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Beverly: 978-927-7246
Woburn: 781-927-7246
Back pain, whether in the lower or upper regions, can disrupt your daily life and limit your mobility. Commonly caused by conditions like herniated discs, muscle strain, arthritis, or spinal stenosis, this pain can range from mild discomfort to severe, chronic issues. At North Shore Pain Management, we specialize in diagnosing and treating back pain with personalized care plans, including advanced, non-surgical therapies designed to relieve pain, restore function, and improve quality of life. Let us help you regain comfort and mobility.
Herniated discs in the lumbar spine/pinched nerves/radiculopathy
Lumbar Spinal Arthritis
Lumbar Spinal Stenosis
Sacroiliac Joint Pain
Lumbar Degenerative Disc Disease / Vertebral Endplate Changes
Compression Fracture
Vertebrogenic Back pain
Failed Back Syndrome/ Postlaminectomy Syndrome
Coccydynia
Herniated discs in the lumbar spine/pinched nerves/radiculopathy
Effective Treatment for Lumbar Herniated Discs, Pinched Nerves, and Radiculopathy
Lumbar herniated discs, pinched nerves, and radiculopathy are common sources of lower back pain that can cause radiating discomfort, numbness, and weakness in the legs. These conditions occur when spinal discs or surrounding structures compress nearby nerves, leading to chronic pain and limited mobility. At North Shore Pain Management, we specialize in diagnosing and treating these conditions with advanced, non-surgical therapies designed to relieve pain, reduce inflammation, and restore function. Let us help you find lasting relief and regain your quality of life.Lumbar Epidural Steroid Injections for Lower Back Pain Relief
Lumbar Epidural Steroid Injections (LESIs) are a minimally invasive treatment designed to relieve lower back pain, leg pain, and sciatica caused by conditions like herniated discs, spinal stenosis, and nerve compression. This procedure delivers anti-inflammatory medication directly into the epidural space of the lower spine to reduce inflammation and alleviate nerve pain. At North Shore Pain Management, we offer personalized LESI treatments to help reduce pain, improve mobility, and enhance your quality of life.Transforaminal / Epidural Steroid Injection (TFE)/(ESI)
This outpatient procedure is an injection of a steroid-anesthetic medication. The medication can reduce swelling and inflammation of irritated spinal nerves. This procedure is performed to relieve pain in the lower back and pain that radiates from the back to the legs. The injection takes only a few minutes to complete.
What is a Transforaminal / Epidural Steroid Injection (TFE/ESI)?
This is an outpatient procedure in which we inject steroid medication into the epidural space. Sometimes, a local anesthetic is added to the steroid mixture. The epidural space is a space located in the spine between the vertebrae. The goal of a TFE/ESI is to provide relief by reducing the inflammation (swelling) of the nerve roots as they exit the spine. A TFE/ESI will not correct the pre-existing medical problem (i.e. spinal stenosis, herniated or bulging disc, arthritis, etc.) but may decrease the level of pain. The injections are done in a series of three, approximately 1 month apart. An injection may be repeated every 3 months if the pain returns.How long does the TFE/ESI procedure take?
The procedure takes about 10 minutes.What are the pre-requisites in order to perform this procedure?
You may need to stop taking certain medications several days before the procedure, especially anticoagulant or “blood thinning” medications, as well as other prescription and/or over the counter medications, including herbal and vitamin supplements.Will the injection hurt?
Most people report that the stinging or burning of the numbing medicine is the most uncomfortable part of the procedure though every person’s response to any procedure is individual.What should I expect after the procedure and what are the side effects?
Most people don’t feel any different immediately after the injection though the pain may be temporarily removed or worsened. The steroid medication takes two or three days to start to have an effect in most people and peaks in about one week. Therefore, it may be awhile before you feel a change in your pain. Some tenderness around the injection site may be experienced for a couple of days after the injection. Using an ice pack with a barrier such as a towel between the ice and skin three or four times a day will help this. You may take your prescribed pain medications after the injection. It is important that you keep track of the amount of pain medication you are using.What should I do after the procedure?
