UI SPINE CENTER

Our Mission

The mission of the UI Spine Center is to provide the full continuum of spine care to our patients. From the latest surgical interventions to research proven rehabilitation techniques, our team of physicians and medical practitioners strives to care for our patients whose lives have been affected by spine pain and dysfunction. Our multidisciplinary center is comprised of health professionals who evaluate, recommend, and provide treatment using a patient-centered focus.

The Academic Difference

The "academic difference" at the UI Spine Center encompasses an approach that educates patients about the latest medical and surgical advances, while also promoting proven, effective treatments for pain relief in relation to these new technologies.

Research and Education

The UI Spine Center has many ongoing orthopaedic research projects, including:

• Outpatient Pain Rehabilitation Programs (pdf)
• The State of Physical Medicine and Rehabilitation in Iowa:2000-2005 (pdf)

Some research focuses on biomechanical properties of spinal implants. Others focus on clinical questions such as the overall outcomes of spine surgery, exercise, and rehabilitation.

Education

The UI Spine Center sponsors both the Iowa Spine Symposium and an annual Physical Medicine and Rehabilitation Conference with medical specialists from across the country speaking on developments in the field of spine injury, pain, and rehabilitation.

Staff

	Heather Bingham, MD, joined the UI Spine Center in 2008. She received her Doctorate of Medicine from the University of Texas Southwestern Medical Center at Dallas, and competed a Physical Medicine and Rehabilitation residency at the Mayo Clinic in Rochester, Minnesota. She is board-certified in Physical Medicine and Rehabilitation. Her clinical interests include spinal cord injury, electrodiagnostic medicine, spasticity management, and musculoskeletal rehabilitation.
	Joseph Chen, MD, is a physical medicine and rehabilitation physician, a physiatrist, who joined the UI Spine Center in 2000. He also performs electrodiagnostic medicine consultations including nerve conduction studies and electromyography to determine the extent of nerve or muscle injury. He is the medical director of the Spine Rehabilitation Program. He has achieved subspecialty certification in both spinal cord injury medicine and pediatric rehabilitation medicine. Feature profile of Joseph Chen, MD
	Charles Clark, MD, joined the UI Spine Center in 1980. His clinical interests include conditions of the cervical spine. His research interests include cervical spine biomechanics. He is past president of the Cervical Spine Research Society and edited the third and fourth editions of the textbook entitled, "The Cervical Spine."
	Ernest Found Jr., MD, and James Weinstein, MD, created the Spine Rehabilitation Program in the 1980's. With more than 20 years of experience at UI Hospitals and Clinics, Found is noted for his excellent surgical reputation. His surgical interests include kyphoplasty to treat osteoporotic compression fractures, adult spine reconstruction, and spinal instrumentation.
	Valerie Keffala, PhD, joined the UI Spine Center in 1997. She is a licensed psychologist specializing in behavioral medicine. She developed the curriculum for the Spine Rehabilitation Program and the components of stress management, cognitive coping skills, and relaxation training. Her research interests include behavioral medicine topics such as psychosocial assessment and outcome and effectiveness of psychological interventions before and after surgical or non-surgical intervention.
	Sergio Mendoza, MD, joined the UI Spine Center in 2001 following a spine deformity fellowship with Stuart Weinstein, MD. His surgical interests include: adult reconstructive surgery for degenerative conditions, spine trauma, minimally-invasive and endoscopic-assisted spine surgery, and motion-sparing technologies. His research interests include disc replacement technologies, spinal stenosis models, degenerative disc disease models, and outcomes based practice.
	Neil Segal, MD, joined the UI Spine Center in 2004. He is a board-certified physical medicine and rehabilitation physician. His clinical skills include musculoskeletal ultrasound and spinal interventions using fluoroscopic guidance. His research interests include osteoarthritis, obesity, and musculoskeletal rehabilitation. In addition to his local research projects, Segal also is chair of the musculoskeletal research committee for his national specialty society.
	Joseph Smucker, MD, joined the UI Spine Center in 2005 after completion of an orthopaedic spine surgery fellowship at Emory University. His surgical interests include: cervical spine disorders, disc replacement, kyphoplasty, spinal fusion, spinal tumors, and spinal trauma. His research interests include: motion sparing technologies in the spine and fusion technologies and methods.
	Stuart Weinstein, MD, is one of the most well-respected scoliosis and spinal deformity experts in the nation, conducting comprehensive long-term studies on the surgical and non-surgical outcome of scoliosis. His surgical interests include pediatric spinal deformity and pediatric orthopaedics. His research interests include the natural history and long term consequences of pediatric musculoskeletal conditions.
	Robert Yang, MD, joined the UI Spine Center in 2007. He is board-certified in physical medicine and rehabilitation and will see patients with acute or chronic musculoskeletal conditions or pain. He completed his physical medicine and rehabilitation residency at the Mayo Clinic before joining the physical medicine and rehabilitation faculty at the University of North Carolina, Chapel Hill. Yang also has additional training and expertise in medical acupuncture.

