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Advanced Pain Management

Dr. Deuk
An expert in all things spine, Dr. Deukmedjain is a board certified neurosurgeon who has performed thousands of minimally invasive surgeries and procedures including the revolutionary Deuk Laser Disc Repair and the Deuk Spinal Fusion. 

If you're suffering from chronic back and neck pain, it can negatively impact your life. 

People suffering from chronic pain find it difficult to engage in basic activities such as dancing, swimming, and even playing around with their kids.

One way of managing chronic pain is through advanced pain management. In this article, you'll learn everything you need to know about advanced pain management.

What is Advanced Pain Management?

Before delving into advanced pain management, we need to understand more about chronic pain.

There are various types of chronic pains, but the most common ones are:

  • Back pain &
  • Neck Pain

Back Pain

You can watch a comprehensive video on what causes back pain here:

Every day millions of people across the United States experience back pain. Back pain can occur when there’s a traumatic injury to a disc in the spine, which causes an annular tears to form. The pressure on the disc causes herniation of the nucleus pulposus through the annular tear. This causes inflammatory tissue to develop within the annular tear, causing back pain. The inflamed annular tear generates pain signals. When this occurs, additional injuries can cause symptoms to worsen. Inflammation from the annular tear can spread to nearby nerve roots, causing leg pain. Signals travel up nerves to the brain, causing localized back pain. 

Neck Pain:

You can watch a comprehensive video on what causes neck pain here:

Over 30% of adults in the US suffer from neck pain. Neck pain occurs when a traumatic injury of a disc in the spine causes an annular tear to form. Pressure on the disc causes herniation of the nucleus pulposus through the annular tear. This causes inflammatory tissue to develop within the annular tear, causing neck pain. The inflamed annular tear generates pain signals. Additional injuries can cause worsening symptoms. Inflammation from the annular tear can spread to the nearby nerve root, causing arm pain. Pain signals travel up the nerves to the brain, causing localized neck pain.

Understanding Advanced Pain Management

Advanced Pain Management is devoted to diagnosing and treating pain-related disorders mainly with the application of interventional techniques in managing chronic, persistent pain, independently or in conjunction with other forms of treatment.

Advanced pain management helps reduce and manage pain while also improving a patient's overall quality of life using minimally invasive techniques designed to diagnose and treat chronic conditions. It also strives to help patients return to their daily lives with little to no reliance on medications.

Doctors who engage in advanced pain management must have special training in evaluating, diagnosing, and treating different types of pain, including:

  • Possessing an in-depth knowledge of the physiology of pain.
  • Having an understanding of the various specialized tests used in diagnosing painful conditions. 
  • The ability to prescribe medications to varying pain problems.
  • Possessing enough skill to perform procedures (such as Epidural Injections, Facet Block Injections, Platelet-rich plasma (PRP) therapy, and other interventional techniques).

Advanced Pain Management Treatments for Back Pain (Non-surgical)

If you’re suffering from chronic back and neck pain, various advanced pain management treatments can be employed. 

These treatments include:

BMAC (Bone Marrow Aspirate Concentrate) Therapy

BMAC therapy is a stem cell-based therapy because bone marrow houses stem cells, forming new bone, cartilage, and muscle cells. A special needle is used to gather the bone marrow. This needle can collect a high concentration of stem cells from a patient's marrow. The newly concentrated stem cells are then injected into the problematic area to stimulate cell regeneration.

PRP Therapy

Platelet-rich plasma therapy is a method of concentrating platelets from the patient’s blood. This concentrate contains healing cells such as stem cell signaling markers, growth factors, and white blood cells. PRP therapy stimulates the healing process, promoting increased tissue strength, reducing pain, and improving overall function.

Epidural Injections:

Epidural steroid injections are used in the treatment of low back, neck, and leg pain. It may be used alone or in combination with other pain management measures. In some instances, epidural injections have proven to be an effective pain management tool for those with sciatica, a disease that causes numbness, weakness, and tingling to travel down the lower back and into the legs.

Facet Block Injections

Many pain management techniques involve the application of a nerve block injection. Nerve blocks serve to block the transmission of pain signals from the spine. Depending on each individual's particular circumstances, nerve blocks may be applied by injecting alcohol or phenol or, in some cases, through freezing techniques or the creation of heat lesions.


A radiofrequency rhizotomy injection (RFA) procedure uses radiofrequency heat to deaden nerves that transmit pain signals from the spine. 

Rhizotomy injection can also be used to manage pain effectively when the pain is due to osteoarthritis of the spine's facet joints. Various other facet block procedures can also block the transmission of pain signals from the facet joint.

