Low Back & Cervical Muscle Pain Treatment | Raleigh & Cary, NC

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Back and Neck Pain That Lives in the Muscles

A lot of back and neck pain isn't coming from discs, nerves, or the spine itself. It lives in the muscles around the spine — strained paraspinal muscles, locked-up trigger points in the neck, shoulders, and back, myofascial pain that keeps firing long after the original injury healed.

That's the only kind of back and neck pain we treat. On purpose.

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Who This Page Is For

You had back surgery and you still hurt. The operation addressed the structural problem, but the muscles around it never calmed down. Residual muscular pain after lumbar surgery is common — and it's often the part nobody treated.

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Your neck and shoulders are locked up with muscle pain. Stiff, aching neck muscles, trigger points in the trapezius and levator scapulae, the knot at the base of the skull that never quite lets go — the kind of neck pain that comes from the muscles themselves, not from a pinched nerve.

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You had epidural steroid injections and they didn't finish the job — or you don't want another one. Epidurals target inflammation around nerves. They don't do anything for knotted, guarded muscles and trigger points. If the injection helped partly, or not at all, or you just don't want more steroids, the muscular component may be what's left.

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You want your back or neck treated without drugs or surgery. No opioids, no pain-med management, no procedures on the spine itself. Just direct treatment of the muscles.

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If any of that sounds like you, keep reading. If your pain shoots down your leg or arm, skip to the section below on what we don't treat.

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One More Thing: Sometimes It's the SI Joints

A lot of what people call "low back pain" actually sits a little lower and off to one side — right around the sacroiliac (SI) joints, where the spine meets the pelvis. SI-region pain is one of the great mimics: it feels like back pain, but the problem is in the muscles and ligaments surrounding the joint — gluteal trigger points, piriformis dysfunction, strained SI ligaments.

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That muscular and ligamentous pain around the SI joints is squarely in what we treat, using the same tools: laser, shockwave, and PRP into the affected soft tissue.

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One distinction matters: if the pain is truly coming from inside the SI joint itself, that diagnosis requires image-guided diagnostic injections — which is interventional spine care, not what we do. Part of your evaluation is sorting that out. If the joint itself is the problem, we'll refer you to someone who does SI joint injections rather than guess.

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What We Treat — and What We Don't

We treat: muscle pain in the low back and neck

• Muscle strains and spasms of the low back

• Cervical muscle pain — stiff, aching neck muscles and muscle spasm

• Myofascial trigger points in the paraspinal, trapezius, levator scapulae, and gluteal muscles

• Tension-type neck and shoulder muscle pain and stiffness

• Persistent muscular guarding after the original injury has healed

• Residual muscular pain after lumbar surgery or epidural injections

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We do not treat: spine problems

To be direct, we are not a spine practice. We do not treat:

• Radicular pain — pain, numbness, tingling, or weakness shooting down the leg (sciatica) or down the arm

• Discogenic pain — pain originating from herniated or degenerated discs, in the low back or the neck

• Structural spine conditions — spinal stenosis, spondylolisthesis, fractures, scoliosis requiring bracing or surgery

• Post-surgical hardware problems — failed fusions, loose screws, adjacent-segment disease

• Pain from inside the SI joint itself — diagnosing that requires image-guided SI joint injections, which is interventional spine care

If that's your situation, you need a spine specialist — an interventional pain physician, neurosurgeon, or orthopedic spine surgeon. We'll tell you that at your evaluation and point you in the right direction. We'd rather turn you away than treat the wrong problem.

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We also don't do pain management

We do not prescribe opioids or controlled substances, and we do not manage long-term pain medications. Our treatments are procedural and rehabilitative, not pharmaceutical.

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When Epidural Steroid Injections Fail

This deserves its own section, because it's one of the most common ways patients find us.

An epidural steroid injection does one specific job: it calms inflammation around an irritated spinal nerve root. That's a real job, and for shooting leg pain from a pinched nerve, it can help. But an epidural delivers nothing to the muscles around your spine — it was never designed to.

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So when an epidural "fails," one of a few things is usually true. Sometimes the pain was never nerve pain in the first place — it was muscular all along, and the injection was a good treatment aimed at the wrong structure. Sometimes the epidural worked on one component: the nerve calmed down, the leg pain eased, and what remained was the muscular pain — months of guarding and trigger points that had become a pain generator of their own. And sometimes the steroid simply did what steroids do and wore off, because an anti-inflammatory doesn't repair anything.

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What matters is what didn't happen in any of those scenarios: nobody treated the muscles. Guarded, knotted paraspinal and gluteal muscles don't reset just because a nerve got quieter or a disc got operated on. They keep generating the deep, aching, belt-line pain that patients describe long after the "spine problem" was addressed.

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That's the piece we treat — with shockwave, laser, and PRP into the muscle itself, as described below. And to be just as clear about the reverse: if your remaining pain is coming from inside the spine or inside the SI joint, an epidural failing doesn't make it muscular. That evaluation comes first here, and if the problem is spinal, we'll send you back to a spine specialist with our findings rather than treat the wrong thing.

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We wrote a longer version of this for patients working through it: Epidural Steroid Injection Didn't Work? Why You Still Hurt.

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How We Treat Muscle Pain in the Back and Neck

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Every patient starts with an evaluation to confirm the pain is actually muscular. If it's not — if we find signs of nerve involvement or structural disease — we'll say so and refer you appropriately.

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When the pain is muscular, we use three tools, alone or in combination:

MLS laser therapy. Focused light energy applied over the painful muscles, aimed at reducing local inflammation and easing muscle spasm. Non-invasive, no downtime.

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Shockwave therapy. Acoustic pressure waves delivered to trigger points and chronically tight muscle tissue, intended to break up dysfunctional tissue patterns and stimulate a healing response. It can be briefly uncomfortable during treatment — that's normal.

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PRP injections into the muscles. Your own platelet-rich plasma, injected under ultrasound guidance directly into trigger points and injured muscle tissue. The goal is to concentrate your body's own repair signals where the muscle isn't healing on its own. This is not a spinal injection — no epidurals, no injections into discs or around nerves.

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We'll recommend the approach that fits your specific pattern — not every patient needs all three, and we'll tell you when we don't think a treatment is worth your money.

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