Why Multidisciplinary Approach To Your Problem?

Spinal conditions are often complex. Many factors may contribute to your pain and how you expierience it. We will assess not only your physical impairment, but evaluate any associated psychosocial factors that can aggravate pain. We try to coach patients and to teach them how to keep the pain from overwhelming their lives. Therefore, we assemble a team of experts in anesthesiology, family medicine, neurology, occupational medicine, orthopedics, pain medicine, pain psychology and alternative/complementary medicine and integrate your work up into a multidisciplinary process to assure that all appropriate diagnostic and therapeuric approaches are available to you as a patient.

Schematic of the mutidisciplanary approach to working up a painful spinal condition with the patient at the center. The goal is to optimize care by organizing a coordinated effort revolving around the patients spinal pain.


How Does It Work?

The spinal surgeons at the Center of Advanced Spinal Surgery of Southern Arizona are part of a multidisciplinary team of experts needed to help spine patients to find the answer to the three most commom questions:

  1. What is causing the pain?
  2. What options are there to help me?
  3. Where can I get the best treatment?


What Are The Core Elements Of The Multidisciplinary Approach?

Establishing a precise diagnosis whenever possible is the key to effective treatment. Diagnosing your problem correctly will improve your chance of having your painful spinal disease treated optimally. For example, when a patient has painful nerves from diabetes (diabetic neuropathy) rather than from pinched nerves dues to spinal stenosis, good control of the diabetes is important to control the pain. Surgery may be unnecessary in that scenario.

Prevention – help patients understand how to keep the painful disease form getting worse.

Palliation of pain (often referred to as “Pain Management”) – when appropriate we will refer you for medication management; and also injections, complementary and alternative medicine strategies, and more to control pain that cannot be eliminated through treatment of the painful underlying disease process.

Evaluation of the psychosocial factors that can aggravate pain, and coaching of patients to teach them how to keep the pain from overwhelming their lives. This is extremely important when assessing patients for surgery. Patients with significant confounding psychosocial factors, depression, fear or dependency issues (click here to see example evaluation) will have a less favorable outcome with spinal surgery, when compared to patients whose disability is mostly due to loss of function, and pain intensity (click here to see example evaluation).

Coordination of care among the different specialists and primary care team is of crucial importance. This will avoid unnecessary tests, unproductive referrals, and duplication of efforts. This is similarly true for coordination of palliation efforts where it is crucial to establish close communication between physical rehabilitation and spinal surgery specialists, for example.

Education and counseling – We educate and counsel patients on their painful disease and involve experts from the respective areas as it becomes necessary.


Are There Any Procedures Involved?

You may need one of the following diagnostic / palliative interventional procedures done:

Interlaminar Epidural Steroid Injection

Transforaminal Epidural Steroid Injection


Lumbar Sympathetic Block

Sacro-Iliac Joint Injection

Radio Frequency Lesioning


Occipital Nerve Block

Epidurolysis With Hypertonic Saline

Trigger Point Injections

Facet Joint Injections

Interscalene Block


Who Is Part Of The Team?

We refer locally, regionally, and beyond to trusted partners for many, many more specialty pain treatments, incuding surgical specialists in peripheral nerve, neurosurgical, and orthopedic techniques; pain management, accupuncture and oriental medicine; massage; physical and prolotherapy; Chiropractic; Feldenkreis and other alternative medicine options; and more. We work closely with the Integrative Pain Center of Arizona. You may be referred to Tucson Pain Institute for a consultation with Dr. Charles Stevens or an interventional procedure.

By cooperating with your primary care team, other subspecialty and spine care providers, we offer a truly integrated multidisciplinary team-based approach – an approach that has been successfully applied to diseases like breast cancer and which we find works extremely well for diagnosis and treatment of painfull spinal diseases.