Spine Rehabilitation Team

The Spine Rehabilitation Team is a comprehensive pain rehabilitation program. Our extensive experience provides the best multidisciplinary care to patients with chronic spine pain. The team's medical director is Joseph Chen, MD.

UI Spine Center has assembled a team of health professionals who work together with your doctor to effectively develop a diagnosis and treatment plan for your pain.

The team includes:

• Orthopaedic spine specialists
• Clinical nurse specialists
• A medical social worker specialist
• A psychologist
• A vocational consultant
• An activities therapist
• Physical therapists

Denny Bewyer, PT, completed physical therapy training at the University of Iowa in 1973 and worked in private practice for 20 years treating musculoskeletal disorders of the spine. He joined the UI Spine Center in 1992. His research interests include muscle imbalances causing back and/or leg pain.

Jeff Nicholson, PT, graduated from The University of Iowa physical therapy program in 1988. He evaluates and screens patients in spine physical therapy clinics and suggests appropriate treatment. Treatment can include patient education on the spine and how it works, exercises tailored to meet individual needs and directions for self-care. His clinical interests include muscle imbalances, spine movement impairments, therapeutic exercise, and physical therapy diagnoses.

Karen Drake, PT, works with our Spine Rehabilitation Program participants and has interests in osteoporosis rehabilitation. She developed the Golf to Your Advantage program that has been effective in teaching patients with back pain methods of improving their posture while playing golf.

Pam Lee, PT, graduated from The University of Iowa with a master's degree in physical therapy in 2000. She also is a certified strength and conditioning specialist. She primarily works in the Spine Rehabilitation Program, but also conducts functional capacity evaluations, job site evaluations, and teaches spine health to employees and patients.

Debra Parrott, PT, is also a Certified Strength and Conditioning Specialist. She works with our spine rehabilitation program participants and lectures on cardiovascular fitness.

Ann M. Vogel, MA, CRC, LMHC, graduated in 1990 with a MA in Vocational Rehabilitation Counseling from The University of Iowa. She is a Certified Rehabilitation Counselor and a Licensed Mental Health Counselor. She joined the UI Spine Rehabilitation Team in 2005 and has over eight years of experience counseling and assisting a wide range of individuals with job-seeking skills training and career exploration.

Teresa Kober is the Spine Rehabilitation Team's program coordinator. She serves a vital role as the first contact within the UI Spine Center, sending patients, nurse case managers, or physicians to the appropriate team members.

Evaluations and Appointments

Our scheduler will help you or the person who referred you to decide which type of appointment best meets your individual needs.:

Appointment with a UI Spine Center Physician

An evaluation by one our orthopedic spine surgeons or one of our physical medicine and rehabilitation physicians includes:

• Neurological examination of reflexes, sensation, and muscle strength and flexibility
• Evaluation of past examinations, X-rays, MRIs, and other diagnostic tests
• New diagnostic tests, X-rays or MRIs if needed
• Medication management using medications with low potential for side affects or addiction
• Discussion of diagnosis, prognosis and treatment options

 

Appointment with a UI Spine Center Physical Therapist

Our licensed physical therapists are trained in the care of spine pain. An appointment with our therapist includes:

• Neurological examination of reflexes, sensation and muscle strength and flexibility
• Range of motion assessment
• Structural posture analysis
• Other tests as needed
• Education and activity-based instruction

Our physical therapists work closely with our physicians to develop a plan to treat your back or neck pain. For most people with acute spine pain, this visit is enough to diagnose the problem, begin an exercise-based treatment program, and see results.

Appointment with the Spine Rehabilitation Team: Chronic Spine Pain

This full-day evaluation includes appointments with our UI Spine Center physician and our interdisciplinary spine rehabilitation team to help decide what approach will work for you. The team, based on input from you and our evaluation, will make recommendations. One recommendation may be an invitation to participate in our Spine Rehabilitation Program.

Screenings and Evaluations

Because spine pain has so many components, we use a multidisciplinary approach to help patients help themselves. Our multidisciplinary program provides the necessary skills, physical activities, and direction to effectively cope with pain. In addition to UI Spine Center physicians, the team includes:

• Physical therapists who incorporate posture, flexibility, back and abdominal strengthening, and cardiovascular conditioning
• Psychologists who instruct patients in coping skills and relaxation techniques
• Social workers who are experienced in working with patients with chronic pain and knowledgeable about available community resources
• Vocational counselors who help patients evaluate their vocational goals

Our multidisciplinary rehabilitation team evaluates and recommends treatment that focuses on your situation, taking into consideration the nature of your pain and how long you have had it.

Following the evaluation, the team makes recommendations for safe, active physical exercises, to begin using simple stress and pain management exercises, and to set short-and long-term goals. Each patient receives a complete report following the evaluation.

Spine Physical Therapy Clinic
(For acute or recent pain)

If your spine or neck pain has existed for less than 12 weeks, your evaluation will be conducted by a licensed physical therapist experienced in spine care. The evaluation includes:

• Neurological examination of reflexes, motor strength, and sensation
• Range of motion assessment
• Structural posture analysis
• Other tests as needed
• Education and activity-based instruction
• Consultation with a physician and other UI Spine Center team members as needed

Spine Rehabilitation Evaluation
(For chronic or long-term pain)

If you have chronic spine pain that has lasted longer than six months, you will be evaluated by the UI Spine Rehabilitation team.

This full-day evaluation includes meetings with members of our multidisciplinary spine rehabilitation team to help decide if this program will work for you. The team will discuss your evaluation results, make recommendations, and send a report to you. One recommendation may be an invitation to participate in the Spine Rehabilitation Program.

Consultation/Refer a Patient

For a consultation or to refer a patient to the UI Spine Center call:

UI Spine Center Referral Line
877-60SPINE
(877-607-7463)

To refer specifically to the Spine Rehabilitation Team for chronic pain management call:

319-356-8400 or

UI Spine Center Referral Line
877-60SPINE
(877-607-7463)
and ask for the Spine Rehabilitation Team at 6-8400

Submit an online Refer a Patient form.

Physicians may also call UI Consult at 800-322-8442, 24-hours a day, seven days a week.

Spine Rehabilitation

While some people may benefit from the latest technologies in spine surgery, much of the newest research in spine care focuses on long-established principles of non-surgical treatments for chronic back pain using exercise and stress management.

In a study, spine surgeons in Europe treated one group of chronic spine pain patients with exercise and pain management and another group with spine surgery. They were surprised to find that patients treated with exercise and pain management skills had nearly the same improvement as those patients who underwent spine surgery. The patients who exercised also increased the density of their back muscles, which can also be helpful in resuming an active lifestyle.

The UI Spine Center's non-surgical approach teaches patients that by improving their muscle flexibility, strength, and endurance, and using coping skills and stress management skills, they can successfully reduce their pain without undergoing invasive surgery or taking excessive medications.

Since 1985, we have helped hundreds of patients to lead active lives following back injury or disease with minimal reliance on passive treatment modalities, prescription pain medications, or injections.

UI Spine Rehabilitation Team

Services offered by the UI Spine Rehabilitation Team

• Detailed neurological and musculoskeletal assessment
• Specialized physical therapy from professionals who practice only in spine care
• Pharmacotherapy, with an emphasis on minimizing prescription pain medication
• Image-guided interventional therapy, including nerve blocks and epidural injections
• Psychotherapy—learning and practicing proven coping skills, relaxation and stress management with chronic pain

How to schedule an evaluation

Referrals are accepted from any source including medical providers, insurance carriers, patients, families and case managers. As a guideline, our patients are considered chronic after four months of pain that interferes with lifestyle. A physician willing to provide primary medical care is helpful during treatment at the UI Spine Center, and to resume patient care following discharge from our program

Call 319-356-1638 or 319-356-8400 for an evaluation or if you have questions.

