Pain-Free … Without Surgery

COVER STORY | Photos by Mary Favre –

Members of the Neuroscience & Spine Center care team: Christian Peccora, M.D., pain management specialist; Monique Dillard, PT, CLT; Jeffrey B. Wood, M.D., orthopedic spine surgeon and Irfan Lalani, M.D., neurologist.

At the Houston Methodist Neuroscience & Spine Center at Sugar Land, doctors and therapists successfully treat back pain with a variety of non-surgical treatments that provide lasting relief.

Greg Herring was helping his daughter paint a room in her house when it hit him like a lightning bolt – an excruciating pain in his back that just about knocked him off his feet.

Like many adult Americans, Herring had long suffered back problems on and off before, but this time was worse. “It was like my back just suddenly decided it wasn’t going to work anymore,” Herring recalled.

The 67-year-old Missouri City resident couldn’t walk more than a few steps before the pain would force him to stop. It quickly became clear that this injury wasn’t something he could just tough out. So he called the Houston Methodist Neuroscience & Spine Center at Sugar Land and scheduled an appointment with Irfan Lalani, M.D., board-certified neurologist and pain management specialist.

Imaging tests showed that Herring was suffering from spinal stenosis, a narrowing of the spaces within the spine that puts pressure on nerves. In addition, one of the bony structures in his spine had slipped out of place. To Herring’s relief, Lalani believed he could get better without surgery.

Non-Surgical Treatment for Back Pain

Back pain is one of the most common ailments that adults face. The multitude of forces placed on the back – bending, twisting, lifting and supporting – means that pain from overuse and just plain aging is almost certain at some point in everyone’s life.

While surgery can often be an effective treatment option, especially for severe conditions, it’s not always necessary. In fact, many back pain sufferers can find relief without surgery.

Doctors at the Neuroscience & Spine Center offer a wide range of surgical options. However, they also specialize in treating back and neck pain with non-surgical treatments that enable patients to minimize and manage their pain long-term, enabling a return to an active lifestyle.

“We have a number of options today for treating people without surgery,” said Lalani. “For many patients, a combination of physical therapy and lifestyle modifications – like more frequent exercise and improved ergonomics – can bring relief and make it possible to avoid future problems.”

Discover how we can be the solution to your back or neck pain.

Patients can expect:

• Expedited, timely appointments
• Access to world-class specialists and sub-specialists at Houston Methodist Sugar Land Hospital
• Customized, coordinated care from a multidisciplinary team
• Comfortable, accurate diagnostic testing with state-of-the-art technology

Houston Methodist Sugar Land Hospital.

The care team includes:

• Neurologists
• Neuroradiologists
• Neurosurgeons
• Orthopedic Spine Surgeons
• Pain Management Specialists
• Primary Care Sports Medicine Specialists
• Nurse Practitioners
• Physical And Occupational Therapists

To make an appointment with a Neuroscience & Spine Center doctor, call 281.205.4662 or go to and click on “Request an appointment.”

Customized Treatment Plans

Because every back injury or condition is unique, communication and coordination between the patient and the physician contributes to a successful outcome.

“We work closely with our patients on the design and implementation of their treatment program,” said board-certified anesthesiologist and pain management specialist Christian Peccora, M.D. “The objective is not to simply mask symptoms but to give patients the knowledge they need to understand the cause of their pain and the skills to prevent or manage future issues.”

The first step in the process is a thorough exam, including imaging, to identify the cause of pain.

Then, doctors work with patients to develop an individualized treatment plan that fits their needs. Most patients require some pain relief early in the process to provide enough mobility to allow physical therapy.

“While we do prescribe medications to help people with pain, we are very conservative, and we really focus on non-pharmacological treatments,” said Peccora.

In addition to physical therapy, doctors can administer an epidural steroid injection in which a corticosteroid and an anesthetic numbing agent are delivered into the affected area. The numbing agent provides immediate relief, while the cortisone reduces the swelling that is pressing on nearby nerves. Some patients find permanent relief from these injections, while others may need a reinjection in six months or more.

Doctors with the Neuroscience & Spine Center use several other treatments to help with pain relief, including facet joint injections, nerve blocks, botulinum toxin injections, implantable nerve and spinal cord stimulators and radiofrequency neurotomy, which uses heat to temporarily disable targeted nerves’ ability to transmit pain signals.

The Best Diagnostic Imaging

Dan Kershner, PT, encourages proper posture while on the treadmill to reduce low back pain.

One of the keys to the Neuroscience & Spine Center’s success is Houston Methodist Sugar Land Hospital’s sophisticated imaging capabilities that enable doctors to pinpoint neck and spine problems and accurately diagnose each patient’s condition.

The hospital houses three whole-body, 3-Tesla MRI scanners – the industry’s most powerful technology typically found only in the nation’s top academic medical centers — as well as advanced CT scanners that provide more detailed views than traditional units.

Physical Therapy that Works

Monique Dillard, PT, CLT, illustrates how practicing exercises on the total gym engages core muscles while performing a functional activity.

Houston Methodist Sugar Land also offers one of the country’s leading physical therapy/rehabilitation programs. Trained experts in back and neck therapy work directly with Neuroscience & Spine Center physicians to create and implement training plans that help patients overcome their injury or condition, reduce or eliminate pain and regain their mobility.

Houston Methodist Sugar Land is one of just a handful of sites in the U.S. offering resident and fellowship training programs in physical therapy, which requires a highly skilled, experienced staff that stays up-to-date on the latest techniques and studies.

A Wealth of Advantages

The Neuroscience & Spine Center offers a number of advantages that provide direct benefits to patients. For example, the entire range of care – from imaging to treatment to surgery, if necessary – is available on-site at Houston Methodist Sugar Land, with no need to travel to multiple locations all over town.

Monique Dillard, PT, CLT, educates how to engage abdominal muscles to support the low back.

In addition, the center has a patient care navigator, Dave Graves, who provides information and assistance as needed and works to expedite appointments for patients. In fact, most patients are scheduled within a few days with a specialist.

For complex cases that don’t respond to therapy, medication or anti-inflammatory injections, the Neuroscience & Spine Center physicians also offer the most advanced surgical options. “Back and neck surgery are sometimes necessary to eliminate pain,” said Jeffrey Wood, M.D., board-certified orthopedic spine surgeon also with Houston Methodist Neuroscience & Spine Center. “If a patient requires surgery, they can take comfort in knowing we have highly-trained surgeons, nurses and technical staff who understand what the patient needs and ensure the success of the surgery.”

Pain-Free and Pleased

For Herring, physical therapy in conjunction with an epidural steroid injection, helped him overcome his initial pain and begin moving. Initially, the therapy team had him working to stretch his muscles and improve his flexibility, and later, as his condition improved, he focused on strengthening his core to give his back more support.

“The therapists were great,” said Herring. “They were very conscious of my movements and were always looking out to make sure that I wasn’t hurting. They were always in tune with me, and I could see myself getting better each time I went.”

Herring is still exercising at home, using the program his therapists provided. He is grateful to the team at the Neuroscience & Spine Center for the care and treatment he received. “I was very impressed with Dr. Lalani and everyone at Houston Methodist Neuroscience & Spine Center,” said Herring. “From the very beginning, I felt like I was in good hands.”

To make an appointment with a Neuroscience & Spine Center doctor, call 281.205.4662 or go to and click on “Request an appointment.”