Back and neck pain are very common conditions that can make it more challenging to enjoy life—but for many people, relief is available.
Sentara Back & Neck Specialists offers a wide range of pain management options, both surgical and nonsurgical, to help reduce your pain and get you back to doing the things you love.
With on-site diagnostic imaging, our orthopedic and pain management specialists can quickly and accurately offer the best treatment plan for each patient, including medication management and physical therapy to aid the return of function, as well as interventional options like injections, nerve blocks, spinal cord stimulators, radiofrequency neurolysis, surgery and more.
Freed From Debilitating Back Pain
Beatriz Gutierrez de Meza says everything with her health was normal until one day in August 2016, when she suddenly felt a sharp pain in her back. The pain started traveling down her entire left leg, rendering the everyday functions of daily life almost impossible to accomplish.
“The pain was unbearable,” she says. “I couldn’t stand. I couldn’t sit.” To get around her Harrisonburg home, Gutierrez de Meza, 68, says she had to hold onto the walls and furniture for support. “I couldn’t do anything, and my quality of life was terrible. I would sit inside and just cry.”
The retired mother of three and grandmother of three worried that she would have to spend the rest of her life in a wheelchair. “I was ready to buy a cane to help me walk,” she recalls.
She tried physical therapy and painkillers to bring her symptoms under control. Though the painkillers helped some, she knew she couldn’t take them forever. Her healthcare provider then referred her to physiatrist and pain management specialist C. Joel Hess, MD, of Sentara Back & Neck Specialists. Dr. Hess ordered an MRI and X-rays of her back, which revealed a cyst growing on the nerves in her lower back.
“The facet joints in Beatriz’s lower back became arthritic, and the inflammation caused a cyst to grow from the joint into the spinal canal and press against her nerve root,” says Dr. Hess. “This condition was the source of her pain.”
Gutierrez de Meza initially thought she would need surgery to treat the cyst, but Dr. Hess informed her that a less invasive, nonsurgical option was available for her situation. She underwent a procedure known as a facet injection, during which Dr. Hess placed a needle into the joint using X-ray imaging guidance. He then overfilled the joint and cyst in her spine with saline, which caused the cyst to rupture. Although the procedure requires local anesthetic and intravenous medication for sedation, Gutierrez de Meza was awake throughout, according to Dr. Hess.
“When he inserted the needle, it was painful, but I got immediate relief,” says Gutierrez de Meza. “I came into the hospital barely able to walk, and when I left, I was walking like nothing had happened to me. The procedure only took 10 minutes, but the way it impacted me was as if I had been taken from hell to heaven.”
Recovery from facet injections like the one Gutierrez de Meza had is usually very quick, Dr. Hess notes. “Patients go home the same day,” he says. “As long as the cyst ruptures during the procedure, pain relief is instant, just like Beatriz experienced.”
Today, when she describes her experience with Dr. Hess, Gutierrez de Meza has tears in her eyes. “I left the office just blessing him and being ever so thankful that he was able to help me so much,” she says. “My life went back to how it was before the pain started. Dr. Hess was my salvation. I really trusted his skills and his experience.”
Now she appreciates the simple things—things that weren’t so simple at all when she was in pain. “It’s good to just walk,” she says.
Originally from Colombia, Gutierrez de Meza once more can enjoy going out for coffee with her good friend from her home country. “Before my procedure, I was stuck inside the house and couldn’t go anywhere,” she says. “In fact, I couldn’t do anything.”
She’s also thankful for the team at Sentara RMH. “The care from the whole team there is really impressive,” she adds. “I would be crying, and the nurses and the staff would hug me and put their hands on me and just try to pamper me and calm me. Everyone, from the receptionist to the people in the procedure room, and from the time I registered to the time I came out of the procedure—everyone was so caring. The quality of the care they provided was just so impressive.”
Back in the Saddle
Horseback riding is one of Christine Moore’s true loves. When traveling to Florida each fall, in fact, the Mount Jackson resident and her husband, Charlie, take two of their five horses with them so they can continue to enjoy their favorite pastime. Recently, however, chronic severe back pain had left Moore unable to ride.
Though she’s retired now, Moore, 72, says years of being tough on her body, including working at her job as a grocery store manager, led to the pain. “I used to carry a lot of things around at the store, and it wasn’t good for my back,” she notes.
She now has dysfunction of the sacroiliac joint, which is located at the junction of the spine and pelvis—a condition known as sacroiliitis, according to Dr. Hess. Moore tried to relieve the pain with steroid injections and numerous rounds of physical therapy, but neither gave her any relief. She also takes oral steroids for an unrelated autoimmune disease, but they don’t help to lessen the pain, either.
However, Moore was determined to do something about her pain. Not only did it keep her from horseback riding, but it was also affecting her ability to interact with and give sewing lessons to her grandchildren and great-grandchildren.
“It could be a real trial and tribulation to sit in front of the sewing machine or to bend around a child trying to knit,” she says. “When you’re in pain, you’re tired. Your body is fighting, and you don’t have the energy level you feel you should have. But you can’t sit there and wallow—you’ve really got to take some responsibility for the condition of your body.”