What referral sources can expect

• A professional and thorough consultation with detailed recommendations for treatment
• A determination regarding appropriateness for the Spine Rehabilitation Program at the UI Spine Center
• Timely communication to facilitate decisions about the next step in a care plan

Treatment goals for chronic back and neck pain patients

• Help the patient assume responsibility for self care and management.
• Stabilize financial stress with return-to-work plan. Facilitate disability and Worker’s Compensation issues, or a combination of both.
• Increase measurable and quantifiable strength, flexibility, and cardiovascular conditioning
• Develop a specific plan of self directed care including exercise, stress management, and vocational goals.
• For legal purposes, ratings of impairment, restrictions, determination of “maximum medical improvement” are all an integral part of a rehabilitation plan, and will be done as needed by our medical team.

Determining appropriate candidates for the Spine Rehabilitation Program.

• Patients with chronic pain who are not candidates for surgery
• Patients who demonstrate a desire to improve their situation
• Patients who are willing to actively participate in all areas of the Spine Rehabilitation Program
• Patients willing to eliminate or significantly reduce use of prescription pain medication

Insurance contracts (Corporate Relations)

The Spine Rehabilitation Program

The Spine Rehabilitation Program is a comprehensive two-week program that involves a firm commitment from you to change how you deal with chronic pain.

The program helps you develop skills to manage your pain more effectively while improving your quality of life. All activities take place in the UI Spine Rehabilitation Unit, a non-residential group setting where you learn and work with others who also experience chronic spine pain.

The goal of the program is to help you develop a clear plan for the future that will allow you to:

• Become more active and stay active
• Understand the role of conditioning and fitness to manage pain
• Use medication safely and appropriately
• Learn new psychological skills to cope with stress and pain
• Develop a vocational plan that will enable you to return safely to full-or part-time employment

Our program has been in existence for almost 15 years. Patients treated in an interdisciplinary setting function better, have higher rates of returning to work, fewer disability payments, and have reduced the duration of pain. The benefits of interdisciplinary treatment can be maintained for a lifetime.

Our success is due, in part, to an excellent staff dedicated to treating complex patients with chronic pain. The medical director of the program is a physician who specializes in physical medicine and rehabilitation. Our team includes a social worker, a psychologist, physical therapists, and a vocational counselor. Other specialty areas available for consultation include spine surgery, psychiatry, internal medicine, and smoking cessation.

Because so much of the stress facing chronic back patients is financial, our program includes extensive vocational exploration as a critical component of rehabilitation that few other pain rehabilitation programs can offer.

A typical day of group activities includes:

• Movement therapy
• Lectures and/or discussions
• Conditioning activities
• Training in coping skills
• Activities modifications
• Functional restoration activities
• Vocational counseling
• Leisure activities

Integrated Care Approach

To handle the challenges involved with diagnosing and treating chronic spine pain, the spine rehabilitation team combines its skills into a multidisciplinary, integrated spine-care approach. Our program incorporates:

Education

Some of the lectures describe pain mechanisms, explain how something can be solid, stable, and healed and still hurt and explain the difference between acute pain (short-term, warning) and chronic pain (long-term, non-warning).

• Patients learn to dispel myths and misunderstandings about the spine.
• Patients are taught a wide array of exercises and cognitive skills that affect spine health and emotional well being. What is understood is much easier to deal with than what is not understood.

Physical and Aerobic Conditioning

Patients learn the benefits of physical exercise and conditioning to increase:

• Strength—using proper body mechanics
• Flexibility—developing supple muscles
• Endurance—developing staying power

Coping Skills

We use the term "coping skills" to refer to a variety of skills and techniques taught for pain management. All of these skills have a psychological component to them. Coping skills are sometimes referred to as "mind-body" techniques because they integrate both the mind and body for pain management.

Coping skills are taught in a group setting, using psycho-educational and group therapy/support techniques. While we validate the experience and stress of chronic pain, we do not dwell on pain. Instead, we focus on moving toward a more functional future.

Relaxation exercises to deal with stress and pain:
We teach various breathing and relaxation exercises to help patients learn to decrease unnecessary muscle tension and release the naturally occurring pain relieving responses by the body. We teach patients about these naturally occurring processes as a way of increasing their perceived control over their pain.

Imagery to focus on things other than pain:
We talk with patients about the relationship between stress and pain, and help them identify better ways of managing their current stressors through problem solving, cognitive restructuring, and identifying myths.

