At our clinic we use physical medicine and rehabilitation approach for pain management with body mechanics and spine mechanics as the basis of the approach to analyze the pain source. We do a detailed evaluation including a thorough examination and discuss with the patient possible pain sources and with that in mind various possible options of non-surgical treatments. The treatment focus is to involve the patient in decision-making providing information about the role of physical management, medication management, and role of various injections. Physical management focus includes physical therapy, chiropractic care, pool therapy, and life style modifications. Medications discussion includes various available classes of medications including nerve-based medications, local applications and non-narcotic and narcotic medications. Injections discussed include office-based injections, and injections performed under X-ray guidance including joint injections and epidural injections. Certain advanced procedures are also discussed as needed. An appropriate amount of discussion about the indications to see a surgeon is also done.