Resolution Spine and Joint · Cary, NC
Your Questions,
Answered.
New to interventional spine care? We've put together honest, plain-language answers to the questions we hear most.
Procedures and Treatments:
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Interventional spine care sits between your primary care doctor and a spine surgeon. We specialize in precisely identifying the source of your pain and treating it with image-guided procedures, without surgery.
Rather than simply managing symptoms with medication, we use tools like fluoroscopy (live X-ray) and ultrasound to guide injections and treatments to the exact location causing your pain. Most of our procedures are done right in our office and take under an hour.
Think of it this way: If your primary care doctor is the first step and surgery is the last resort, we're the specialists in the middle who can often resolve or dramatically reduce pain without an operating room.
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An epidural steroid injection (ESI) delivers an anti-inflammatory steroid and a local anesthetic directly to the area around an irritated spinal nerve. It's one of the most common and well-studied treatments for disc herniations, spinal stenosis, and sciatica.
The procedure typically takes 15–20 minutes. Your skin is numbed first, so most patients feel pressure or mild discomfort, not sharp pain. You'll be awake throughout. We use live X-ray (fluoroscopy) to ensure the medication goes exactly where it needs to go.
Most patients describe it as: "Less uncomfortable than I expected." You can drive yourself home if no sedation is used, though we recommend bringing someone with you for your first time.
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Radiofrequency ablation (RFA) uses precisely controlled heat to disrupt the small nerves that carry pain signals from arthritic facet joints in the spine. It doesn't treat the joint itself, it stops the pain signal from getting through.
RFA typically provides relief for 12 to 24 months, and in many patients even longer. It's usually offered after a diagnostic test called a medial branch block confirms that those specific nerves are the source of your pain.
The procedure takes about 30–45 minutes. Some patients experience soreness for a few days afterward as the nerves settle, this is normal and temporary.
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A medial branch block is a short diagnostic injection that temporarily numbs the nerves we're planning to treat with RFA. It serves as a "test run" - if you experience significant pain relief after the block, it confirms that those nerves are the true source of your pain, and that RFA is very likely to help you.
Skipping this step would mean performing a more involved procedure without knowing it will work. Most insurance carriers also require this diagnostic step before authorizing RFA. We know it can feel like an extra step, but it meaningfully improves outcomes.
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Platelet-Rich Plasma (PRP) therapy uses your own blood to promote healing. We draw a small sample, spin it in a centrifuge to concentrate the platelets and growth factors, and inject that concentrate into the affected area.
Unlike a steroid injection (which reduces inflammation but doesn't heal tissue), PRP is designed to actually accelerate your body's natural repair process. It's commonly used for knee and hip osteoarthritis, tendon injuries, and certain joint conditions.
Important note: PRP is generally not covered by insurance and is offered as an out-of-pocket treatment. We'll discuss all costs transparently before scheduling.
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A spinal cord stimulator (SCS) is a small implantable device, about the size of a matchbox, that delivers gentle electrical pulses to the spinal cord to interrupt pain signals before they reach the brain. Patients describe it as replacing pain with a mild sensation or simply nothing.
It's typically considered for patients with chronic, hard-to-treat pain that hasn't responded to other treatments, particularly failed back surgery syndrome, CRPS, or severe neuropathic leg pain.
Importantly, a trial period is always done first, a temporary version is placed for 5–7 days so you can evaluate whether it actually helps you before any permanent implant is considered.
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Kyphoplasty is a minimally invasive procedure for vertebral compression fractures, most often caused by osteoporosis or a fall. A small balloon is inserted into the collapsed vertebra to gently restore height, then a medical-grade cement is injected to stabilize it.
Most patients go home the same day. Many report dramatic pain relief within 24–48 hours. It is not a major surgery and does not require general anesthesia in most cases.
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We treat the full range of musculoskeletal pain, not just the spine. We offer image-guided injections for the knee, hip, shoulder, and sacroiliac (SI) joints, as well as regenerative treatments like PRP for joint conditions.
If you're unsure whether your condition is within our scope, just call us at 919-655-4757 and our team can advise you before scheduling.
What to Expect at Appointments
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Your first visit is a comprehensive evaluation, not a procedure. Your physician will spend time reviewing your full medical history, prior imaging, current medications, and the story of your pain. A physical examination will follow, and together you'll build a personalized treatment plan.
Please allow about 60 minutes for your first visit. We recommend arriving 15 minutes early to complete paperwork.
You will not receive any injections at your first visit unless specifically arranged in advance. The goal is to understand your condition fully before recommending any treatment.
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Photo ID and your insurance card
A list of all current medications and dosages
Any relevant imaging, MRI, CT scan, or X-rays on disc or with written reports
A referral from your primary care or referring physician, if required by your insurance
Any prior procedure notes or surgical records related to your condition
Can't find your imaging? Call us before your appointment and we can help you request records from your previous providers.
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Not always, but it depends on your insurance plan. Many PPO plans allow you to self-refer to a specialist. HMO plans typically require a referral from your primary care physician before they'll cover a specialist visit.
We recommend checking with your insurance provider before your appointment. If you do need a referral and haven't gotten one yet, your primary care doctor's office can usually arrange this quickly.
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If you take blood thinners, including warfarin, clopidogrel (Plavix), rivaroxaban, apixaban, or even daily aspirin, you may need to pause these before certain procedures to reduce bleeding risk.
Our team will give you personalized instructions based on your specific medication and the procedure planned. Please do not stop any medication on your own without receiving those instructions from us first, especially blood thinners prescribed for heart conditions.
When in doubt, call us: 919-655-4757. We'd rather answer the question twice than have you manage it alone.
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If your procedure involves sedation or IV medication, yes, a responsible adult driver is required. You will not be cleared to drive yourself home, and we will need to confirm your ride before the procedure begins.