Cognitive behavioral and mind/body techniques for pain management:
We work to build self-esteem and self-efficacy, helping patients rediscover a better quality of life. We look at personal strengths and talk about how people view and operate in the world in different ways. We extend this discussion to different ways people cope with the stressors related to chronic pain.

Self Esteem Training

People with long-term pain may need help addressing self-esteem issues arising from:

• Not contributing financially
• Not helping around the house
• Not interacting with family as you would like

Vocational Exploration

During the Spine Rehabilitation Program, you will meet with a vocational specialist to:

• Identify your vocational interests, work values, and transferable skills
• Clarify your goals
• Explore how networking, informational interviewing, and volunteering can be effective tools for your job search
• Expand your job seeking skills, including resume and cover letter writing and improving interviewing skills
• Learn more about the current job market and career opportunities

A Typical Day in the Spine Rehabilitation Program

The non-residential program runs two weeks, Monday through Friday with weekends off.

• 8 a.m. -- Movement Therapy

  We start every morning with 35 minutes of stretching and strengthening to music. The program was developed with an aerobics instructor specifically for people with spine pain. There is no impact (jumping or bouncing) just stretching and strengthening with our staff members. It is a fun way to stretch out, loosen up and warm up for the day.

• 9 a.m. -- Discussions/Vocational Exploration

  Lectures and discussions about issues regarding the spine include information about pain mechanisms—how something can be solid, stable, and healed and still hurt. The difference between acute and chronic pain will be explained.

  Vocational exploration encompasses a variety of topics to:

  • Expand your knowledge of your vocational interests, values, and employment goals
  • Improve your job seeking skills
  • Provide you with tools to assist you in reaching your employment goals


• 10 a.m. -- Functional Restoration

  The purpose of this part of the program is to provide a means for patients to increase their level of physical function, a time when we expect you to stay physically busy.

• 11 a.m. -- Coping Skills

  During the course of the program, patients meet daily with a psychologist to learn mind/body techniques for pain management and stress management. These sessions focus on cognitive behavioral techniques, building on the knowledge and skills learned from the previous session.

• 1 p.m. -- Cardiovascular Conditioning

  Cardiovascular conditioning uses various types of exercise equipment including treadmills, bikes, steppers, ski machines, and the use of a pool. Each day, you will exercise using all or some of these pieces of equipment. During your evaluation, you complete a graded exercise test establishing a baseline for your functional level and determining an appropriate pace for your exercise at home.

• 2 p.m. -- Functional Restoration

  There are two blocks of time in the afternoon to cover other areas of functional restoration. This includes instructions in activity modification to give you more options for doing activities across the day. We also address stretching, strength training, and balance work exercises.

• 2:30 p.m. -- Learning to Modify Activities of Daily Living--
  
  
• 3 p.m. -- Relaxation Training

  Each day ends with relaxation training, applying the mind/body techniques taught in coping skills. This session gives you an opportunity to practice a method of pain management that encourages self-reliance on pain management techniques and is one of the first steps in effective managing of chronic pain.

Spine Surgery

Surgical interventions for patients with spinal disorders are multifaceted and often technically challenging. UI Spine Center surgeons lead the way in the development and modification of options in order to address the needs of our patients.

While not all patients with spinal disorders require surgery, when surgery is necessary, we match the latest surgical techniques with leading-edge devices and state-of-the-art diagnostic facilities to meet the patient's needs.

Surgery is one possible step in a patient's road to healing. Our surgeons match their diagnostic and technical skills in the operating room with a multi-disciplinary treatment approach that can only be found at a dedicated spine center. From the more "straightforward" disc herniation to complex issues such as spinal fracture, spinal tumors, and scoliosis, our surgical team works to address the individual and unique needs of our patients.

Our surgeons also participate in the investigation of next-generation surgical technologies that can benefit the lives of our patients.

