At Virginia Spine Institute, your first visit is comprehensive and thorough. Your first appointment gives us the necessary framework to customize your treatment plan. As part of that comprehensive initial evaluation for back or neck pain, it is important to obtain a detailed health history and pain story, a comprehensive physical examination, and appropriate imaging studies.
Our comprehensive team at the Virginia Spine Institute can help patients prioritize what important diagnostic testing they need to help them through their diagnoses and treatment options. At our facility, we have the ability to do a lot of diagnostic tests in-house.
Diagnostic injections are injections designed to better understand your pain generator. This typically is an anesthetic agent like lidocaine injected to block pain-sensing nerves in a specific structure guided by imaging (x-ray and/or ultrasound). Other diagnostic injections use contrast, a special dye, used to assess the integrity of different structures and if they are pain generators.LEARN MORE
Discography is a diagnostic test performed by your doctor to determine if the intervertebral discs in your spine are responsible for some or all of your back pain. Under x-ray guidance, small needles are placed in the center of the disc. Then a special dye called contrast is injected into the disc under pressure. In a healthy disc, the dye collects in the center and does not cause pain. In an unhealthy disc, the dye may spread to the outer edges of the disc and reproduce your back pain. Based on how you respond to each injection, your physician can determine if those discs that were tested need to be addressed in your treatment plan to get you out of pain.LEARN MORE
Electromyogram, commonly referred to as an EMG, is an electrical study of muscle. It is a type of electrodiagnostic testing used to help determine if there is evidence of nerve or muscle injury contributing to your symptoms.
The EMG test helps to clarify the cause of symptoms by confirming and any nerve or muscle damage. This is especially helpful when exam findings or other diagnostic tests are not clear. Electrodiagnostic testing cannot tell you the cause of nerve or muscle damage, it only confirms details of the damage.LEARN MORE
Ultrasounds can be used to visualize and assess tendons, ligaments, nerves, bone and joints, as well as be used to guide ultra-precise injections to treat your pain. There is no risk of radiation to the patient, and gives us important information to help diagnose a variety of musculoskeletal conditions.LEARN MORE
The proper x-rays are absolutely essential in diagnosing spine disorders and developing the proper treatments for those disorders. As part of routine imaging, proper x-rays should be done in the standing position. There are several different views available, include front-to-back, side, bending forwards and backwards, among others. Each view shows something different and your physician will determine which views are best in your particular case. The technique performed during the filming process is quite precise with many nuances, and therefore best done by a radiology technician specifically trained in taking spine x-rays.LEARN MORE
Dr. Niteesh Bharara
Director of Regenerative Medicine
Orthopedic Specialist - Non-Surgical Sports Medicine
Dr. Thomas Nguyen I Regenerative Medicine Specialist
Interventional Pain Specialist
Aesthetic Regenerative Medicine
Reviewed by: Dr. Christopher Good, MD, FACS.