No heat is to be used on or around the injected area for the remainder of the day. No tub, bath, or soaking in water (i.e. pool, Jacuzzi, etc.) for at least 48 hours. You may eat, drink, and take your medications as prescribed on the day of the procedure (both before and after) unless instructed otherwise by your physician.Lumbar Spinal Arthritis
Comprehensive Care for Lumbar Spinal Arthritis
Lumbar spinal arthritis is a degenerative condition that affects the lower back, causing pain, stiffness, and reduced mobility due to inflammation and joint damage. Common in aging adults, this condition can result from wear and tear of the spinal joints and discs. At North Shore Pain Management, we offer advanced, non-surgical treatments—including medication management, physical therapy, and targeted injections—to reduce inflammation, alleviate pain, and restore mobility, helping you return to an active, pain-free lifestyle.
Lumbar Medial Branch Blocks & Radiofrequency Lesioning (RFL) for Lasting Back Pain Relief
Lumbar Medial Branch Blocks (MBB) and Radiofrequency Lesioning (RFL) are advanced, minimally invasive treatments designed to relieve chronic lower back pain caused by facet joint arthritis or degenerative spine conditions. MBB involves injecting a local anesthetic near the medial branch nerves to diagnose and temporarily relieve pain. If successful, Lumbar RFL can provide longer-lasting relief by using heat energy to disrupt pain signals. At North Shore Pain Management, we offer these targeted procedures to help you regain comfort and mobility.
Radio Frequency Lesioning (RFL)
What is Radiofrequency Lesioning (RFL)?
This is an outpatient procedure using a specialized machine to interrupt nerve conduction on a semi-permanent basis. Pain relief may last for at least 6 to 18 months. This procedure is performed using Fluoroscopy. Fluoroscopy is a type of X-ray that identifies bony structures. A local anesthetic is used to numb an area on the skin. After confirmation of needle tip placement, a small electrical current is passed through the needle to perform sensory and motor testing. Finally, an electrode is used to send a radio wave frequency, which turns the nerve off.
What are the pre-requisites in order to perform this procedure?
In order to perform the RFL, we would need to perform two separate diagnostic test injections, called Medial Branch Blocks (MBB). These injections consist of different types of numbing medications. Depending on the amount of pain relief after these injections, we may continue to proceed with the final RFL procedure.
How long does the RFL procedure take?
The procedure takes about 30 minutes.
Will the procedure hurt?
This should easily be tolerated by the patient with only mild sedation. Intravenous sedation and analgesia will be available. This makes the procedure easier to tolerate. It is necessary for you to be awake enough to communicate easily during the procedure. We also numb the skin and deeper tissues with a local anesthetic prior to inserting the needle. There is moderate discomfort involved for a few weeks after. You may have numb areas with increased sensitivity (like a deep sun burn).
What should I expect after the procedure and what are the side effects?
Initially, there will be muscle soreness for up to 7-10 days afterward. Ice packs will usually control this discomfort. After the first 4-6 weeks, your pain may be gone or quite less. Some patients may have some “deep sun burn” type of feeling. Some may develop hypersensitivity or burning pain, or numb areas for a few weeks.
What should I do after the procedure?
You should have a ride home. We advise the patients to take it easy for a day or so after the procedure. You may want to apply ice to the affected area. Perform activities as tolerated.
Lumbar Spinal Stenosis
Advanced Treatment for Lumbar Spinal Stenosis
Lumbar spinal stenosis is a condition where the spinal canal in the lower back narrows, putting pressure on the spinal cord and nerves. This often leads to lower back pain, leg pain, numbness, and weakness, especially during walking or standing. At North Shore Pain Management, we offer personalized, non-surgical treatments—such as lumbar epidural steroid injections to relieve pain, reduce inflammation, and improve mobility, helping you regain comfort and return to daily activities.
Lumbar Epidural Steroid Injections for Lower Back Pain Relief
Lumbar Epidural Steroid Injections (LESIs) are a minimally invasive treatment designed to relieve lower back pain, sciatica, and leg pain caused by conditions like herniated discs, spinal stenosis, and nerve compression. This procedure involves injecting anti-inflammatory medication directly into the epidural space of the lower spine to reduce inflammation and relieve nerve pain. At North Shore Pain Management, we offer personalized LESI treatments to help patients achieve lasting pain relief, improve mobility, and restore their quality of life.
Minimally Invasive Lumbar Decompression (MILD®) Procedure for Spinal Stenosis Relief
The MILD® procedure is a safe, minimally invasive treatment for lumbar spinal stenosis that relieves nerve pressure by removing small pieces of bone and excess ligament tissue in the lower spine. This outpatient procedure restores space in the spinal canal, reducing back and leg pain and improving mobility without the need for stitches or general anesthesia. At North Shore Pain Management, we offer the MILD® procedure as an effective alternative to traditional back surgery, helping patients return to a more active lifestyle.