Dr. Hess suggested that Moore try radiofrequency neurolysis, or denervation, a procedure that uses special needles to heat the nerves supplying the sacroiliac joints. During the procedure, which is performed in an outpatient setting with mild sedation, Dr. Hess uses X-ray imaging to guide the needle into position. The heat inhibits the transmission of pain signals coming from the joint, according to Dr. Hess.
While denervation itself has been around for several decades, Dr. Hess is now using different needles that make the procedure faster and less invasive. He notes that patients with chronic neck or back pain originating from the facet joints of the spine or the sacroiliac joint are good candidates for the procedure, as are those with degenerative spondylolisthesis, a forward slip of a vertebra in the spine.
The nerves do grow back within 6-18 months following a denervation procedure, so Moore has had the procedure three times over the last few years and will continue to have it as needed in the future. “The procedure helps tremendously,” she says. “I still have pain, but the pain is manageable. I have some pretty good days.” She notes that she has experienced some temporary tenderness at the site following the procedure.
Now she’s back to taking care of her house and enjoying sewing time with her grandchildren and great-grandchildren, two activities that weren’t possible with her extreme pain. She’s also back on her horses, although she does need some assistance with mounting. “We ride a lot in the forest in Florida,” she says. “That’s the main benefit of this procedure. It gives me back that freedom to do something I just love.”
Moore appreciates the care she received from the entire staff at Sentara RMH. “I’m so grateful,” she says. “I would recommend this procedure to anybody who has continual back pain—it’s really, really helpful. Dr. Hess has a wonderful bedside manner, and I think that’s what we look for in a doctor—someone who will talk to us and explain things. He’s definitely there for you.”
Husband and Wife Surgeries
Three years of back and leg pain left Sheila Lambert, 69, of Franklin, W.Va., sick and barely able to get around on many days. “Sometimes I could hardly walk due to my excruciating pain,” she says. “Some days I couldn’t even eat, because the pain would make me sick to my stomach.”
Lambert had a condition called lumbar spondylolisthesis with stenosis, or narrowing of the spinal canal, that caused vertebrae in her back to slip forward and pinch her sciatic nerve, resulting in pain that ran down into her legs. She tried physical therapy and acupuncture to help find some relief, with only temporary results. “Each thing I tried would help for a couple of months, and then the pain would be the same again,” she recalls. Frustrated after an unsuccessful acupuncture treatment, that’s when she learned from a friend about spine surgeon Mark E. Coggins, MD, of Sentara Back & Neck Specialists.
She saw Dr. Coggins, who, after a thorough assessment of her condition, recommended spine surgery. He performed a decompression, in which he removed the parts of the vertebrae that were compressing Lambert’s nerves. After that, he did a spinal fusion to stabilize her spine, inserting two rods and four screws into her back.
Having exhausted all her other options, Lambert was an ideal candidate for the surgery, according to Dr. Coggins. “We try to do everything we can to treat nonsurgically,” he states. “We maximize the use of physical therapy, medications and injections—everything we can do before resorting to surgery, because it’s a significant procedure.”
Dr. Coggins says recovery from the procedure, which can take six months to a year, is largely dependent on patients and how they embrace and participate in their recovery. “You will be a lot better as you go, but it takes time, effort and energy on your part to make that happen,” he explains. “Your body has to heal, and that doesn’t happen overnight. Sheila has done very well—she was very disabled when she came to see me.”
Lambert’s recovery happened faster than she expected. She was nervous about walking for the first time after the procedure, but a physical therapist encouraged her, and she was able to walk around the room. By the third day following surgery, she was walking up the hospital stairwell and was ready to go home.
Almost two years later, Lambert’s only side effect is an occasional tingling in her toes. “I can live with that, and they tell me it may go away over time,” she notes.
Her surgery was so successful, in fact, that her husband, Jerry, also recently had a decompression performed by Dr. Coggins. “After six months of pain, now I’m ready to go back to work,” says Jerry, a carpenter—although he says he’ll hold off on returning to work until he gets the green light from Dr. Coggins.
Sheila now tries to walk at least a mile every day—something she never would have imagined before her procedure. “If I hadn’t had surgery, I wouldn’t be walking,” she says. “Dr. Coggins encouraged me every step of the way.”
The Lamberts live 50 miles from Sentara RMH, but they say the drive is well worth it. “It’s the only hospital we respect and go to,” says Jerry. “Our parents went to Rockingham Memorial Hospital in the old days, and we just love Sentara RMH. They’ve all been so nice to us—the nurses, the therapists. Everybody’s been great, and you couldn’t ask for anything more. I’ll go there anytime I need to make a hospital visit.”
Sheila appreciates the quality of follow-up care and the concern the Sentara RMH staff has shown her, and she hopes others with back and neck problems can benefit from Dr. Coggins’ expertise. “I carry Dr. Coggins’ cards in my purse to give out to anyone who may need them,” she says.
“I’m a businessman,” Jerry notes, “and I have business cards to hand out. Sheila doesn’t hand out my cards, though—she hands out Dr. Coggins’ cards.”