Regenerative Treatment · Interventional Pain Management Diagnosis and treatment at the source

Chronic spinal pain is often multifactorial. We use targeted diagnostic procedures to identify exactly which structures are generating your pain, then deliver regenerative treatment with certainty.

Chronic spinal pain is diagnostically challenging because multiple structures can refer pain to the same region. Low back pain may originate from a degenerating disc, an arthritic facet joint, a lax sacroiliac joint, or a combination of all three. Imaging alone cannot reliably identify which structure is the primary pain generator; MRI shows structural abnormalities, but abnormalities do not always correlate with pain.

Interventional pain management resolves this diagnostic uncertainty through targeted, image-guided procedures that test each structure individually. By selectively anesthetizing one structure at a time and assessing your pain response, we build a precise map of which structures are generating your symptoms. This diagnostic process is not preliminary to treatment—it is the foundation of treatment. Without knowing which structure to treat, regenerative therapy is speculative. With diagnostic confirmation, it is targeted.

Diagnostic Procedures

  • Medial branch blocks. Small-volume anesthetic injected onto the medial branch nerves that innervate a specific facet joint. If the block relieves your pain, the facet joint at that level is confirmed as a pain generator. This is the gold standard for diagnosing facet arthropathy.
  • Selective nerve root blocks. Anesthetic placed at a specific spinal nerve root under fluoroscopic guidance. Pain relief confirms that the targeted nerve root is the source of radicular symptoms. Essential for diagnosing the specific level of stenosis or disc herniation responsible for your symptoms.
  • SI joint diagnostic injection. Anesthetic injected into the sacroiliac joint under image guidance. Greater than 75% pain relief confirms the SI joint as the primary pain generator.
  • Provocation discography. A controlled procedure that pressurizes individual discs to determine whether a specific disc reproduces your typical pain pattern. This identifies the symptomatic disc in patients with multi-level disc degeneration.

Diagnosis drives treatment. We do not guess which structure to treat. Every regenerative treatment plan at Bluetail Medical Group begins with diagnostic confirmation of the pain source. This approach eliminates the trial-and-error that characterizes conventional pain management and ensures that regenerative biologics are delivered to the structure that will benefit most.

Therapeutic Procedures

Once the pain-generating structure is identified, therapeutic intervention targets that structure with precision:

  • Intra-articular regenerative injection. PRP, BMAC, or prolotherapy delivered directly into the facet joint, SI joint, or other synovial articulation confirmed as the pain source.
  • Intradiscal biologic therapy. PRP or BMAC injected directly into the nucleus pulposus of a confirmed symptomatic disc, targeting the cellular environment responsible for degeneration.
  • Perineural injection therapy. Targeted treatment around inflamed or irritated nerve roots, reducing neuroinflammation and supporting nerve healing.
  • Ligament and enthesis injection. Prolotherapy or PRP at the ligament-bone interface for confirmed ligamentous instability contributing to spinal pain.
  • Epidural biologic injection. Delivery of regenerative agents into the epidural space for conditions involving neural inflammation, disc-nerve interaction, or central canal pathology.

Integration with Regenerative Medicine

Interventional pain management and regenerative medicine are not separate disciplines at Bluetail Medical Group—they are integrated components of the same clinical approach. The interventional techniques provide the diagnostic precision. The regenerative biologics provide the therapeutic substance. Image guidance provides the delivery accuracy. Together, they form a system in which the right treatment reaches the right structure at the right time.

This integration is what distinguishes our practice from conventional pain management, which often relies on steroid injections and nerve ablation—approaches that suppress inflammation and silence nerves without addressing tissue degeneration. Our interventional approach uses the same procedural skill and imaging precision, but delivers regenerative agents that promote tissue repair rather than simply managing symptoms.

When Interventional Pain Management Is Appropriate

Interventional procedures are appropriate when clinical examination and imaging have narrowed the differential diagnosis but have not definitively identified the pain-generating structure. They are also appropriate when conservative measures (medication, physical therapy, activity modification) have failed to provide adequate relief and a more targeted approach is needed.

Not every patient requires interventional diagnostics. When the clinical picture is clear—a single-level disc herniation with corresponding radiculopathy, for example—we may proceed directly to treatment. But when the picture is complex, when multiple structures are potentially involved, or when prior treatments have failed, interventional diagnostics provide the clarity needed to direct effective therapy.

Ready to find your pain source

Schedule your interventional pain management consultation with Dr. Crane.

Precision diagnostics guide precision treatment. Let's identify exactly which structures are generating your pain and develop a targeted regenerative therapy plan.