For procedures that involve only local anesthesia at the skin level and no sedation, driving yourself is generally fine. We'll confirm this specifically when we schedule your procedure.
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Most in-office procedures take 15–45 minutes from start to finish. However, you should plan for 1 to 2 hours total at our office to account for check-in, pre-procedure assessment, the procedure itself, and a brief recovery period before you're cleared to leave.
We'll give you a more specific estimate when your procedure is scheduled.
It's typically considered for patients with chronic, hard-to-treat pain that hasn't responded to other treatments, particularly failed back surgery syndrome, CRPS, or severe neuropathic leg pain.
Importantly, a trial period is always done first, a temporary version is placed for 5–7 days so you can evaluate whether it actually helps you before any permanent implant is considered.
Recovery & Aftercare
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It depends on the type of injection. Most injections contain a local anesthetic that may provide partial relief within a few hours, but this is temporary as the numbing agent wears off. The actual therapeutic effect from the steroid component typically builds over 3 to 7 days and may continue improving for up to two weeks.
If your pain returns to baseline after the anesthetic wears off before the steroid kicks in, that's completely normal, it doesn't mean the injection didn't work.
Keep a simple pain diary for the first 2 weeks after your procedure. Rating your pain morning and evening gives your doctor valuable feedback at your follow-up.
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For most injections, we recommend taking it easy for the rest of the day. For the first 24 hours, please avoid:
Strenuous activity or heavy lifting
Submerging the injection site (pools, hot tubs, baths)
Driving if sedation was used
Light activity like walking is generally encouraged and beneficial. You should be able to return to desk work the following day in most cases. Your care team will give you procedure-specific instructions before you leave.
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Yes, a temporary increase in pain (called a "post-injection flare") can occur in the 24–48 hours following a steroid injection. It usually resolves on its own. Applying ice to the area for 15–20 minutes several times a day can help.
However, please call us immediately if you experience:
Fever or chills
Severe pain that is significantly worse than your baseline
New weakness, numbness, or loss of bladder/bowel control
Redness, swelling, or discharge at the injection site beyond 48 hours
These are rare but warrant prompt evaluation.
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This is genuinely individual. Some patients achieve lasting relief from a single procedure. Others benefit from a planned series, or from combining interventional treatment with physical therapy and rehabilitation. We don't follow a rigid protocol, your plan evolves based on how you respond.
We'll always discuss the realistic goals and expected timeline for your specific condition before any treatment begins, so you know what to expect.
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For many patients, yes, and we think of interventional procedures and rehabilitation as complementary, not competing. A well-placed injection can reduce pain enough to allow you to engage fully in physical therapy, which then helps stabilize the area and reduce the likelihood of pain recurring.
We offer rehabilitation services and functional restoration programs in-house, and we coordinate with physical therapy providers as part of your care plan when needed.
Insurance and Billing
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We accept most major commercial insurance plans and Medicare. Because insurance networks change frequently, we recommend calling our office directly at 919-655-4757 to verify that your specific plan is in-network before your first visit.
We also welcome self-pay patients. Please ask about transparent self-pay pricing when you call.
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Many interventional procedures, including injections, radiofrequency ablation, and spinal cord stimulation, require prior authorization from your insurance company before they'll cover the cost. This is standard in our specialty.
Our team manages this process on your behalf. We'll submit documentation to your insurer and follow up as needed. If your insurance requires additional information from you, we'll contact you directly. We will not schedule a procedure without confirming coverage first whenever possible.
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Unfortunately, most regenerative treatments, including PRP, are currently classified as "investigational" by the majority of insurance carriers and are not covered. This is true across most practices in our specialty, not something unique to our clinic.
We will always discuss costs transparently with you before any out-of-pocket treatment is scheduled. We never assume you want to proceed without a clear conversation about what's involved financially.
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You can pay online anytime through our secure patient billing portal here You can also pay by phone or in person at the time of your visit.
If you have questions about your bill or need to discuss a payment arrangement, please call our billing team at 919-655-4757 - we're happy to work with you.
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We welcome self-pay patients and believe everyone deserves access to quality spine care. We're happy to discuss our self-pay rates and any available payment options before you commit to anything. Please call us at 919-655-4757 so we can provide transparent pricing for the services you're considering.
About Our Practice
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Our physicians are Dr. Peng Bai, DO and Dr. Schmidt, both fellowship-trained in interventional spine and pain management. Dr. Bai is nationally recognized as a clinical instructor for the North American Spine Society and serves as co-chair of the NASS Coding Committee, bringing subspecialty expertise that few practices in our region can match.
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We are located at 1505 SW Cary Parkway, Suite 201, Cary, NC 27511. We serve patients throughout the greater Triangle region, including Raleigh, Durham, Apex, Morrisville, Holly Springs, Chapel Hill, and surrounding communities.
If you're unsure whether traveling to us makes sense for your situation, call us we're happy to help you think it through.
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Monday – Thursday: 8:00 AM – 5:00 PM
Friday: 8:00 AM – 12:00 PM
Saturday & Sunday: ClosedFor after-hours urgent concerns, you can reach our after-hours line at 919-855-0555.
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You can pay online anytime through our secure patient billing portal here You can also pay by phone or in person at the time of your visit.
If you have questions about your bill or need to discuss a payment arrangement, please call our billing team at 919-655-4757 - we're happy to work with you.
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Absolutely. While we specialize in non-surgical care, our commitment is to your outcomes, not to keeping you in our practice. If your condition requires surgical evaluation, we will tell you directly and refer you to an appropriate spine surgeon.
In many cases, we continue to co-manage patients before and after surgery, providing adjunctive procedures and rehabilitation. Your best outcome is always the goal.
Still have questions?
Our team is happy to talk through your situation before you book.