MILD Procedure (Minimally Invasive Lumbar Decompression)
What is the MILD Procedure?
Mild or Minimally Invasive Lumbar Decompression is a procedure in which a device the diameter of a paper hole punch is inserted down to the spine to decompress the nerves being pinched by lumbar spinal stenosis. Lumbar Spinal Stenosis or LSS is a narrowing of the spinal canal which pinches the nerves causing low back, buttock, and leg pain, numbness, or heaviness with walking or standing for a short period. The symptoms usually resolve shortly after leaning forward or sitting. This is called Neurogenic Intermittent Claudication or NIC. It is a procedure for those who have failed conservative and injection therapies as well as a much less invasive (hence the term minimally invasive) step before considering a much more invasive spine surgery decompression.
What are the pre-requisites in order to perform this procedure?
You may need to stop taking certain medications several days before the procedure, especially anticoagulant or “blood thinning” medications, as well as other prescription and/or over-the-counter medications, including herbal and vitamin supplements.
How long does the procedure take?
The procedure can take about 1 hour.
Will the procedure hurt?
You will be under IV sedation similar to a colonoscopy but not general anesthesia. Numbing medicine is also used.
What should I expect after the procedure and what are the side effects?
Pain relief may be immediate with the ability to walk and stand much longer or it can take a few weeks to notice relief. There are no side effects but you may experience some pain or discomfort from the procedure for a week or so.
What should I do after the procedure?
You will return to the office between 7-14 days for a post-op check. Some localized tenderness may be experienced for a couple of days after the procedure. Using an ice pack with a barrier such as a towel between the skin and ice, three or four times a day will help this. You may take your prescribed pain medications after the injection.
Minuteman Procedure
Minimally invasive, interspinous-interlaminar fusion device
The Minuteman® is a minimally invasive, interspinous-interlaminar fusion device intended for the fixation and stabilization of the lumbar spine while awaiting bony fusion to occur. The Minuteman® is designed for attachment to the posterior lumbar spine at the spinous processes through its bilateral locking plates, and it is intended for use with bone graft material placed within the device. It provides immobilization and stabilization of the spinal segments. The core threaded post allows for optimal placement and a wide range of sizes allows for enhanced anatomical fit. The Minuteman® is delivered sterile and individually packed. This procedure is indicated for those patients with a diagnosis of : lumbar spinal stenosis, degenerative disc disease, spondylolisthesis, trauma, tumor. Our primary indication for this procedure is for those patients with lumbar spinal stenosis. These symptoms include: persistent lower back pain, stiffness in your back and legs, lower back tenderness, thigh pain and tight hamstring and buttock muscles. The following questions would help to determine if you’re a candidate for this procedure:
- Does your back or leg pain worsen with prolonged standing or walking?
- Does you back or leg pain improve while you are sitting?
- Does leaning forward improve your pain?
During the procedure, a 1-inch incision is made on the side of your body, dilation is used to access the spine, and the Minuteman® is implanted with bone graft material. The lateral approach does not require dissection or stripping of the sensitive back muscles, bones or nerves. This advantageous approach may lead to a shorter operative time, less blood loss, reduced hospital stay, and a faster recovery time.
Sacroiliac Joint Pain
Understanding and Treating SI Joint Pain
Sacroiliac (SI) joint pain is a common source of lower back and pelvic discomfort that can radiate into the buttocks, thighs, and legs. At North Shore Pain Management, we recognize that SI joint pain may present as either sharp or dull sensations, often accompanied by numbness, tingling, or a feeling of instability in the hips and lower back.Common Symptoms
- Worsening pain after prolonged sitting, standing, or sleeping
- Increased discomfort during activities like running or climbing stairs
- Morning stiffness in the hips or lower back
- Pain that is more pronounced on one side
- Disturbed sleep patterns
- A sensation of leg instability or lower extremity weakness
Potential Causes SI joint pain can be triggered by various factors, including:
- Arthritis, particularly ankylosing spondylitis
- Infections originating from the urinary or gastrointestinal tract
- Hormonal changes during pregnancy and the pressure from a growing baby
- Hypermobility leading to joint instability
Effective Treatment Options
At North Shore Pain Management, we offer a range of non-surgical treatments to help manage SI joint pain. Treatment plans may include physical therapy, over-the-counter pain medications, and lifestyle modifications such as using supportive pillows or mattress toppers to cushion the joint. It’s important to note that SI joint pain can sometimes mimic symptoms of sciatica or lumbar disc herniation, making an accurate diagnosis essential for effective treatment. Our expert team is dedicated to providing personalized care to help you achieve lasting pain relief and improved quality of life.Sacroiliac Joint Injection (SI)
This injection procedure is performed to relieve pain caused by arthritis in the sacroiliac joint where the spine and hip bone meet. The steroid medication can reduce swelling and inflammation in the joint.
