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COVID-19 Inova Spine Program Scheduling Appointments Notice

Inova is taking the appropriate steps to protect the safety of our patients, community, team members and caregivers. Virtual visits are now being offered. Please call 703-776-4700 to schedule your spine appointment or change an existing appointment. If you are experiencing a fever or symptoms of respiratory infection, such as cough or difficulty breathing, or had exposure to a COVID-19 patient, please contact your primary care physician and arrange a virtual visit or primary care clinic appointment if indicated.

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Inova offers various pain management procedures to manage your spine discomfort.

Inova's Spine Program-Pain management discusssion with doctor and patient image

Electrical (neurostimulation)

Neurostimulation blocks pain signals from the spinal cord as they go to the brain. A tiny generator is implanted beneath the skin and low levels of electricity are delivered directly to the nerves. This treatment masks pain by substituting a tingling sensation. The electrical impulses can be targeted to specific locations and adjusted as pain changes or improves.

Pain medication

  • Non-steroidal anti-inflammatory medications (NSAIDs) include common over-the-counter medicines such as aspirin, ibuprofen and ketoprofen.
  • Steroids are powerful, anti-inflammatory, non-narcotic prescription medication used for short periods of time (one to two weeks).
  • Opiates are narcotic medications such as codeine, morphine, OxyContin, Percocet and Vicodin prescribed for episodes of severe, acute pain. Inova spine specialists do not prescribe opioid analgesics for chronic spine pain.
  • Muscle relaxants are typically prescribed on a short-term basis to relieve muscle spasms in the low back.
  • Less commonly, antidepressants and antiseizure medications are prescribed to alleviate back pain.

Pain injections

  • Trigger point injections (TPI) treat painful, knotted areas of muscle in the neck and lower back. TPI contains a local anesthetic that renders the trigger point inactive and alleviates the pain.
  • Epidural steroid injections (ESI) and blocks provide relief from certain types of low back and neck pain. The translumbar approach (between two vertebrae) is the most common way of performing an ESI. An epidural block is injected into the epidural space below the lumbar spine near the sacrum.
  • Facet injections are a diagnostic tool to isolate and confirm a specific source of back pain. They also can numb the source of pain and soothe the inflammation.
  • Selective nerve root block (SNRB)/transforaminal epidural injections are primarily used to diagnose the specific source of nerve root pain, as well as for therapeutic relief of low back pain.
  • Sympathetic blocks are a series of injections of local anesthetic in the sympathetic nerve tissue located on the either side of spine to relieve pain from sciatica and other conditions.
  • An intrathecal pain pump infuses morphine directly into the spinal cord through the intrathecal space. It is used when back pain persists despite maximum conservative therapy and surgery.


For some patients, cognitive behavioral therapy including biofeedback, relaxation, distraction and pacing can reduce feelings of pain and may be equally or more effective than drugs or surgery.

Additional resources from our health library

Coping with Chronic Pain
Effective pain treatments are available. You can also take steps yourself to ease ongoing discomfort.

Lifestyle Changes and Alternative Treatments
Sometimes, simple changes to your lifestyle or making use of alternative treatments (like chiropractic or massage therapy) may help prevent or relieve symptoms.

Ice Packs vs. Warm Compresses For Pain
It sometimes is confusing whether to use heat or cold when treating sore muscles or an injury.

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