Set up an appointment for a thorough evaluation to determine the exact cause of your pain. A comprehensive treatment plan will be established that places you at the center of care. The main focus at Signe Spine & Rehab is a diagnostic approach in order to provide the correct, targeted treatment. 



Physical Therapy

The key to lasting relief and prevention of future re-occurrences is spine specific physical therapy.  Spine specific therapy focuses on dynamic stabilization and strengthening in a neutral spine position.  Referrals will be given to spine specific therapists throughout the Charleston area.

Diagnostic Selective Nerve Root Injections

Many patients present with non-classic symptoms.  Sometimes it is difficult to pin point the exact cause of the problem.  Most interventionists will provide broad treatment options such as caudal or interlaminar epidural steroid injections in the hope to provide some relief.  At Signe Spine, diagnostic selective nerve root injections are utilized to find the specific cause of pain so that a targeted approach can be used.

Epidural Steroid Injections

Epidural steroid injections are useful in many conditions such as disc herniation and stenosis to reduce inflammation and help with pain. Transforaminal epidural steroid injections are targeted injections to provide the maximal benefit.


Medial Branch Block Injections

Facet joints are a common cause of neck and back pain.  Medial branch blocks are diagnostic injections that can help determine the root source of pain.  Much like Novocaine injections are used by the dentist, medial branch blocks are injections that temporarily numb the facet joint to determine if they are the cause of the pain.

Facet Joint Injections

Once the facet joints are determined to be the pain generator, steroids can be injected into these joints.  This is similar to steroid injections into the knee and shoulder joints.  These injections are not cures, but are utilized to decrease inflammation and pain so that therapy can be initiated to help stabilize the spine and provide lasting relief.


Radio-Frequency Neurotomy

If steroid injections into the facet joint do not provide lasting relief, one can consider eliminating the nerves to the facet joints to provide lasting relief. This is a simple outpatient procedure that burns the nerve to the facet joint using radio-frequency waves so that the patient can continue enjoying activities with less pain.

Sacroiliac Joint Injection

Sacroiliac joints are a common source of low back pain that are difficult to diagnose.  Even with a thorough physical exam and advanced imaging, sacroiliac joints are difficult to determine if they are the source of the pain.  Diagnostic and therapeutic sacroiliac joint injections can be utilized to provide lasting relief.

Intra-Articular Peripheral Joint Injection

Hip and back pain as well as shoulder and neck pain commonly mimic each other and are difficult to diagnose. Diagnostic/therapeutic joint injections can be used to determine the pain generator as well as hopefully provide a minimally invasive approach to pain relief and prevent surgical options.

Trigger Point Injections

Trigger point injections can be utilized to diagnose and treat muscular related pain. These injections are directed into the belly of the muscle.  Injections, along with stretching and strengthening of the muscles, can help provide lasting relief.  

Electrodiagnostic Evaluation

Electromyograms (EMG) and nerve conduction studies (NCS) are useful to diagnose carpal tunnel, ulnar neuropathy, radiculopathy, and other nerve entrapment conditions. 


Discs are a common source of pain.  It is important to determine if the discs are the source of pain to see if intra-discal steroid injections or surgical options may be beneficial. Discography helps to determine the exact disc causing pain.


Compression fractures are a common cause of pain from patients suffering with osteoporosis.  Usually, compression fractures can be treated conservatively with bracing and therapy.  If pain is not improved, one may consider  a kyphoplasty.  This involves injection of cement into the compressed bone to restore height and provide pain relief.

Spinal Cord Stimulator Trial


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