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JAYESH VALLABH: Most of the time what we're seeing at the Spine Center is we're seeing patients who come in with new or old neck or a little back pain. Sometimes they have signs of a pinched nerve or numbness in the hands or numbness in the legs or symptoms that a lot of people just call sciatica. And trying to figure out what's the reason why they're having pain-- is there any additional diagnostic information that we need-- while also getting patients started on early treatment.

For patients who have predominantly sciatica type pain or pain that shoots down an arm or shoot down a leg, we like to use-- if imaging correlates with their symptoms, we like to use something called an epidural injection, which is putting numbing medicine or saline with steroids around the area where there's inflammation by the disc or by the nerve to help calm the symptoms in the arms and the legs so patients can better tolerate therapy, strengthening, all the things they need to do to support the structures in the spine so the body can heal on its own as well.

Patients who have mostly muscular pain, which is very common, traditionally have to work mostly on exercise. If the muscle pain is quite severe, there's things like trigger point injections, which are injections of numbing medicine to bring blood flow back to these muscles and help with healing. The other types of things that we can do are diagnostic injections where we numb nerves that sense pain from certain areas to kind of figure out what are the reasons why people are having pain.

Common things are joints in the neck or the back that we can do nerve blocks for. And if those are helpful, then we can do ablative procedures, or radiofrequency ablations, where we go down and we burn the nerves, which can provide temporary relief of their pain so patients can tolerate physical activity that they need to do to condition their body or tolerate the things they want to do.

I think one of the unique things about the Comprehensive Spine Center is that we really have a group of specialists all under one roof. At any given day, I can walk across the hall and ask the opinion of an anesthesiologist or ask a surgeon to review imaging and get rapid opinions from various specialists to provide hopefully rapid care for our patients.

So when we're treating chronic pain, it's critical that within our comprehensive center that we have pain psychology and psychological services for patients to help work through some of their pain. If there's not a magic bullet or an injection for their pain, to be able to talk through it and help cope with their pain.

When we're treating neck or back pain or chronic pain, the idea is to really identify what the patient's goals are beyond just not being a pain. For grandparents, do you want to tolerate a day at the zoo with the kids? Do you want to tolerate being able to work or just get to retirement-- which I've had some patients who are just like, I just need three more years so I can retire. Get me through these three years. The idea is just getting people where they want to be or need to be to carry on just being able live their life.

One of my actual favorite things about being at the Ohio State Comprehensive Spine Center is we're in this phase of tremendous growth, both clinically and with what research we're trying to do. From a non-surgical side, we're growing our outcomes research, we're working on modulation, trying to find better ways to do procedures, but also identify people who may be more successful or less successful with certain procedures so we can choose them a little bit better.