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An estimated 619 million people worldwide live with some form of lower back pain, making it the leading cause of disability. If you’re struggling with back pain that won’t go away, you might wonder whether you should visit a pain doctor or a surgeon.
A hybrid physician is a doctor whose practice combines surgical expertise with nonsurgical treatment skills. For spine care, that means understanding how to manage pain through targeted procedures and how to address structural problems through surgery.
At Silver Spine & Neurological Center - Interventional Pain Management & Spine Surgery, Dr. Silver brings that broader perspective to your care. A double board-certified neurosurgeon, he has over 20 years of experience in outpatient spinal surgeries and interventional pain management.
As a hybrid physician skilled in both surgical and nonsurgical approaches, he can help you understand which treatment fits your condition and when your care needs to change.
Back pain can develop for numerous reasons. Common ones are:
Different causes require different treatments. For example, an injection that reduces nerve inflammation won’t stabilize an unstable spinal segment. Likewise, surgery has little benefit when a structural problem can’t explain your symptoms.
Dr. Silver evaluates your symptoms, examines your spine and nerve function, and reviews imaging when appropriate. He considers how pain affects your sleep, walking, work, and everyday activities.
Your assessment helps establish whether your pain comes from nerve irritation, joint disease, instability, or another cause. It also helps us distinguish pain that stays in your back from symptoms that travel into your buttock or leg.
This approach supports a treatment plan that can evolve. You might start with physical therapy and medication, move on to injections if your condition worsens, or eventually need surgery. Seeing a physician who understands the full range of care helps connect those decisions.
Spinal injections deliver medication near a suspected pain source. An epidural steroid injection places anti-inflammatory medication around spinal nerves and may help when nerve irritation causes pain that travels down your leg.
A comprehensive 2025 American Academy of Neurology review confirmed that epidural steroid injections can modestly reduce pain and disability from spinal nerve irritation for up to three months. Benefits vary, so steroid injections can be highly effective in some patients while not providing lasting relief for everyone.
However, even temporary relief can still serve a purpose. Less pain may help you participate in physical therapy, rebuild strength, and increase activity.
Other injections help clarify a diagnosis. For example, a medial branch block temporarily numbs nerves serving the facet joints. Your response can help us assess whether those joints contribute to your pain and whether radiofrequency ablation deserves consideration.
Dr. Silver offers these interventional treatments alongside surgery, allowing him to assess where each procedure fits within your overall care.
Surgery may help when a clearly identified structural problem continues to cause disabling symptoms despite appropriate nonsurgical care.
For example, a surgeon may remove herniated disc material that presses on a nerve or create more room for nerves affected by spinal stenosis. Certain patients need stabilization when abnormal spinal movement contributes to their symptoms.
Increasing weakness or other progressive nerve symptoms may require earlier surgical evaluation. Seek emergency care for new loss of bladder or bowel control, numbness around your groin, or rapidly progressing leg weakness.
Dr. Silver’s experience includes minimally invasive and outpatient spinal surgery. Your diagnosis, overall health, and procedure determine whether outpatient treatment suits you.
A hybrid physician can explain what an injection might accomplish, what surgery could address, and the limitations of each treatment.
That perspective also supports timely reassessment. If an injection provides little meaningful benefit, we can reconsider the diagnosis and next steps. If nonsurgical treatment improves function, your plan can continue to build on that progress.
Your preferences matter throughout. Ask about expected benefits, risks, recovery time, and the consequences of waiting. Clear answers help you make informed decisions.
Managing chronic back pain often requires several treatments working together. Physical therapy, appropriate activity, medication, and targeted procedures can each play a role.
Contact Silver Spine & Neurological Center to schedule an evaluation and explore a plan that draws on both surgical and nonsurgical expertise. Call your nearest office or get in touch via the online form.