Vertiflex interspinous spacer is a procedure in which a little metal device is placed between 2 spinal levels to decompress the nerves being pinched by lumbar spinal stenosis. Lumbar Spinal Stenosis or LSS is a narrowing of the spinal canal which pinches the nerves causing low back, buttock, and leg pain, numbness, or heaviness with walking or standing for a short period. The symptoms usually resolve shortly after leaning forward or sitting. This is called Neurogenic Intermittent Claudication or NIC. It is a procedure for those who have failed conservative and injection therapies as well as for those who are not spine surgery candidates or refuse to have spine surgery.
You will be under IV sedation similar to a colonoscopy but not general anesthesia. Numbing medicine is also used.
What is a Sacroiliac (SI) Joint Injection?
A Sacroiliac (SI) Joint Injection is performed with a long acting steroid medication and local anesthetic (numbing medication). The sacroiliac joints are located in the back where the sacrum joins the pelvis. The goal of a sacroiliac injection is to provide pain relief by reducing the inflammation at the SI joint.How long does the SI joint injection take?
The procedure takes about 10 minutes. What are the pre-requisites in order to perform the procedure? You may need to stop taking certain medications several days before the procedure, especially anticoagulant or “blood thinning” medications, as well as other prescription and/or over-the-counter medications, including herbal and vitamin supplements.Will the injection hurt?
Most people say the stinging/burning of the numbing medicine is the most uncomfortable part of the procedure, though everyone’s response to pain is individual.What should I expect after the procedure and what are the side effects?
Immediately after the injection, you may feel that your pain may be lessened or gone. This is a result of the local anesthetic that was injected. This should only last for a few hours. Your pain may return and you may have a sore back for one to two days. This is due to the mechanical process of needle insertion as well as initial irritation from the steroid itself. You should start noticing pain relief by the third to fifth day, which may last days to months. It is important that you keep track of the amount of pain relief you received as well as how long the pain relief lasted.What should I do after the procedure?
Unless there are complications, you should be able to return to work the next day. The most common thing you may feel is soreness at the injection site. You may apply ice with a barrier such as a towel between the skin and ice to the affected area to help relieve the soreness. After the first day, you may perform activity as tolerated.Radio Frequency Lesioning (RFL)
What is Radiofrequency Lesioning (RFL)?
This is an outpatient procedure using a specialized machine to interrupt nerve conduction on a semi-permanent basis. Pain relief may last for at least 6 to 18 months. This procedure is performed using Fluoroscopy. Fluoroscopy is a type of X-ray that identifies bony structures. A local anesthetic is used to numb an area on the skin. After confirmation of needle tip placement, a small electrical current is passed through the needle to perform sensory and motor testing. Finally, an electrode is used to send a radio wave frequency, which turns the nerve off.What are the pre-requisites in order to perform this procedure?
In order to perform the RFL, we would need to perform two separate diagnostic test injections, called Medial Branch Blocks (MBB). These injections consist of different types of numbing medications. Depending on the amount of pain relief after these injections, we may continue to proceed with the final RFL procedure.How long does the RFL procedure take?
The procedure takes about 30 minutes.Will the procedure hurt?
This should easily be tolerated by the patient with only mild sedation. Intravenous sedation and analgesia will be available. This makes the procedure easier to tolerate. It is necessary for you to be awake enough to communicate easily during the procedure. We also numb the skin and deeper tissues with a local anesthetic prior to inserting the needle. There is moderate discomfort involved for a few weeks after. You may have numb areas with increased sensitivity (like a deep sun burn).What should I expect after the procedure and what are the side effects?
Initially, there will be muscle soreness for up to 7-10 days afterward. Ice packs will usually control this discomfort. After the first 4-6 weeks, your pain may be gone or quite less. Some patients may have some “deep sun burn” type of feeling. Some may develop hypersensitivity or burning pain, or numb areas for a few weeks.What should I do after the procedure?
