New Back Procedure Addresses Disc Disease

Outpatient treatment deactivates nerve that sends pain signals to brain.

For a 76-year-old with two reconstructed knees, Georgia Ainsworth sure does get around a lot.

“I play tennis four or five days a week, and I also spend one day a week volunteering in the gift shop at our local hospital,” Georgia says proudly. “And to tell you the truth, I wouldn’t have it any other way.

Georgia Ainsworth

Georgia Ainsworth

“I tell the ladies I play tennis with that just by showing up at the club we’re probably ahead of 99 percent of the people in our age group who are sitting on the couch at home eating bonbons and watching the soaps.”

Georgia has never been a watcher; she’s always been a doer. When she married a ski enthusiast years ago, she learned how to ski. When she moved to Florida and found that her new friends played tennis, she learned to play right alongside them.

“I do it for the fun, really, the social aspect of it,” Georgia adds. “For me, it’s just fun to be out there socializing with people; that’s the big thing for me. And believe me, we have a really good time out there.”

Since having her knees replaced a couple of years ago, Georgia has been playing mostly doubles tennis. Recently, though, even that became a struggle as aggravating back pain sometimes forced her to the sidelines.

“I have suffered from back pain for 40 years,” Georgia relates. “When it comes to back problems, you name it and I’ve had it. I’ve had disc problems and arthritis, and now that I’m older, I have stenosis,” a narrowing of the spinal canal that puts pressure on nerves.

“Because of that, I’ve also been to every kind of doctor you can name and taken every kind of pain pill and muscle relaxer you can think of and tried every procedure known to man short of surgery to get rid of my pain.

“Nothing worked, so for as long as I’ve been dealing with this back pain, I have always kept on moving because I’m afraid that if I stop, I’ll freeze up. That’s one of the reasons I play tennis a lot. I need to keep moving.”

Georgia tried to keep moving through her most recent bout with back pain but eventually had to relent. Not only did the pain force her to stop playing tennis in the middle of matches, it also forced her to abandon simple household chores.

“I couldn’t stand on my feet for very long, so I couldn’t vacuum the whole house in one standing,” she explains. “But sitting was even worse than standing for me. The only relief I could get was if I lay flat in bed.

“But like I said, I’m afraid to stop moving so I forced myself to get up and do things like play tennis. I played through the pain for as long as I could, but I eventually had to say, Sorry ladies, I just can’t go anymore, which was embarrassing.”

Last summer, after the pain became excruciating, Georgia asked her primary care physician if there was any treatment she hadn’t tried yet. This time, her PCP recommended she visit Michael Hanes, MD, at Jax Spine & Pain Centers.

“He said he heard that Dr. Hanes was doing some good work there, and as it turns out, two of the women I play tennis with had seen Dr. Hanes and were very happy with their results,” Georgia notes. “I made an appointment.”

Exclusive Access 

During his initial visit with Georgia, Dr. Hanes examined an MRI of her back. The MRI showed that she was suffering from degenerative disc disease, a condition in which the aging process causes discs between vertebrae to lose their cushioning.

As that cushioning slowly disappears or degenerates, excess stress is placed on the vertebrae. That excess stress can create so much pressure on a nerve in the area that it causes pain.

For years, the best treatments for degenerative disc disease have been medications that ease swelling and inflammation, epidural steroid injections, or spinal fusion surgery. About a year ago, though, a minimally invasive option became available.

Known clinically as the Intracept® Procedure, it is available in St. Johns County exclusively at Jax Spine & Pain Centers, which specializes in interventional treatments for chronic joint, neck and back pain.

“The Intracept Procedure is an FDA-approved outpatient treatment that alleviates the chronic back pain associated with vertebral degeneration by deactivating the nerve that sends pain signals from the defective disc to the brain,” Dr. Hanes educates.

“That nerve is called the basivertebral nerve, and it’s a nerve that many physicians were unaware of until recently because it’s located within the vertebral body, or bone, is not easily accessible, and there was not any therapy available that addressed this nerve until the Intracept Procedure.

“It’s a nerve a lot of doctors were never even taught about. Now that we know about it, we can deactivate it by heating it up, or ablating it. Once that’s done, this nerve doesn’t grow back, so this is a procedure that does not have to be repeated.”

The Intracept Procedure is covered by insurance and can be performed under moderate sedation. During the procedure, the doctor uses x-ray guidance and a thin probe to access the nerve. The probe then heats the nerve.

“The probe is placed into the vertebral body through a small incision that doesn’t even require sutures to close,” Dr. Hanes notes. “The heating process takes about 15 minutes.  When we’re done, we just close the incision with skin glue.”

Immediate Relief 

Patients undergoing the Intracept Procedure typically begin to feel relief from their chronic back pain within a few weeks. Georgia is among those who experienced improvement almost immediately.

“Dr. Hanes told me some patients come in for their two-week follow-up saying, It’s not working; I don’t feel any difference,” she explains. “But I felt better right away.

“I still get some flare-ups here and there, but even then, the pain is tolerable, so I’m a happy camper. I was afraid I was going to have to live with the back pain forever, but with the pain level I have now, everything is doable.

“The bottom line is, I have the relief I was looking for, so the treatment was a success. One of the best things is that I haven’t had to quit a tennis match since I had the Intracept Procedure done, so I’m very happy with the results.”

She’s happy with Dr. Hanes and the staff at Jax Spine & Pain Centers as well.

“I’ll tell you what, those people know what they’re doing,” she enthuses. “I gladly recommend them to anyone. And I recommend the Intracept Procedure as well. It’s made a huge difference in my life.”

