Spine & Interventional Pain
Back and neck pain worked up like a diagnostic problem, not a surgical referral — prove the pain generator, then treat it with image-guided, opioid-sparing care.
Prove the pain generator first
Few problems in medicine collect surgeries faster than back pain — fusions get scheduled off MRI reports that were never proven to be the pain source. We run the sequence the other way: prove the generator first, treat it conservatively second, and let surgery argue for itself only if the evidence demands it.
An MRI is a hypothesis, not a verdict — imaging routinely shows changes that have nothing to do with your pain. We confirm the generator with a focused exam, imaging correlation and, when the answer matters, fluoroscopy-guided diagnostic procedures such as medial branch blocks.
Once the source is confirmed, fluoroscopy- and ultrasound-guided interventional and orthobiologic procedures are applied exactly there — facet and SI joint treatment, image-guided orthobiologics, and multimodal, opioid-sparing care coordinated with rehabilitation.
The scalpel stays in reserve
Dr. DeWald is fellowship-trained in the full toolkit of image-guided spine procedures — fluoroscopy-guided medial branch blocks, facet injections and SI joint procedures — and holds IOF certification in Advanced Spine, the Interventional Orthobiologics Foundation's procedural credential for regenerative spine care, combined with the practice's protocols for ligament and paraspinal tendon support.
The whole model is engineered around not needing narcotics: precise procedures, active rehab, and multimodal support coordinated with the right specialists. And when a case genuinely belongs with a surgeon, we say so early and help you get there.
Your spine care, step by step
Precise diagnosis
Exam findings, imaging correlation and diagnostic procedures converge on the one structure actually responsible.
Targeted intervention
Fluoroscopy-guided procedures — medial branch blocks, facet or SI joint treatment — address the confirmed source.
Regenerative support
Where appropriate, image-guided orthobiologic treatment supports ligament and disc-adjacent tissue repair.
Clear escalation
If conservative care can't finish the job, we coordinate the referral — early, not after a year of drift.
Conditions we address
- Degenerative disc disease
- Disc bulges & herniations
- Sciatica & radiating leg pain
- Facet joint pain
- SI joint dysfunction
- Chronic low back & neck pain
Who it’s for
For anyone whose back pain persists without a proven diagnosis — and anyone determined to exhaust the real alternatives before fusion enters the conversation.
Common questions about spine care
Can disc pain really improve without surgery?
Most disc problems do improve without an operation — and confirmed-target treatment plus focused rehab moves that timeline up considerably.
How do you know which disc or joint is the problem?
We treat the MRI as a hypothesis, not a verdict. Exam findings and, when the answer matters, diagnostic blocks confirm the level before we commit to treating it.
What about opioids?
The model is built around not needing them — precise procedures and active rehab in place of escalating prescriptions.
Is this covered by insurance?
Some interventional spine procedures do carry coverage; it varies by procedure. You'll have exact numbers before anything is scheduled.
Make your back pain explain itself.
Exam, imaging correlation and diagnostic precision — then an image-guided, opioid-sparing plan aimed at the proven source.