East Carolina University. Tomorrow starts here.®
The Brody School of Medicine
Department of Physical Medicine & Rehabilitation

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Musculoskeletal and Spine Clinic

People with acute pain need to be treated early on in the process to maximize the probability of recovery. ECU Physicians Neurosurgical and Spine Center features a Musculoskeletal and Spine Clinic that is a new location with multiple providers onsite. Physical Medicine & Rehabilitation physicians work with neurosurgeons and physical therapists to allow care from multiple providers in one location.

The Musculoskeletal and Spine Clinic combines the approach of board-certified Pain Medicine, Physical Medicine and Rehabilitation, and Electromyography (EMG) physicians with innovative treatment approaches. State of the art clinical services are available for patients experiencing severe back and extremity pain.

Due to the intensity of clinical care at the Musculoskeletal and Spine Clinic, services are provided only by referral from a physician. We invite a patient's primary care physician to remain closely involved in the long-term care program.

Treatment at the Musculoskeletal and Spine Clinic may last several months and will provide an optimal level of care for our patients. We will also create a program of long-term pain management that allows patients to return to their primary care physician.

Lumbar Injection

Low back pain (LBP) is a leading cause of disability and productivity loss in the United States. Some studies indicate the lifetime prevalence of LBP may be as high as 84%. Although most episodes of LBP resolve fairly quickly, others may not resolve on their own. Causes of LBP include, but are not limited to, radiculopathy, degenerative changes, facet joint dysfunction, and sacroiliac joint dysfunction.

Treatment may involve physical therapy, medications, and the use of modalities such as heat, ice, or TENS units. Spinal injections are also available for the treatment (and sometimes diagnosis) of some types of LBP. These procedures are performed under fluoroscopy to insure proper needle placement. Once the needle is in the correct location, and confirmed by the injection of contrast, an injection of steroid and anesthetic is performed (please see animation).


Lumbar Epidural Steroid Injection

Joint Injection

Arthralgia (joint pain) is often caused by overuse, or osteoarthritis. For example, the medial knee compartment can be damaged by overuse and may result in decreased mobility. Physical examination and possible radiologic studies can pinpoint the problem. There is evidence in medical literature that several treatment options are effective. For example, strengthening of lower extremity muscles can improve function. Onsite therapists can design a strengthening program to meet an individual patient need. Some oral medications for pain are prescribed through the Musculoskeletal and Spine Clinic, however we do not advocate the use of narcotics. Joint injections also may be recommended, as the injection of medication near the source of the pain can be beneficial and decrease symptoms (please see animation).


Shoulder Injection

Carpal Tunnel Syndrome (median nerve)

Diagnosis and Treatment

Often the best way to find the cause of pain or disability is to test the nerves in the affected areas. These evaluations, known as electrodiagnostic tests, uncover nerve injury or disease. The results will guide a patient's rehabilitation program.

We are pleased to offer several types of electrodiagnostic testing with Board Certified physicians available (American Board of Neuromuscular and Electrodiagnostic Medicine): www.aanem.org

  • Electromyography, or EMG
  • Nerve Conduction Study, or NCS
  • Visual Evoked Potential, or VEP
  • Somatosensory Evoked Potential, or SSEP

Our electrodiagnostic tests are offered five days a week, on an outpatient basis. Same-day appointments are available for urgent and emergency situations. Inpatient diagnostic testing is also provided seven days a week.

Electrodiagnostic tests can help diagnose conditions such as carpal tunnel syndrome prior to treatment being implemented. Proper positioning with a night splint, use of analgesic medication, injection of medication around the carpal tunnel (please see animation) and surgery are all possibilities.

Procedures performed at the Musculoskeletal and Spine Center include:

  • Joint injections
  • Lumbar epidural steroid injections
  • Sacroiliac joint injections
  • Facet joint injections
  • Medical Branch blocks
  • Ultrasound guided injections
  • Fluoroscopic guided injections