Serendipity 

A study conducted a few years back showed that married couples who initially connected through social networking sites such as Facebook were more likely to be satisfied with their marriages than couples who met in more conventional ways.

Korey Shumway has no reason to dispute such data.

Korey Shumway

Korey Shumway

While living in St. Augustine several years ago, Korey reconnected with an old friend living in his hometown in upstate New York through Facebook. The couple “hit it off” immediately, according to Korey, and they were soon married.

“You could not have scripted it any better,” Korey says. “It was quite serendipitous. Here we were, thousands of miles away, then we find each other on Facebook, and the next thing I know, I’m moving back to New York and getting married.”

Tired of the snowy New York winters, Korey brought his family to Florida seven years ago, but not before Korey, 46, suffered a nasty workplace fall that sparked what became a long and arduous ordeal with debilitating back pain.

“I was working in the kitchen of a medical facility, and it was a typical slip and fall,” Korey explains. “I hit a wet spot on the floor, my foot went out from under me, and I fell. I tried catching myself, but I wound up falling right on my back.

“I knew instantaneously that I had done some serious damage. I’ve played hockey my entire life, skied and done a lot of winter sports and been injured before, but I’d never felt anything like this. It was like someone took a sledgehammer to my spine.”

Korey tried working through the pain, but it grew worse. When it became excruciating, he visited his primary care physician, who ordered an MRI. The MRI confirmed Korey’s initial suspicion that he had a serious injury.

“The MRI showed that I had an L5-S1 disc herniation,” Korey reveals. “That made sense to me because the amount of pain I was in was excruciating. There’s back pain that you can take Advil® or something like that for, and then there’s the kind of pain I had.”

The lower back is made up of five lumbar vertebrae, labeled with an “L” and numbered top to bottom. S1 is the first vertebra of the triangle-shaped sacrum, between the hip bones. L5-S1 identifies the lumbosacral joint, an area that receives a high degree of stress.

“The pain limited me in everything I wanted to do,” Korey continues. “Even everyday activities like standing, walking and sleeping were hard, so things like running a vacuum cleaner, reaching up to get something off a shelf or just picking up a bag of groceries were things I couldn’t do.

“I hate to use the word, but it almost emasculated me in a way. I mean, the pain was so bad that it pretty much took away everything that made me who I am, things like doing martial arts, playing hockey, going to the gym, that kind of thing.”

The pain also robbed Korey of the ability to work and pushed him into what he refers to as a “forced retirement.” 

That forced retirement may finally be coming to an end, though, thanks to Jax Spine & Pain Centers, which he also found serendipitously.

A Good Candidate 

“After moving to Florida, I started looking for someone to help me with my back,” Korey relates. “Jax Spine & Pain Centers was the only practice that accepted New York state workers’ comp insurance, so once again, by the grace of God, I lucked out.”

Korey didn’t fully realize just how fortunate he was because Dr. Hanes had not started performing the Intracept Procedure. Prior to that, none of the treatments delivered the results hoped for by Korey and Dr. Hanes.

“We tried everything from epidural injections to radiofrequency ablation of his facet joints and even some medications, but nothing ever helped him,” Dr. Hanes recalls. “Then I ordered a new MRI of his back that showed us something new.

“It showed that the disc causing all of Korey’s pain had deteriorated and there had been what we call Modic changes within the bone. In his case, there was inflammation within the bone next to the degenerated disc.

“The inflammation was what was causing his pain, and because of that, he became a candidate for the Intracept Procedure, which does carry some prerequisites that patients need to meet before becoming eligible for the treatment.”

To undergo the procedure, patients must have chronic back pain due to degeneration of a vertebral disc for more than six months and failed to receive adequate relief through other conservative care options for at least six months. Korey met those requirements. 

The Intracept Procedure has shown in clinical studies sponsored by Relievant Medsystems, the company that developed it, to improve pain scores by 53 percent over 24 months.

Korey’s pain score improved even more than that. Since having the procedure in December, he says there are days when he forgets he ever had a back problem.

“Phenomenal” Work 

“It’s made a world of difference,” Korey says. “It’s given me a big portion of my life back. I’m not doing anything crazy just yet, but I can function again, and I’ve even gone back to working out at the gym.

“There are days when I feel so good that I need to remind myself to slow down and take it easy because there’s still an injury there. But as far as relieving my pain, I can testify as to how effective this treatment is.”

Korey says he highly recommends the Intracept Procedure for those who are eligible for it and highly recommends Dr. Hanes and Jax Spine & Pain Centers as well. 

“I can’t tell you how thankful I am that I was able to have this procedure done, and I would definitely encourage others who are suffering with back pain to get it,” he concludes. “And I just can’t say enough good things about Dr. Hanes.

“He’s a phenomenal human being who legitimately cares about people. He called after the treatment was approved and told me that he immediately thought of me when he found out he’d be treating his patients with it.

“He’s a great guy, and the work that he and everyone else at Jax Spine & Pain Centers is doing is phenomenal.”

© FHCN article by Roy Cummings. Photos by Jordan Pysz. mkb
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    • Jax Spine & Pain Centers

      Jax Spine & Pain Centers is one of north Florida’s leading providers in progressive interventional pain relief for the treatment of back, neck, shoulder, knee, hip and chronic pain. Their team of board-certified physicians and ... Read More

    • Michael Hanes, MD

      Michael Hanes, MD, is a board-certified anesthesiologist and interventional pain medicine specialist. He earned his bachelor’s degree from the University of Michigan in 2006 and his medical degree from Michigan State University in 2010. He comp... Read More