Disc herniation is a condition in which part, or all, of the soft, gelatinous central portion of an intervertebral disc is forced through a weakened part of the disc. This results in back pain and leg pain (lumbar heriniation) or neck pain and arm pain (cervical herniation) as the nerve root gets irritated.

Degenerative disc disease is a condition in which the intervertebral discs degenerate, or break down, causing pain. Intervertebral discs are fibrous, cartilaginous cushions that sit between the vertebrae. They act as the spine's shock absorbers, thereby protecting not only the vertebrae but also the brain and other structures such as the nerves. They also allow the spine to be mobile.

Lumbar disc degeneration is very common and appears to be part of the aging process. Only in limited cases does it become painful. For people who experience discogenic pain, that is, pain from degenerative discs, they usually go through three phases: 1) a period of acute back pain; 2) a long phase of instability in the affected disc(s) with intermittent episodes of back pain; and 3) the body eventually stabililizes and there are relatively few bouts of pain. What this means is if you are having back pain at 35, it does not mean you will be bed-bound by 55. Nor does it mean you will need surgery; rather, conservative, minimally invasive treatments will be all that is needed in most cases.

Spinal stenosis is a narrowing of the spinal canal that may squeeze and irritate the nerve roots branching out from the spinal cord, or squeeze and irritate the spinal cord itself. Usually starts gradually and develops over time, spinal stenosis may cause pain, cramping, numbness, or weakness, most often in the legs, feet, and buttocks.

Sciatica is an inflammation of the sciatic nerve cord, which branches off the spinal cord in the lower back, runs beneath the buttock muscles and continues all the way down the leg. Typically experienced as a pain shooting down one of your legs.

Spondylolisthesis is a condition in which one of the vertebrae slips or slides forward off the disk and onto the vertebra underneath it. Normally, your vertebrae are stacked on top of one another with discs in between to cushion them and act as shock absorbers. Spondylolisthesis, or spine slippage, can cause the vertebrae to rub together and can lead to 1) pain that radiates down one or both legs; 2) numbness in legs and/or feet; 3) problems with bowel or bladder control.

Chrondomalacia an irritation of the under-surface of the kneecap. The under-surface of the kneecap, or patella, is covered with a layer of smooth cartilage. This cartilage normally glides effortlessly across the knee during bending of the joint. However, in some individuals, the kneecap tends to rub against one side of the knee joint, and the cartilage surface become irritated, causing knee pain.

Epicondylitis is a condition caused by chronic overuse, it is the degeneration of the tendon fibers that attach on the bony prominence (epicondyle) on the outside of the elbow. These tendons are responsible for anchoring the muscles that extend or lift the wrist and hand.

Carpal tunnel syndrome is a compression of the median nerve at the wrist in a closed space called the carpal tunnel. The median nerve and all the flexor tendons run through that small space. The median nerve supplies sensation to the thumb, index, middle and the thumb side of the fourth finger. CTS is frequently associated with occupational, repetitive use of the hands such as typing or packing.

Comprised of four muscles and some tendons, the rotator cuff forms a cover around the head of upper arm bone (humerus). The rotator cuff holds the humerus in the shoulder joint and allows the arm to rotate.

The rotator cuff can be torn due to repetitive overuse (often seen in people playing sports that involve a lot of overhead motion, such as tennis and baseball). It may also occur from a single traumatic injury.

A tear of a meniscus, a rubbery, C-shaped, fibrous cartilage in the knee. The lateral and medial menisci help the knee joint carry weight, pivot, and change direction. They also keep the femur and tibia from rubbing against one another.

A meniscal tear is usually caused by twisting or turning quickly with the foot planted and knee bent, such as during sports or lifting a heavy object. A severe tear can cause a fragment of the meniscus to move into the knee joint. causing the knee to lock or pop. The knee can be bent at an angle, or it can feel wobbly and give way without warning. Left untreated, it can lead to athritis of the knee.

Shoulder impingement occurs when tendons in the subacromial space become compressed. The subacromial space is a narrow space between the head of the upper arm bone and the acromion (a bony projection from the top of the shoulder blade) that the rotator cuff passes through. If this space is compressed, it can cause the tendons to rub, or impinge, against the acromion. Impingement can occur due to bursitis (inflammation of the bursa overlying the rotator cuff) or tendonitis (inflammation of the rotator cuff tendons). Impingement can also be caused by repetitive overhead movement of the arm, e.g., from swimming or playing tennis.