You should have a ride home. We advise the patients to take it easy for a day or so after the procedure. You may want to apply ice to the affected area. Perform activities as tolerated.SI Joint Stabilization
How The LinQ SI Joint Stabilization System Works
The LinQ™ SI Joint Stabilization System is intended to help patients suffering from low back pain due to sacroiliac (SI) joint dysfunction find long-term relief. LinQ is a minimally invasive procedure that allows for the long-term fusion and stabilization of the SI joint in low back pain patients where other treatments have failed. If you experience chronic low #BackPain and have not responded to other therapies, then it may be a good idea to talk with your physician about LinQ. The LinQ procedure is a patented, minimally invasive option created by Tampa-based medical technology company PainTEQ. Watch this video to understand how the minimally invasive LinQ procedure works to create an ideal environment for long-term fusion to occur.Understanding and Treating SI Joint Pain
Sacroiliac (SI) joint pain is a common source of lower back and pelvic discomfort that can radiate into the buttocks, thighs, and legs. At North Shore Pain Management, we recognize that SI joint pain may present as either sharp or dull sensations, often accompanied by numbness, tingling, or a feeling of instability in the hips and lower back.Common Symptoms
- Worsening pain after prolonged sitting, standing, or sleeping
- Increased discomfort during activities like running or climbing stairs
- Morning stiffness in the hips or lower back
- Pain that is more pronounced on one side
- Disturbed sleep patterns
- A sensation of leg instability or lower extremity weakness
Potential Causes SI joint pain can be triggered by various factors, including:
- Arthritis, particularly ankylosing spondylitis
- Infections originating from the urinary or gastrointestinal tract
- Hormonal changes during pregnancy and the pressure from a growing baby
- Hypermobility leading to joint instability
Effective Treatment Options
At North Shore Pain Management, we offer a range of non-surgical treatments to help manage SI joint pain. Treatment plans may include physical therapy, over-the-counter pain medications, and lifestyle modifications such as using supportive pillows or mattress toppers to cushion the joint. It’s important to note that SI joint pain can sometimes mimic symptoms of sciatica or lumbar disc herniation, making an accurate diagnosis essential for effective treatment. Our expert team is dedicated to providing personalized care to help you achieve lasting pain relief and improved quality of life.Vertiflex Interspinous Spacer
What is Vertiflex Interspinous spacer?
Vertiflex interspinous spacer is a procedure in which a little metal device is placed between 2 spinal levels to decompress the nerves being pinched by lumbar spinal stenosis. Lumbar Spinal Stenosis or LSS is a narrowing of the spinal canal which pinches the nerves causing low back, buttock, and leg pain, numbness, or heaviness with walking or standing for a short period. The symptoms usually resolve shortly after leaning forward or sitting. This is called Neurogenic Intermittent Claudication or NIC. It is a procedure for those who have failed conservative and injection therapies as well as for those who are not spine surgery candidates or refuse to have spine surgery.
This is an implant that lifts and separates your vertebrae. It’s used to treat lumbar spinal stenosis. That’s a narrowing of the space around your spinal nerves in your lower back. The Superion implant makes more room for these nerves, relieving painful compression.
What are the pre-requisites in order to perform this procedure?
You may need to stop taking certain medications several days before the procedure, especially anticoagulant or “blood thinning” medications, as well as other prescription and/or over-the-counter medications, including herbal and vitamin supplements.
How long does the procedure take?
The procedure can take anywhere from 20 minutes to 1 hour with an average of about 30 min.
Will the procedure hurt?
You will be under IV sedation similar to a colonoscopy but not general anesthesia. Numbing medicine is also used.What should I expect after the procedure and what are the side effects?
Pain relief may be immediate with the ability to walk and stand much longer or it can take a few weeks to notice relief. There are no side effects but you may experience some pain or discomfort from the procedure for a week or so.
What should I do after the procedure?
You will return to the office between 7-14 days to have either a couple staples or sutures removed. Some localized tenderness may be experienced for a couple of days after the procedure. Using an ice pack with a barrier such as a towel between the skin and ice, three or four times a day will help this. You may take your prescribed pain medications after the injection.
Lumbar Degenerative Disc Disease / Vertebral Endplate Changes
Advanced Treatment for Lumbar Degenerative Disc Disease and Vertebral Endplate Changes
Lumbar Degenerative Disc Disease (DDD) and vertebral endplate changes are common causes of chronic lower back pain, resulting from the gradual wear and tear of spinal discs and structural damage to the vertebral endplates. These conditions can lead to disc thinning, inflammation, and nerve compression, causing persistent pain and reduced mobility. At North Shore Pain Management, we offer advanced, non-surgical treatments—such as lumbar epidural steroid injections and medial branch blocks—to reduce pain, restore spinal function, and improve overall quality of life.