Spine Surgery CareMaps

(PDF documents for download)

Lumbar Fusion

• Cover Letter
• Before Admission to the Hospital
• The Day of Your Operation
• Day of Surgery - After Your Operation
• Post-operative Days 1, 2 and 3
• Post-operative Day 4/Discharge
• Return to Clinic: 4 to 6 Weeks / 12 Weeks
• Return to Clinic: 6 Months

Cervical Fusion

• Cover Letter
• Before Admission to the Hospital
• The Day of Your Operation
• Day of Surgery - After Your Operation
• Post-operative Days 1
• Post-operative Day 2/Discharge
• Return to Clinic: 6 Months

Laminectomy for Partial Discectomy

• Cover Letter
• Before Admission to the Hospital
• The Day of Your Operation
• Day of Surgery - After Your Operation
• Post-operative Days 1/Discharge
• Return to Clinic: 3 to 6 Weeks / 10 to 12 Weeks

Laminectomy for Decompression of Spinal Stenosis

• Cover Letter
• Before Admission to the Hospital
• The Day of Your Operation
• Day of Surgery - After Your Operation
• Post-operative Days 1 and 2
• Post-operative Day 3/Discharge
• Return to Clinic: 4 to 6 Weeks / 12 Weeks

Treatment Services

Scoliosis Care
Osteoporosis/Kyphoplasty
Disc Replacement
Spinal Injections
Rehabilitation Physicians (Physiatrists)
Electrodiagnosis
Spine Rehabilitation Program

Scoliosis Care

The UI Spine Center has surgical and rehabilitative specialists to treat both young patients with adolescent scoliosis and older patients with degenerative scoliosis. Treatment techniques include simple observation, bracing, physical therapy, and surgical reconstruction. Contact a spine specialist for specific recommendations.

• Stuart Weinstein, MD
• Sergio Mendoza, MD

Osteoporosis/Kyphoplasty

Patients who have sustained a compression fracture typically endure months of mid-back pain waiting for the fracture to heal.

Using a new technique called kyphoplasty, surgeons insert a catheter into the site of the fracture and inject a bone cement which can heal the fracture nearly instantaneously. Patients are placed in a spinal brace for several weeks to allow the spine to heal and are typically able to resume light daily activities. This procedure can be helpful in some patients who have developed a traumatic fracture or a pathological fracture due to spread of cancer.

• Sergio Mendoza, MD
• Ernest Found Jr., MD

Disc Replacement

An innovation that may be helpful for many patients with degenerative disc pain is disc replacement. Although studies are still ongoing, there may be evidence that some patients with chronic discogenic back pain may benefit from this procedure.

• Joseph Smucker, MD
• Sergio Mendoza, MD

Spinal Injections

Spinal injections can be helpful for diagnosis and treatment of patients with various types of low back pain, including spinal stenosis, nerve root, or "radicular" pain, facet pain or sacroiliac joint pain. When patients have pain going from their back to below their knees, this pain is sometimes due to a "pinched nerve." Spinal injections using local anesthetics and powerful steroid medications can decrease the inflammation around the nerve root and decrease pain. These injections are best done under fluoroscopic guidance in a specially equipped procedure room.

• Neil Segal, MD

Rehabilitation Physicians (Physiatrists)

Physicians in this specialty, called physiatry, diagnose and treat patients with disorders of the brain, spinal cord, and peripheral nerves, as well as patients with bone, muscle and joint pain. Using this non-surgical, rehabilitative approach, most patients are able to improve their quality of lives without surgical intervention. Physiatrists are physicians who use a combination of physical therapy referrals, prescription medication management, injection therapy, or surgical referral if structural problems continue to hold back function.

• Joseph Chen, MD
• Neil Segal, MD

Electrodiagnosis

Nerve conduction studies and needle electromyography, performed as a part of the electrodiagnostic medicine consultation, can help spine physicians determine the extent of nerve or muscle injury due to a pinched nerve. These tests are performed by a physician with training in the performance and interpretation of these diagnostic tests and then can correlate these findings with your specific clinical situation.

• Joseph Chen, MD

Is My Pain Chronic or Acute?

Only a complete medical examination by a spine specialist can tell for sure, but if you answer “yes” to any of these questions, you are probably dealing with chronic pain.

• Has your pain lasted longer than three months?
• Does your pain change in intensity, but you still have pain?
• Have you tried:
  • Injections?
  • Occasional physical therapy?
  • Chiropractic manipulation?
  • Surgery that did not relieve the pain or worked only for a short time?
• Are you or someone who cares about you worried that you take too much medication?
• Do the medications give you less and less relief?
• Would you like to reduce or stop altogether the pain drugs you are taking?
• Has your physician said there is nothing more he can do or that surgery is a last resort?
• Do you feel like you are at the end of your rope?

