Back and Neck Pain

Josiah Orina, M.D., neurosurgen with the OHSU Spine Center
Dr. Josiah Orina specializes in the surgical treatment of spinal conditions. He works with his patients to customize their treatment plans.

The OHSU Spine Center offers a full range of diagnostic and treatment options for back and neck pain. Our team includes experts in pain management, rehabilitation, orthopaedics and surgery who will tailor a plan to your needs.

Diagnostic tests

  • Discography: This test uses a needle guided by a type of X-ray to identify the spinal disc causing pain.
  • Electromyography: A doctor places tiny needles in muscles to measure electrical activity. This can help diagnose the cause of arm or leg pain, numbness or other symptoms. 
  • Nerve conduction studies: Measure how quickly electrical signals travel along your nerves.

Nonsurgical treatments

Many causes of back and neck pain can be treated without surgery, an approach the OHSU Spine Center favors whenever possible.

  • Bracing: A brace can be the answer for sprains, strains and fractures.
  • Medication: Doctors can prescribe medications to reduce pain and inflammation.
  • Physical therapy: A physical therapist can offer treatments and exercise programs to treat back and leg pain.

Minimally invasive treatments

  • Epidural steroid injections: Injections can treat pain caused by pressure on spinal nerves.
  • Intradiscal electrothermal therapy: The doctor uses a needle and catheter to provide heat that relieves the pain caused by spinal disc degeneration or lower-back disc problems.
  • Kyphoplasty: Plastic cement is placed in a vertebra (spinal bone) using a needle and balloon device. The procedure can stabilize the spine and reduce pain.
  • Radiofrequency facet denervation: This outpatient procedure involves using a needle to end a spinal nerve's ability to send pain signals.

Surgical treatments

  • Artificial disc replacement: A damaged or diseased disc is replaced with a prosthetic one.
  • Laminotomy/laminectomy: This surgical procedure removes part of a spinal bone called the lamina to relieve pressure on nerves or the spinal cord.
  • Spinal cord stimulation: Tiny wires are placed near spinal nerves and connected to a small device that sends mild electrical pulses to reduce pain.