Intracept® Procedure
What is Vertebrogenic Pain?
Vertebrogenic pain is a distinct type of chronic low back pain caused by damage to vertebral endplates, the tissue that covers the top and the bottom of each vertebral body and separates it from the disc. Disc degeneration, and the wear and tear that occurs with everyday living, produces stresses on the endplates that damage them, leading to inflammation and vertebrogenic pain. The basivertebral nerve (BVN), found within the vertebrae, carries pain signals from the inflamed endplates to the brain.
How Do Patients Describe Vertebrogenic Pain?
The disc and endplate are both part of the anterior spinal column and produce similar low back pain symptoms. However, endplate pain is associated with distinctive changes on routine MRI called Modic changes. Patients who find relief from the Intracept Procedure often describe pain in the middle of their low back that is made worse by physical activity, prolonged sitting, and bending forward or with bending and lifting.1
How is Vertebrogenic Pain Treated?
The basivertebral nerve (BVN) enters the bone at the back of the vertebral body (the bones in your spine) and “branches” to the endplates (that are located at the top and the bottom of each vertebral body). When endplates are damaged, these nerve endings increase in number and “pick up” pain signals that are then sent to the brain through the BVN. The Intracept® Procedure relieves vertebrogenic pain by heating the basivertebral nerve (BVN) with a radiofrequency probe to stop it from sending pain signals to the brain.
How does the Intracept® Procedure Work?
The Intracept Procedure is a minimally invasive, implant free procedure that preserves the overall structure of the spine. The Intracept Procedure is a same-day, outpatient procedure. Patients are under anesthesia, and the procedure generally lasts an hour. The procedure is FDA-cleared and is proven in multiple studies to be safe, effective, and durable. 2,3
How Long Does Pain Relief Last following the Intracept® Procedure?
Clinical evidence demonstrates the majority of patients experience significant improvements in function and pain 3-months post procedure that are sustained more than 5 years after a single treatment. 2
How Do I Know If I’m a Candidate for Intracept®?
The Intracept® Procedure is indicated for patients who have had:
- Chronic low back pain for at least six months,
- Who have tried conservative care for at least six months, and
- Whose MRI shows features consistent with Modic changes – indicating damage at the vertebral endplates has led to inflammation.
The Intracept Procedure, as with any procedure, has risks that should be discussed between the patient and medical provider.
1 Koreckij T, Kreiner S, Khalil JG, Smuck M, Markman J, Garfin S. Prospective, randomized, multicenter study of intraosseous basivertebral nerve ablation for the treatment of chronic low back pain: 24-month treatment arm results. NASSJ. Published online October 26, 2021. DOI: https://doi.org/10.1016/j.xnsj.2021.100089.
2 Fischgrund J, Rhyne A, Macadaeg K, et al. Long-term outcomes following intraosseous basivertebral nerve ablation for the treatment of chronic low back pain: 5-year treatment arm results from a prospective randomized double-blind sham-controlled multi-center study. Eur Spine J. 2020;29(8):1925-34. doi.org/10.1007/s00586-020-06448-x
3 Relievant data on file as of January 2023.
Compression Fracture
Comprehensive Care for Spinal Compression Fractures
Spinal compression fractures occur when the vertebrae weaken and collapse, often due to conditions like osteoporosis or trauma. These fractures can cause sudden back pain, height loss, and spinal deformity, significantly impacting mobility and quality of life. At North Shore Pain Management, we specialize in diagnosing and treating compression fractures with advanced, non-surgical options such as pain management therapies and minimally invasive procedures like vertebroplasty and kyphoplasty. Our goal is to relieve pain, stabilize the spine, and help you return to daily activities with greater comfort.What is Kyphoplasty?
Kyphoplasty is a procedure in which a device the diameter of a paper hole punch is inserted down into the vertebral body in the spine in order to inject cement to stabilize a vertebral compression fracture or VCF. VCF’s usually occur in patients older than 65 from osteoporosis, which is a weakening of the bones. This weakening of the bones makes the spine more fragile and prone for such fractures. The goal of the kyphoplasty is 2 fold: to stabilize the fracture and prevent worsening compression of the vertebral body as well as to treat the pain associated with the VCF which can become chronic if not treated early.