Symptoms begin gradually and usually include pain and weakness in the shoulder. For most people, rest, ice or heat, anti-inflammation medication, and physical therapy are all that is needed for treatment.

The anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) are two of the ligaments connecting the shin bone (tibia) and thigh bone (femur) at the knee joint. The ACL prevents the tibia from sliding too far forward front of the femur, while the PCL prevents the tibia from sliding too far backward from under the femur. These two ligaments work together to provide rotational stability to the knee joint, that is, allow the knee joint to rotate but not too much.

The ACL is often torn when the tibia and femur twist in opposite direction under full body weight. This typically occurs while playing sports. When the ACL is strained or partially or completely torn, the knee becomes unstable. Some people may perform normally with a damaged ACL, but most experience instability at the knee and feel as if their knee will "give way". Athletes usually elect to have surgery in order to regain full competitive function.

The anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) are two of the ligaments connecting the shin bone (tibia) and thigh bone (femur) at the knee joint. The ACL prevents the tibia from sliding too far forward front of the femur, while the PCL prevents the tibia from sliding too far backward from under the femur. These two ligaments work together to provide rotational stability to the knee joint, that is, allow the knee joint to rotate but not too much.

PCL injuries are far less common than ACL injuries and most often occur with a blow to the front of the tibia while the knee is bent, such as falling on the shin or the dashboard hitting the shin in a car collision. As with ACL injuries, PCL injuries also cause instability in the knee and feeling of the knee "giving way" Treatment is usually by physical therapy. Reconstructive surgery of the PCL is controversial and only done in the most severe cases.

An epidural injection places anti-inflammatory medicine into the epidural space to decrease inflammation of the nerve roots, hopefully reducing the pain in the back or legs. The epidural injection may help the injury to heal by reducing inflammation. It may provide permanent relief or provide a period of pain relief for several months while the injury/cause of pain is healing.

Facet joints are small stabilizing joints located between and behind adjacent vertebrae. A facet injection delivers a combination of long-lasting corticosteroid and anesthetic to the facet joints. It can relieve neck or back pain caused by inflamed facet joints. The exact causes of facet joint pain are not clear, but facet joints can become inflamed due to spinal stenosis, spondylolysis,sciatica, herniated disc, and post operative pain.

The relief from a facet injection is usually temporary: the goal is to allow you to resume normal activities.

The sacroiliac or SI joint is the large the joint between the sacrum at the base of the spine and the ilium of the pelvis. There are two (right and left) and when one becomes painful, it can cause pain in its immediate region or it can refer pain into your groin, abdomen, hip, buttock or leg.

A sacroiliac joint injection may reduce inflammation (if present) and provide long term relief. It can also help determine the source of pain, that is, if the pain is reduced or goes away after after injection, it's a good indication the SI joint was the source of pain.

Likewise, piriformis muscle injections are both diagnostic and therapeutic. The piriformis muscle begins in the pelvis and connects to the sacrum. Because it sits on top of the sciatic nerve, pain in the piriformis muscle can cause symptoms of sciatica. Piriformis injections can help pinpoint the source of pain and can relieve back pain if the piriformis is indeed the culprit.

A discogram, aka diskogram, is an enhanced X-ray exam in which a dye is injected into injured or painful intervertebral discs. The dye makes the discs become clearly visible on the CT scan. The injection also increases the pressure in the discs and helps determine which disc(s) are causing pain and which have structural damage.

Facet Rhizotomy, or Radiofrequency neutoromy, is a type of injection procedure in which a small electric current is used to cut the nerves serving the painful facet joints. The idea is to disrupt the signal to the brain, thereby reducing or eliminating pain. It is a short and minimally invasive procedure, requiring only local anesthetics.

Derived from Greek, arthroscopy means "to look in the joint" It is a minimally invasive procedure surgeons use to visualize and diagnose problems inside a joint. The surgeon makes a small incision and inserts a pencil-sized scope with a miniature camera attached to the end. The picture is magnified and transmitted to a monitor, allowing the surgeon to view the internal structure of the joint. The surgeon can determine the type and extent of injury and decide on the course of treatment.

SWT, also known as Extracorporeal Shockwave Treatment (ESWT), is a non-invasive (no incisions) treatment that involves the delivery of acoustical energy, or sound waves, to affected areas of the body to trigger the body’s own natural repair mechanisms and stimulate healing.

It is a safe and effective treatment option. The recovery period is shorter than traditional invasive surgery and the procedure eliminates many of the risks associated with traditional surgery.