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If significant pain occurs on account of joint pain or an incompetent disc and manual treatment, physical therapy, and/or oral medication is not sufficient to address it, injections with local anesthetic and / or steroid medication may be indicated.


Given what your biomechanical examination demonstrates when compared to structural deformity revealed by various imaging studies, you may be a candidate for facet steroid injection (into joint spaces), prolo-therapy (into ligaments surrounding a joint), neurotomy (ablation of painful nerves to joint ligaments), or epidural steroids (instilling medication so that it surrounds a spinal nerve).


Dr. Leifheit has an established referral relationship with several treatment centers in the Puget Sound area, where experienced specialists can administer such injections. Authorization for such a referral is usually necessary from your insurance company; Dr. Leifheit's staff is experieinced at procuring these authorizations.


To better understand how an injection has affected your condition, a re-evaluatuion exam 7-10 days after administration is highly recommended.




The lower back and mid-lower neck are areas of the spine that commonly cause chronic or recurrent pain. Dr Leifheit has managed such conditions for 30+ years and is experienced in promoting rapid resolution of acute episodes, or combinations of manual treatment and orthotics to address chronic / recurrent conditions.


Most medical disciplines agree that many of these painful conditions are associated with degenerative change in the intervertebral discs; altered structure appears to be ubiquitious and common, which can result in painful arthritis of the intervertebral (facet) joints, causing variable reactive muscle contracture.


If degenerative disc disease is so extensive that manual treatment and/or orthotics provide little relief, then spinal (facet joint) injections may be indicated (see "Spinal Injections").


If disc deformity is such that nerve impingement occurs (with muscle weakness or persistent tightness) and is not relieved by conservative treatment or injections, then surgery deserves to be considered.  Dr. Leifheit has knowledge of many Othopedic and Neuro surgeons in the Puget Sound areaand can explain which specialist may be most appropriate for your condition.

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