Neck and Back Pain

Anyone who has experienced neck or back pain knows how debilitating it can be. You want relief, and you want it quickly. When neck or back pain is intense, it can greatly interfere with your daily activities and quality of life.  Fortunately, there are treatments available that can help reduce back or neck pain. Riverwood Healthcare Center offers care from a team of nonsurgical spine specialists who can diagnose your back and neck problems and design custom treatment plans based on a conservative, nonsurgical approach.

When conservative non-surgical care does not relieve symptoms, or when more medically urgent conditions arise, our specialists may refer you to consult with a spine surgeon to discuss other treatment considerations. Together, we can help you get back to the activities you enjoy.

Our Trusted Team for Neck and Back Pain

A team of specialists—two nonsurgical spine specialists, a sports medicine specialist, and a team of other providers at Riverwood—use a comprehensive approach to managing and treating neck and back pain.

Dr. Joshua Horowitz and Dr. Dan Lonergan perform nonsurgical, image-guided procedures for patients experiencing pain from common spinal conditions. Dr.  Austin Krohn is a family medicine physician who specializes in treating sports-related injuries. Nurse Practitioner Christy Nagel acts as program coordinator and provides clinic care for the patients.

For an appointment, call Riverwood at 218-927-5566.

Program Coordinator

Frequently Asked Questions

These suggestions from our team of experts can be tried at home when you need immediate relief of your neck or back pain.

• Using a cold ice pack is a good choice immediately after a strain or injury or to calm sudden pain. Cold helps to reduce inflammation. If you don’t have an ice pack, a cloth-covered bag of ice or frozen vegetables will work in a pinch. Just make sure you use a towel or cloth to protect your skin, and limit ice applications to no more than 20 minutes at a time.

• Use heat if your back muscles are stiff, achy or spasming. A heating pad or hot water bottle will work as well. To avoid burning your skin, test the temperature to make sure the heat isn’t too hot.

• Over-the-counter medications are good pain relievers. Anti-inflammatories such as Ibuprofen, Naproxen and Tylenol are another option to relieve back pain, if you do not have an underlying medical diagnosis that prevents their use.

• Mild to moderate exercise like walking or gentle stretching exercises will loosen tight muscles and help you get moving again. Notice what activities aggravate your pain. Is your pain worse when lifting or twisting? When you’re walking? Does it get better when you’re sitting? When is your pain the most noticeable ---morning or night? Does it get better with anti-inflammatory medication or not? The more information you can share during an evaluation with your doctor on how these activities impact your pain, the more it will help with making a diagnosis and treatment plan.
Epidural Steroid Injections (ESI) are a common treatment option for cases of neck or back pain. This injection involves injecting a local anesthetic into the skin and steroid medication directly into the epidural space of the spine.

Fluoroscopy (live x-ray) is used by the physician to guide the needle into proper placement for the injection. This injection may be recommended after medications and physical therapy have been tried. An ESI can provide relief for one week to a year depending on the patient.

There are three different types of ESIs: Transforaminal, Interlaminar and Caudal. The physician will choose the best approach based individually for each patient.

It is normal to experience temporary weakness or numbness in the legs following a steroid injection. In most cases, the patient can resume daily activities after the procedure. It may take up to 10 days for the steroid to work. The injection can be repeated periodically depending on the need.
A Facet Joint Injection procedure is performed with fluoroscopy (live x-ray) for guidance to properly place the needle for the injection. This procedure does not require the patient to be sedated.

The physician numbs the skin at the injection site with a medication. Contrast dye is then injected to confirm the needle placement in the joint.

After this is confirmed, a small amount of anesthetic steroid medication is injected into the joint. The procedure takes approximately 15 to 30 minutes.

Patients should avoid strenuous activities after the injection. Patients should limit use of pain medication after the procedure to determine if the injection was successful.
Radiofrequency Ablation (RFA) is a minimally invasive procedure performed in a procedure room by a physician. RFA will typically be performed on a patient who is sedated with medications.

A RFA is performed with the patient lying on the stomach and a local anesthetic is injected under the skin at the site where the needle will be injected. The physician uses live x-ray (fluoroscopy) to determine the appropriate injection site for the needle insertion.

Once these are placed correctly, an active electrode is placed within, providing an electrical current that is sent near the targeted nerve. After this confirms the correct nerve, a heat lesion is created on that nerve that results in an ablation. The entire procedure takes 30 to 90 minutes.

Pain relief after a RFA is felt one to three weeks after the procedure.
A sacroiliac joint injection is designed to diagnose and treat pain and inflammation of the sacroiliac joint. Either too much or too little movement has caused tension on this joint, which can lead to pain.

The procedure begins with the patient lying on the stomach and the physician using fluoroscopy (live x-ray) to determine the proper placement of the needle. The site on the patient is numbed with a local anesthetic before the needle is inserted. The needle is then inserted and a contrast dye is injected to confirm needle placement, and a steroid medication is injected into the sacroiliac joint.

The steroid medication could relieve pain and last for weeks to months. This could provide the patient time to pursue physical therapy.
A Medial Branch Block is a diagnostic procedure to determine the location of the pain.

This procedure has the patient lying face down with arms at body’s sides with the head on a pillow. The physician uses a local anesthetic to numb the skin.

Fluoroscopy or live x-ray is used to determine the correct placement of the needle and the medications are then injected.

It is important that the patient resumes normal activities of daily living that would typically provoke their pain. A successful test block will give the patient a minimum of four hours of 80% pain relief.

If successful, a second test block procedure may be completed to confirm the site.