Invasive Techniques
  4. Surgery

Facet joint injections

Facet joint injections are performed for facet joint pain. Facet joints can be injected with long acting local anaesthetic and anti-inflammatory steroids, which can alleviate facet joint pain for long periods.


Discography involves the insertion of a thin needle into one or more back discs. Then either saline is injected into the disc to see if it is painful, or radio-opaque contrast dye is injected and x-rays will be taken to show the internal structure of the disc.

Epidural steroid injection

In an epidural a solution of long acting local anaesthetic, long acting anti-inflammatory steroid, and sometimes other pain modifying drugs is injected into the epidural space in the spine, the layer of supporting tissue outside the spinal cord.


A technique for the decompression of contained or expanded lumbar herniated discs. A special device is inserted into the affected back disc which removes some of the disc nucleus providing decompression. This allows the bulge to reduce and reduces the pain from both the disc and the nerve root.

Spinal Fusion

There are two main types of spinal fusion, which may be used in conjunction with each other: posterolateral and interbody.

Posterolateral fusion places the bone graft between the transverse processes in the back of the spine. These vertebrae are then fixed in place with screws and/or wire through the pedicles of each vertebrae attaching to a metal rod on each side of the vertebrae.

Interbody fusion the disc is removed entirely and a bone graft is placed between the vertebra in the area usually occupied by the intervertebral disc.