Nonsurgical Spine Care and Injections
Most patients who come to a spine surgeon's office do not need surgery, and the best surgeons are the ones who say so. Dr. Michael's practice includes the full range of nonsurgical care, and the goal of every first visit is an accurate diagnosis and the least invasive plan that will work.
Physical therapy and conditioning
For most spine conditions, the most effective long-term treatment is a stronger, better-coordinated trunk and hips, and the habit of moving. Physical therapy provides the right starting point when pain has made activity difficult, teaches movement patterns that protect the spine, and progresses to independent exercise. Dr. Michael works with therapists across the Tampa Bay area and provides specific guidance about what to focus on for each diagnosis.
Medications
Short courses of anti-inflammatory medication reduce pain and inflammation during flares. Muscle relaxants help with acute spasm. Medications aimed at nerve pain can help with radiating symptoms. Opioids have a limited role after surgery or injury and are not a treatment for chronic spine pain; they do not address the cause and carry real risks.
Spinal injections
Injections are both a treatment and a diagnostic tool. An epidural steroid injection places anti-inflammatory medication around an irritated nerve root and is used for sciatica and cervical radiculopathy when pain limits recovery. Facet joint injections and medial branch blocks target the small joints at the back of the spine, which can be a source of neck or back pain; when a block confirms the joint is the cause, radiofrequency ablation can quiet the nerve to that joint for many months. Injections are done under X-ray guidance for accuracy.
Injections are not a cure for structural problems, and they are not repeated indefinitely. Their value is in reducing pain enough to allow recovery and conditioning, and in clarifying the diagnosis when the picture is unclear.
When surgery is discussed
Surgery becomes part of the conversation when symptoms remain disabling after a fair trial of nonsurgical care, when there is significant or progressive weakness, when the spinal cord is compressed, or when the spine is unstable. Dr. Michael's philosophy is that the decision is more important than the incision: the operation only helps if it is the right one for the right problem.
Common questions
Do I need to see a spine surgeon if I don't want surgery?
A spine surgeon's value is in diagnosis and in knowing the full range of options. Most patients Dr. Michael sees are treated without surgery, and a clear diagnosis helps the nonsurgical plan work.
How many injections can I have?
Steroid injections are generally limited to a few per year in a given area. Radiofrequency ablation can be repeated when its effect wears off. The plan is individualized.
Does Dr. Michael perform injections himself?
Yes. Dr. Michael performs spinal injections under X-ray guidance and coordinates with pain management colleagues when a broader program is appropriate.