Common symptoms include chronic, severe pain in the neck, often with radiation to the shoulder, arm, or hand. The pain is present all day for weeks, months, or years. The pain may be accompanied by severe back pain and may worsen with prolonged sitting or standing. The pain is debilitating.
MRI Findings include: Disc bulge, protrusion, herniation, or annular tear involving one or more cervical discs — most commonly c4-5 or c5-6. A single small bulge may be associated with severe pain. Pain due to an annular tear, without a disc protrusion, is often undiagnosed for years.
Common disc disorders, such as disc herniation, disc protrusion, disc bulge, and annular tears of the disc capsule may also affect the neck, producing severe, chronic pain which fails to adequately respond to medical treatment. Disc disorders in the neck often product pain which radiates to the trapezius, shoulder, or down the arm, and may be associated with hand and arm weakness or numbness (cervical radiculopathy), or headache (cervicogenic headache). Consultation, evaluation and anti-TNF treatment are managed in the same way as for patients with chronic severe back pain or sciatica. Please see the video of a patient treated utilizing the INR’s patented local anti-TNF etanercept treatment in 2001. A gentle, rapid, off-label method that takes only minutes, and is done in the privacy and comfort of our office. Anesthesia is not necessary, and following a brief visit patients may return directly to their usual daily activities.
INR medical providers now have been using this fast, gentle, non-surgical method for a decade, with thousands of patients treated, from around the world. This revolutionary approach for severe back pain, neck pain, or sciatica, and other breakthroughs invented at the INR, are cited by scientific publications by physicians and scientists from around the world; are now supported by multiple-studies and multi-center clinical data; and are available for you, today.
What we treat
For further background, please see the following scientific publications:
- Perispinal etanercept: a new therapeutic paradigm in neurology. Edward Tobinick MD. Expert Review of Neurotherapeutics. 2010 Jun;10(6):985-1002.
- Efficacy of etanercept delivered by perispinal administration for chronic back and/or neck disc-related pain: a study of clinical observations in 143 patients. Edward Tobinick MD, Susan Davoodifar MD. Curr Med Res Opin. 2004 Jul;20(7):1075-85.
- Targeted etanercept for discogenic neck pain: uncontrolled, open-label results in two adults. Edward Tobinick MD. Clinical Therapeutics. 2003 Apr;25(4):1211-8.
- Targeted etanercept for treatment-refractory pain due to bone metastasis: two case reports. Edward L. Tobinick MD.Clinical Therapeutics. 2003 Aug;25(8):2279-88.
- Perispinal TNF-alpha inhibition for discogenic pain. Edward L. Tobinick MD, Susan Britschgi-Davoodifar. Swiss Med Wkly. 2003 Mar; 133(11-12):170–7.
- Randomized, double-blind, placebo-controlled, dose-response, and preclinical safety study of transforaminal epidural etanercept for the treatment of sciatica. Cohen SP, Bogduk N, Dragovich A, Buckenmaier CC 3rd, Griffith S, Kurihara C, Raymond J, Richter PJ, Williams N, Yaksh TL. Anesthesiology. 2009 May;110(5):1116-26.PMID:19387178.
- Tumor Necrosis Factor-Alpha Antagonist Reduces Apoptosis of Neurons and Oligodendroglia in Rat Spinal Cord Injury.Chen KB, Uchida K, Nakajima H, Yayama T, Hirai T, Watanabe S, Guerrero AR, Kobayashi S, Ma WY, Liu SY, Baba H. Spine (Phila Pa 1976). 2011 Jan 8. [Epub ahead of print] PMID: 21224756.
- Etanercept restores the antinociceptive effect of morphine and suppresses spinal neuroinflammation in morphine-tolerant rats. Shen CH, Tsai RY, Shih MS, Lin SL, Tai YH, Chien CC, Wong CS. Anesth Analg. 2011 Feb;112(2):454-9.PMID:21081778.
- Direct application of the tumor necrosis factor-alpha inhibitor, etanercept, into a punctured intervertebral disc decreases calcitonin gene-related peptide expression in rat dorsal root ganglion neurons. Horii M, Orita S, Nagata M, Takaso M, Yamauchi K, Yamashita M, Inoue G, Eguchi Y, Ochiai N, Kishida S, Aoki Y, Ishikawa T, Arai G, Miyagi M, Kamoda H, Kuniyoshi K, Suzuki M, Nakamura J, Toyone T, Takahashi K, Ohtori S. Spine (Phila Pa 1976). 2011 Jan 15;36(2):E80-5. PMID: 21057386.
- Therapeutic evaluation of etanercept in a model of traumatic brain injury. Chio CC, Lin JW, Chang MW, Wang CC, Kuo JR, Yang CZ, Chang CP. J Neurochem. 2010 Nov;115(4):921-9. doi: 10.1111/j.1471-4159.2010.06969.x. Epub 2010 Sep 28. PMID:20796174.
- Paths to acceptance. The advancement of scientific knowledge is an uphill struggle against ‘accepted wisdom’. Wolinsky H. EMBO Rep. 2008 May;9(5):416-8.
Disclaimer: Individual results vary, not all patients respond. Continuing maintenance treatment is necessary to maintain the clinical response. Anti-TNF treatment for the indications below is off-label. Please see the Terms of Use. Maintenance dosing, usually weekly, but sometimes as little as monthly, is necessary for optimal effect. The method of local etanercept treatment utilized for these patients is a patented invention of the INR