This minimally-invasive procedure repairs a vertebral compression fracture. It helps restore the spine’s natural shape. Some patients experience rapid pain relief after the procedure.
What are the pre-requisites in order to perform this procedure?
You may need to stop taking certain medications several days before the procedure, especially anticoagulant or “blood thinning” medications, as well as other prescription and/or over-the-counter medications, including herbal and vitamin supplements.How long does the procedure take?
The procedure can take about 1 hour.
Will the procedure hurt?
You will be under IV sedation similar to a colonoscopy but not general anesthesia. Numbing medicine is also used.What should I expect after the procedure and what are the side effects?
Pain relief may be immediate or can take a few days to notice relief. 90% of people experience pain relief the very next day. There are no side effects but you may experience some pain or discomfort from the procedure for a week or so.
What should I do after the procedure?
You will return to the office between 7-14 days for a post-op check. Some localized tenderness may be experienced for a couple of days after the procedure. Using an ice pack with a barrier such as a towel between the skin and ice, three or four times a day will help this. You may take your prescribed pain medications after the injection.Vertebrogenic Back pain
Effective Treatment for Vertebrogenic Back Pain
Vertebrogenic back pain is a specific type of chronic pain caused by inflammation or damage to the vertebral endplates, often associated with conditions like degenerative disc disease. This pain typically originates in the lower back and may radiate to other areas, impacting mobility and daily activities. At North Shore Pain Management, we provide advanced, personalized treatments—including minimally invasive procedures like the Intracept® procedure—to target vertebrogenic pain at its source, reduce inflammation, and restore function. Let us help you find lasting relief and improve your quality of life.
Advanced Treatment for Lumbar Degenerative Disc Disease and Vertebral Endplate Changes
Lumbar Degenerative Disc Disease (DDD) and vertebral endplate changes are common causes of chronic lower back pain, resulting from the gradual wear and tear of spinal discs and structural damage to the vertebral endplates. These conditions can lead to disc thinning, inflammation, and nerve compression, causing persistent pain and reduced mobility. At North Shore Pain Management, we offer advanced, non-surgical treatments—such as lumbar epidural steroid injections and medial branch blocks—to reduce pain, restore spinal function, and improve overall quality of life.
Intracept® Procedure
What is Vertebrogenic Pain?
Vertebrogenic pain is a distinct type of chronic low back pain caused by damage to vertebral endplates, the tissue that covers the top and the bottom of each vertebral body and separates it from the disc. Disc degeneration, and the wear and tear that occurs with everyday living, produces stresses on the endplates that damage them, leading to inflammation and vertebrogenic pain. The basivertebral nerve (BVN), found within the vertebrae, carries pain signals from the inflamed endplates to the brain.
How Do Patients Describe Vertebrogenic Pain?
The disc and endplate are both part of the anterior spinal column and produce similar low back pain symptoms. However, endplate pain is associated with distinctive changes on routine MRI called Modic changes. Patients who find relief from the Intracept Procedure often describe pain in the middle of their low back that is made worse by physical activity, prolonged sitting, and bending forward or with bending and lifting.1
How is Vertebrogenic Pain Treated?
The basivertebral nerve (BVN) enters the bone at the back of the vertebral body (the bones in your spine) and “branches” to the endplates (that are located at the top and the bottom of each vertebral body). When endplates are damaged, these nerve endings increase in number and “pick up” pain signals that are then sent to the brain through the BVN. The Intracept® Procedure relieves vertebrogenic pain by heating the basivertebral nerve (BVN) with a radiofrequency probe to stop it from sending pain signals to the brain.
How does the Intracept® Procedure Work?
The Intracept Procedure is a minimally invasive, implant free procedure that preserves the overall structure of the spine. The Intracept Procedure is a same-day, outpatient procedure. Patients are under anesthesia, and the procedure generally lasts an hour. The procedure is FDA-cleared and is proven in multiple studies to be safe, effective, and durable. 2,3
How Long Does Pain Relief Last following the Intracept® Procedure?
Clinical evidence demonstrates the majority of patients experience significant improvements in function and pain 3-months post procedure that are sustained more than 5 years after a single treatment. 2
How Do I Know If I’m a Candidate for Intracept®?
The Intracept® Procedure is indicated for patients who have had:
- Chronic low back pain for at least six months,
- Who have tried conservative care for at least six months, and
- Whose MRI shows features consistent with Modic changes – indicating damage at the vertebral endplates has led to inflammation.
The Intracept Procedure, as with any procedure, has risks that should be discussed between the patient and medical provider.
1 Koreckij T, Kreiner S, Khalil JG, Smuck M, Markman J, Garfin S. Prospective, randomized, multicenter study of intraosseous basivertebral nerve ablation for the treatment of chronic low back pain: 24-month treatment arm results. NASSJ. Published online October 26, 2021. DOI: https://doi.org/10.1016/j.xnsj.2021.100089.
2 Fischgrund J, Rhyne A, Macadaeg K, et al. Long-term outcomes following intraosseous basivertebral nerve ablation for the treatment of chronic low back pain: 5-year treatment arm results from a prospective randomized double-blind sham-controlled multi-center study. Eur Spine J. 2020;29(8):1925-34. doi.org/10.1007/s00586-020-06448-x
3 Relievant data on file as of January 2023.
Failed Back Syndrome/ Postlaminectomy Syndrome
Comprehensive Care for Failed Back Syndrome and Post-Laminectomy Syndrome
Failed Back Syndrome (FBS) or Post-Laminectomy Syndrome refers to chronic back or leg pain that persists or worsens after spine surgery. This condition can result from scar tissue formation, nerve damage, or unresolved spinal issues, significantly affecting mobility and quality of life. At North Shore Pain Management, we specialize in diagnosing and treating FBS with advanced, non-surgical solutions like spinal cord stimulation or dorsal root ganglion stimulation. Our goal is to reduce pain, improve function, and help you regain your quality of life.What is a Dorsal Root Ganglion Stimulation?
Dorsal Root Ganglion Stimulation is a procedure in which an insulated lead or wire with electrodes is placed in the epidural space, much like having an epidural steroid injection, and stimulates specific spinal nerves with extremely small amounts of electricity which can blunt/block pain signals from focal areas of the body such as the knee or ankle. You will not feel any electrical sensation once the lead is placed correctly in the spine. It is a procedure for those who have failed conservative and injection therapies. Indications may include chronic post-surgical pain, complex regional pain syndrome, neuropathic pain, diabetic neuropathy, etc. This procedure starts with a 5-10 day trial period at which time you will have the ability to “test drive” the device before deciding if the treatment is beneficial.What are the pre-requisites in order to perform this procedure?
You may need to stop taking certain medications several days before the procedure, especially anticoagulant or “blood thinning” medications, as well as other prescription and/or over-the-counter medications, including herbal and vitamin supplements.How long does the procedure take?
The procedure can take anywhere from 20 minutes to 1 hour with an average of about 30 min.Will the procedure hurt?
Most people report that the stinging/burning of the numbing medicine is the most uncomfortable part of the procedure though every person’s response to any procedure is individual. Patients usually receive IV sedation which will relax you for the procedure but you are not asleep.
What should I expect after the procedure and what are the side effects?
Pain relief may take a couple days to notice and until then you may have some discomfort in your back from the procedure. There are no side effects but you may experience a tingling or buzzing sensation during a 7-day trial which can be adjusted with a hand held remote.What should I do after the procedure?
Some localized tenderness may be experienced for a couple of days after the procedure. Using an ice pack with a barrier such as a towel between the skin and ice, three or four times a day will help this. You may take your prescribed pain medications after the injection. It is important that you keep track of the amount of pain relief you received as well as how much more functional you are.
Coccydynia
Effective Treatment for Coccydynia (Tailbone Pain)
Coccydynia, or tailbone pain, is a condition that causes discomfort and tenderness at the base of the spine, often triggered by prolonged sitting, injury, or childbirth. This condition can make daily activities uncomfortable and challenging. At North Shore Pain Management, we provide advanced, personalized treatments for coccydynia, including targeted injections, and pain management strategies. Our goal is to relieve pain, reduce inflammation, and restore your comfort and mobility. Let us help you find lasting relief from tailbone pain.
Ganglion Impar Block for Pelvic and Tailbone Pain Relief
A Ganglion Impar Block is a minimally invasive procedure designed to relieve chronic pelvic, perineal, and tailbone pain caused by conditions such as coccydynia, nerve injuries, or complex regional pain syndrome. This treatment involves injecting a local anesthetic and anti-inflammatory medication near the ganglion impar, a nerve cluster located at the base of the spine, to block pain signals and reduce inflammation. At North Shore Pain Management, our expert team specializes in personalized pain relief solutions, including ganglion impar blocks, to help patients regain comfort and improve quality of life.