Traction can be defined as separation of joint surfaces. The result of applied traction is distraction. Distraction means, “ to pull apart or to draw away”. Traction is a force…

History The term epidural merely denotes a space within the spinal canal but is applied to a variety of injection procedures. They may be classified as to region of interest:…

Historical Perspective Long before the development of modern electricity, “natural electricity” was used for its therapeutic properties of inducing analgesia. In the earliest written description of an electric fish, Aristotle…

Thermal or heat modalities have been popular treatments for soft tissue dysfunction and pain management for centuries. Hot baths, infrared lamps, water bottles, moist warm towels, warm compresses, ultrasound, and…

Over the last 2 decades, the sacroiliac joint (SIJ) has increasingly been recognized as an anatomic source of pain that figures in the differential diagnosis of a patient presenting with…

Theoretical Aspects David G. Vivian, MM, BS, FAFMM Discography is used to determine if an intervertebral disc is the likely source of pain in a person presenting with referred pain thought…

Intradiscal therapies are those that involve the placement under imaging guidance of a needle, probe, or similar device into an intervertebral disc with the goal to reduce the patient’s presenting…

Superficial physical agents such as cold, heat, light, friction, and pressure have been used in therapy for thousands of years. Cryotherapy, or the use of cold, is restricted to superficial…

The sympathetic nervous system contains some of the afferent and efferent neural pathways necessary for generation, perpetuation, or treatment of certain clinical pain states. Sympathetic neural blockade may be useful…

Discogenic pain (DP) and internal disc disruption (IDD) imply that the disc is the source of a patient’s spinal pain. As will be discussed further in this chapter, DP is…