By Dr. John Melek, Board-Certified Physician, The Beloved Interventional Pain and Spine
Spine care is often framed as one liner path. A hospital admission followed by conventional surgery, followed by several days spent recovering in a hospital bed. But it is not the only route and should not be the default assumption for every patient with a disc protrusion, compression fracture, or persistent nerve pain after an accident.
Back and spinal injuries can limit mobility, cause lasting pain, and create major medical costs. Just how much cost? The median first-year medical cost of a nonfatal injury tops $6,600, with some cases reaching over $80,000. Even lower-cost injuries can create financial strain.
The Centers for Medicare & Medicaid Services (CMS) actually requires hospitals to publish online price information so patients can compare services and estimate costs before receiving care. In the cases I see, a three- to five-day hospital admission can run between roughly $50,000 to $75,000. For the right candidate, a minimally invasive procedure performed in a surgical facility may be closer to one-third to one-half of that level, with the patient going home the same day. One-third!
At the low end, medical bills of $1,698 still exceed the savings available to many Americans. Reports Forbes, at least one in four Americans has fewer than $1,000 in savings, leaving many people financially vulnerable after an unexpected injury.
When I say, “minimally invasive,” I do not mean no procedure. The patient may still go to a surgical center and have a small incision. The difference is that, in selected cases, we can treat the underlying problem without the larger surgery, longer admission, and extended recovery that may come with a conventional approach. What’s the adage? You can’t have good, fast, and cheap all at once? I’m here to argue it’s possible.
Care That Matches the Injury
A disc protrusion is one example. In some cases, a patient may need conventional surgery. I know my limitations, and when surgery is needed, surgery is needed. But other patients may be candidates for minimally invasive spinal decompression. Through a very small incision, I can use a guide wire and an implant that expands to decompress the compressed area. The patient goes home that very same day.
The baseline of interventional pain care includes epidural injections, medial branch blocks, radiofrequency ablation, and nerve blocks. We also offer options for more difficult pain presentations. Kyphoplasty can be considered for certain compression fractures after a fall or accident. Spinal cord stimulation and peripheral nerve stimulation can help address chronic nerve pain, including pain that persists after back surgery, a knee fracture, or other injury-related treatment.
In Dallas where our clinic is located, motor vehicle accidents are a frequent source of personal injury cases. Dallas actually has the highest fatal car crash rate in the U.S., averaging ~14 fatal crashes per 100,000 residents. Dallas also ranks the highest in Texas and top ten nationwide for car accidents.
I see many of these car accident victims come in for treatment in need of medical attention. One person may arrive to us with neck or back pain, but the injury story is rarely that simple. They may have a shoulder injury that did not respond to an injection, chronic knee pain after surgery, or a compression fracture that was initially treated with medication and physical therapy but continues to cause severe pain. For those patients, it is important to know that more options may exist.
The Whole Patient Matters
I do not look at the patient as only a spine problem. I look at the patient as one unit.
A patient may come in after an accident with neck or back pain, but uncontrolled diabetes, anxiety, or PTSD may also be part of the clinical picture. Those factors matter. Uncontrolled diabetes can affect whether and how we approach a procedure. If a patient is dealing with significant anxiety or PTSD, that also needs to be addressed because it can affect how well a pain intervention, including nerve stimulation, works for that individual.
That is why I work closely with the full injury team. Pain care should be coordinated care. I also try to see patients quickly, ideally in the same week or the following week.
Our Patients Say Their Quality of Life Has Improved
The importance of more treatment options is best understood through patients’ own experiences. According to patient testimonials, one patient who continued to struggle after back surgery said, “I can now walk straight. I’m not dragging my foot.”
Another patient with neuropathy described what changed after an implantable stimulator: “I was able to sleep through the nights and not feel the pain sensations during the day.”
A third patient, who had been bending forward because of back pain, said after sacroiliac joint injections, “I can stand up straight and I don’t have to bend.”
These are individual patient experiences, not guarantees, of course. But they illustrate what restoring function can mean: sleeping through the night, walking safely, standing upright, running errands, and participating in daily life without constant pain defining every decision.
What I Know for Sure? A Better Referral Path is Here
For Dallas providers caring for personal injury patients, the referral conversation should not start and end with medication management or a hospital admission. It should begin with a thorough evaluation of the patient, their injury, and the options that may help them move forward.
That’s why we’ve partnered with GAIN to help more personal injury patients get the pain management care they need. For more information or to refer your personal injury patients, please contact the GAIN team below and they’ll get back to you shortly:
