If you’re experiencing back pain, you might not know where to turn. If you are in High Point or the surrounding area, neurosurgeon Dr. Michelle De Witt of Novant Health Brain & Spine Surgery and interventional spine specialist Dr. Kyle Sebastian of Novant Health Spine Specialists are ready to help you figure out what’s going on — and how to feel better.

Here they explain just how they do that.

Relief from back and neck pain.

Find help now

Dr. Kyle Sebastian wears white coat and smiles.
Dr. Kyle Sebastian

What are the most common symptoms patients come to see you about, and what is causing their pain?

Sebastian: The No. 1 reason patients come to me is lower back pain. The most common causes for their pain are a herniated disc, a pinched nerve in the lower back, or arthritis in the lower back.

De Witt: My patients come in with lower back pain and radiating leg pain. They’ll also come in with chronic neck pain; weakness, numbness, and tingling in their legs or arms; and radiating pain in their arms.

Some of the main causes include arthritis in the neck or back, a pinched nerve or issues with the spine. Sometimes, patients will get arm symptoms coming from a shoulder condition, groin pain coming from a hip condition, or leg symptoms coming from diabetes, so some of what I sort out is, “Is this a spine issue or not?” Figuring that out helps me treat them correctly or refer them to a colleague if needed.

Michelle De Witt
Dr. Michelle De Witt

Describe how you help patients with pain, based on your different backgrounds.

De Witt: Obviously, as a surgeon, I do surgeries. I do back surgery to help with leg problems, and I do neck surgeries to help with arm or spinal cord problems. I’ll do spinal surgeries to fix issues going on in the spine. If the timing and conditions are right for surgery, that’s where I come in. But I want to emphasize that surgery isn’t usually your first-line treatment. Things like pain management with Dr. Sebastian come before me most of the time.

Sebastian: You put that perfectly. As an interventional spine specialist, my ultimate role, with no offense to Dr. De Witt, is to help patients avoid surgery. I make sure we have tried every other conservative management option patients have — optimizing medication, physical therapy or chiropractic care, acupuncture, massage therapy, nerve blocks and more.

If none of these help, I can step in with some more targeted procedural techniques like injections, ablations, or stimulator devices to try to manage pain while avoiding more invasive surgeries that can have complications for patients in the future.

If I’m in pain, I just want it to stop now. Which one of you should I start with?

De Witt: For pain, I’m probably not the best first line, although I may be the last. If your primary complaint is pain — just pain — try seeing a pain medicine provider like Dr. Sebastian for a few months. A lot of pain does settle down with time. If we can get you to a more manageable place with your pain and help you return to better functioning without surgery, that’s great.

Frequently, patients come to me and say, “I’m in so much pain, I would consider surgery since I have no other options.” I tell them, “Actually, you have a lot of options. Some are surgery, some are not.” There’s a whole checklist of options to make pain more manageable.

Sebastian: I agree. Sometimes when people hear, "We're sending you to pain management,” they think “pill mills” and say, “But I don’t want to take opioids.” That’s an outdated view of pain medicine. The field has developed so much over the last two decades, and we have so many techniques and technologies that can help you.

If you come see me, I will interview you about what you’re experiencing, combine that with imaging like MRIs or X-rays, and put together the most likely reason you are in pain. Then there are so many techniques and procedures we can try. For example, we could try an epidural, ablation or steroid injections — there are so many options out there. Your options will be individualized based on what you’re experiencing and what’s causing it.

I never promise to completely get rid of pain, but my goal is to hopefully reduce some of your pain, improve function, and improve your overall outlook on life. With treatment, a lot of my patients can get back to their daily activities and have a better mentality going through pain.

De Witt: But if you’re experiencing more than just pain — if you’re experiencing weakness in your arms or hands, imbalance like wobbling or falling over when you try to walk, or loss of function like bowel or bladder problems — you may not have a lot of things to try besides surgery. If that’s you, start with a surgeon like me.

Top scores for safety in NC