In my practice, I always look to avoid surgery unless there are neurological changes such as weakness and pain that affects reflexes or function. I saw a patient yesterday with only neck pain scheduled for neck surgery without any attempt at pain management. I always try a series of injection, medication, and therapy first and surgery as a last resort. I also want patients to understand all their options by using Internet sites like We even have added acupuncture as an option. The goal is to use all reasonable modalities prior to offering sugery and to also let patients review their options. New technology can also make a tremendous difference in successs and outcomes.

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