Best Surgical Alternative For Treating Back Pain

The best surgical alternative for treating chronic back and neck pain is deuk laser disc repair.

Deuk Laser Disc Repair

Deuk Laser Disc Repair is an alternative to dangerous invasive spine surgeries like total disc replacement and spinal fusion. It is the most advanced laser surgery in the world.

This revolutionary procedure was developed by Dr. Ara Deukmedjian MD, a world-renowned neuro-spine surgeon and a true pioneer in minimally invasive, laser, and endoscopic back and neck pain treatment.  

Deuk Laser Disc Repair is a form of endoscopic spine surgery performed in a state-of-the-art surgery center under sedation while the patient relaxes. This procedure does not compromise or weaken the health and integrity of the spine.

If you have a herniated or bulging disc or chronic back or neck pain, submit your MRI for a free review

Here's how it works:

To get started, Deuk Laser Disc Repair requires a very small incision, less than a quarter inch long. A cylindrical rod called a dilator is inserted in the small opening to gently spread the muscle to create a small passage and guide through which the surgery is performed endoscopically. The tip of the dilator is advanced into the symptomatic disc through the tear in the annulus where the herniation originates, and a tube called the retractor slides over the dilator and is carefully positioned into the painful disc. The rest of the entire Deuk laser disc repair surgery will occur inside this narrow tube.

To access the spine, an endoscopic camera is inserted into the tubular retractor to allow the surgeon to guide the laser inside each symptomatic disc. This process ensures that bones and surrounding tissues are not damaged, unlike traditional spinal fusions, microdiscectomy

and artificial discs.

The Holmium YAG laser used in the Deuk laser disc repair is manipulated accurately with millimeter precision under endoscopic visualization to remove only painful inflammatory tissue from the back of the disc. The laser is precisely used to remove damaged disc material that is causing the pain. This process is called debridement of the annular tear and Dr. Ara Deukmedjian MD was the first in the world to use and publish this technique.

Once the laser has removed the inflamed painful part of the annular tear and the herniated nucleus pulposus, the endoscope and tubular retractor are removed, leaving less than one-quarter inch incision in the skin, which can be closed with a single stitch and a band-aid. 

The total time for the Deuk laser disc repair surgery is one hour, and the patient is in recovery for about 45 to 60 minutes before being released to go home. Hospitalization is not needed and the risks of hospital-based surgery are avoided. 

Also, with the Deuk laser disc repair, there’s no loss of normal movement, and the flexibility of the disc and joint is preserved. With endoscopic Deuk laser disc repair there is no fusion, metal implants or biological material added to the spine. The procedure is all natural allowing your body to heal the herniated or bulging disc itself.

After the surgery, the Deuk laser disc repair patient is back home, enjoying life with a speedy recovery allowing normal activities without pain. Another advantage of Deuk laser disc repair is that no opioids or powerful narcotic painkillers are needed after surgery. Open spine surgeries like microdiscectomy, laminectomy, artificial disc replacement and fusion all cause so much internal trauma that patients are in severe pain after surgery and must take painkillers for weeks after their surgery but not with Deuk laser disc repair.

Conditions treated by Deuk Laser Disk Repair

Herniated Disc

Herniated disc can cause back or neck pain, arm or leg discomfort and even advance into more complicated syndromes such as sciatica, pinched nerves, radiculopathy, or myelopathy. We call pain originating in a damaged disc “discogenic” pain.

There are 23 intervertebral discs in the spinal column. These discs are soft tissue joints composed of a hydraulic gelatinous core called the nucleus pulposus encased within a firm outer collagen wall termed the annulus fibrosus. The discs protect the spinal vertebrae and nerves from sudden impact and absorb shock from movements of the spine like bending, twisting and jumping. 


Unfortunately, the disc's outer wall, the annulus fibrosus, can develop traumatic tears (annular tear), allowing the jelly-like nucleus pulposus to push backward out of the tear into the spinal canal or neural foramen. 

The part of the jelly nucleus pulposus that pushes out through the tear is called the herniation. In many cases, this hernia can impinge on a nerve, giving rise to inflammation and irritation of the affected nerve. 

Treatment for a herniated disc

Herniated discs can easily be repaired with laser spine surgery at Deuk Spine Institute using state-of-the-art minimally invasive endoscopic techniques. 

The Deuk Laser Disc Repair is the only proven, peer-reviewed and published surgery that uniquely treats the painful inflamed annular tear that is the source of back or neck pain coming from a herniated disc. Dr. Ara Deukmedjian MD, a board certified neurosurgeon, discovered through his endoscopic technique that back and neck pain could be cured when the posterior annular tear of the painful herniated disc(s) was debrided with a medical laser. 

No other spine surgeon has this technology which is why patients treated elsewhere continue to have back or neck pain long after their spine surgery is over. Submit your MRI for a free review.

Bulging Disc:

A bulging disc occurs when the disc —a soft tissue sac — between the vertebrae bones of the spine ruptures or shifts outside of the area it should be in. Also called a ruptured or slipped disc, this problem can occur in the neck or thoracic area, but is most common in the lower back, called the lumbar region.

The most common symptom of a bulging disc is back or neck pain. Other symptoms often include numbness and tingling in the parts of arms or legs that lie on the path of the affected nerve roots, weakness in the limb muscles, and pain that originates in the spine and travels into the arms or legs. In extreme cases, patients might experience difficulty controlling bladder actions.

Treatment for bulging discs

Similar to herniated discs, bulging discs can also easily be repaired with laser spine surgery at Deuk Spine Institute using state of the art minimally invasive endoscopic techniques. Submit your MRI for a free review.

Degenerative Disc Disease

Untreated disc inflammation can lead to degenerative disc disease. The pain in your back from degenerative disc disease comes from irritated (inflamed) nerve fibers within the nearby annular tear.

Degenerative Disc Disease involves a variety of structural, biochemical, nutritional and molecular changes that occur in the spinal disc over time or following an initial injury to the intervertebral spinal disc in your spine. Degenerative disc disease is a common cause of back pain and neck pain (discogenic pain), sciatica and radiculopathy

Treatment for degenerative disc disease

Deuk Laser Disc Repair is the most effective surgery designed to specifically treat degenerative disc disease as well as herniated or bulging discs. This minimally invasive spine surgery uses a small incision, has over a 95% success rate, provides a fast recovery time, and does not weaken the spine by cutting the bone. Submit your MRI for a free review.

Spinal Stenosis

Spinal stenosis occurs when the spinal canal or neural foramen narrows and puts pressure on the important spinal nerves. Spinal stenosis is called thoracic stenosis when it occurs in the middle to upper part of the back, cervical stenosis when it occurs in the neck area, and lumbar stenosis in the lower back area. Narrowing can happen for several reasons, the most common being herniated discs and other causes such as ligaments and cartilage thickening in the canal, or excessive bone growth simply causing the opening to become more slender over time. The risk of this problem increases as a patient passes 50 years of age, due in part to years of stress on the spine and the tendency of tissue and bone to become less sturdy or flexible with decades of repeated use. Disc disease or spinal injury may also be contributing factors in stenosis of the spine, in patients of any age.

Treatment for Spinal Stenosis

Deuk Spine Institute is proud to work with patients in need of many different kinds of spinal stenosis pain relief. Some of our most advanced treatment options include physical therapy plans, injections, and surgery. If you or someone you know is suffering from severe pain associated with cervical, thoracic or lumbar spinal stenosis, Deuk Spine Institute can perform an advanced laser spinal stenosis surgery, which has over a 95% success rate. Many common medical websites, including sites such as WebMD, state that there is no cure for spinal stenosis, but Dr. Deuk, his team, and his results have proven them wrong time and time again.

Deuk Spine Institute sees patients from across the US and throughout the world to have their severe spinal stenosis treated using an advanced laser spinal stenosis surgery techniques. Submit your MRI for a free review.

Curing Chronic Pain

While we treat a variety of spinal conditions, we ultimately treat chronic pain. We understand that becoming pain-free can feel like being reborn. At Deuk Spine Institute, we use world-class interventional pain management techniques, therapy, and groundbreaking surgeries such as Deuk Laser Disc Repair to free our patients from chronic pain.

For more information about Deuk Spine Institute and to begin your path towards living a pain-free life → click here  to visit our website or submit your MRI for a free review

Cure your back and neck pain once and for all.

Deuk Laser Disc Repair has patients back on their feet within an hour, feeling zero pain
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About Deuk Spine Institute
World leader in Laser Spine Surgery
With world-class physicians on staff, the newest and most advanced technology, and a patient experience pathway that is unrivaled in it’s efficiency and and pedagogy of care, Deuk Spine Institute has performed thousands of procedures and achieves a 95% success rate in elimination of pain.

 The services we offer are not offered anywhere else in the world, and the treatments are curative, not palliative.  On top of that, Dr. Deukmedjian is personally invested in the well-being of each and every patient, and has spared no expense to guarantee the best possible outcomes.
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