If you answered “No” to the questions, you probably have acute back or neck pain.

Acute Spine Pain Diagnosis and Treatment

The term “acute” means pain that has occurred recently, usually within the last three to four months. Occasionally, acute pain is an emergency situation from a traumatic injury such as a fall or motor vehicle accident.

More often with acute spine pain, the pain comes on rather quickly and has not gone away or worsened with activity or work. Most people seek medical help after the pain has lingered for a while and does not improve.

At the UI Spine Center, the most important first step in diagnosis and treatment is a detailed history of the problem, and a thorough physical exam focusing on the area of the pain.

Only after the history and physical exam do we talk to you about other tests such as X-rays or MRI. Many acute spine problems can be diagnosed and treated without X-rays, MRIs or other expensive tests. The vast majority of acute spine symptoms do not come at all from the bones of the spine, but the muscles and soft tissues around the spine.

If your physician or therapist in the UI Spine Center determines you need additional tests, they can be completed the day of your evaluation. These test may include:

• X-rays
• MRI
• Nerve conduction studies or EMGs
• CAT scan

Treatment options available for acute spine pain:

• Physical therapy from therapists specializing in spine problems
• Medication management using medications with low potential for addiction or tolerance
• Peripheral or spinal injections performed by physicians using the latest imaging techniques.
• Detailed recommendations for work or leisure that promotes healing and allows time to rehabilitate.
• Surgical options in specific cases.

Help is Available for Chronic Back or Neck Pain

• Has your pain lasted longer than four months?
• Does your pain change in intensity, location, and cause you to become physically exhausted?
• Have you tried many treatments including:
  • Injections
  • Occasional physical therapy
  • Chiropractic manipulation
  • Surgery that has not been effective
• Do you or someone who cares for you worry that you may be taking too much medication?
• Do the medications not appear to help?
• Would you like to reduce or stop altogether the medications you are taking for pain?
• Has your physician said there is nothing more they can do or that surgery is a last resort?
• Do you feel like you are at the end of your rope?

If you answered yes to any of these questions, the UI Spine Center may be able to help you.

Chronic or long-term back or neck pain is a diagnosis that the Spine Center treats separately from surgical or acute (short term) back pain. It is a major problem requiring a unique treatment program. The Rehabilitation Unit for Chronic Spine Pain and our Spine Rehabilitation Program are offered by the Interdisciplinary Spine Rehabilitation Team that specializes in the care and treatment of chronic spine pain.

Benefits to Employers

For most back and neck problems, the following combination will return a worker safely to the job:

• a medical workup from a physician trained extensively in orthopedic spine problems
• a detailed, understandable explanation of the problem
• an active, positive approach with short-term physical therapy

For a small group of spine patients, surgical intervention is an option.

The spine rehabilitation team approach for chronic back pain patients offers a one-day or a two-week rehabilitation program, depending on the complexity of the issues and the willingness of the patient to commit to a very active program of rehabilitation.

For employers, we will always provide:

Current Medical Information - Written diagnosis, specific recommendations for follow-up care, medication management, and impairment rating, end of healing period and/or MMI if appropriate for legal purposes.

Return to Work Plan - This is a comprehensive step-by-step plan developed after looking closely at many variables that affect return to work potential. Our vocational rehabilitation specialist will consult with the patient, the employer, the UI Spine Center team, and insurance/workers' comp professionals to develop a plan is that is safe, active, and focused on returning to employment. This plan can be as simple as a one-sentence return-to-work note or as comprehensive a total change in work focus change involving retraining, relocation, or continuing education.

Results - Return to work rates are approximately 70 percent for chronic spine pain patients.

Psychological Development - We focus on self-management of pain and teach patients how to use the proven coping skills for successful pain management. Our patients have dramatically reduced the number of medications used for sleep and pain. This is one of unique parts of our rehabilitation approach that aids greatly in reducing work stress and provides critical psychological tools as part of a return-to-work plan.

Comprehensive Report and Follow-up Communication - All communication in writing to the employers or their representatives is done immediately following rehabilitation. Our staff is always available by phone or email.

Scheduled Return Visits - Return visits at one month, three months, and six months are provided at no additional charge for patients who have successfully completed the Spine Rehabilitation Program. Job questions and issues are a priority at these follow-up visits.