An Interventional Pain and Sports Medicine Practice
At the Barr Center, we are trained to assess how your core muscles are functioning and whether you may be stuck in a dysfunctional breathing pattern contributing to neck and back pain. This is commonly referred to as a reverse breathing pattern.
Because the low back supports the entire weight of the body and allows us to move and resist gravity, it undergoes significant wear and tear throughout life. Low back pain can inhibit basic day-to-day activities including walking, standing, getting in and out of a car, and even sleeping. Severe low back pain is the most common cause of disability. Patients who visit the Barr Center often find that back pain limits the active lifestyle they enjoy due to injury, overuse, or the cumulative effects of aging. Degenerative changes in the spine are a natural part of aging and do not always require injections or surgery. Sometimes the solution lies in correcting mechanical issues, improving posture, changing diet, and making lifestyle adjustments. We help you determine the right course of care, whether that involves osteopathic manipulation, physical therapy, or interventional procedures such as x-ray-guided injections and radiofrequency ablation.
Our treatments focus on restoring your ability to live a healthy, active lifestyle. This begins by identifying the sources of your pain. Treatment first targets the primary pain generators and then expands to address compensatory issues such as gait abnormalities, posture problems, leg length differences, balance disturbances, core weakness, breathing dysfunction, training errors, and even foot mechanics. Low back pain commonly develops from wear and tear, overuse, injury, or the natural aging process. Pain may arise from the low back itself or from surrounding muscles, ligaments, and tendons in the pelvis, hips, and trunk. Arthritis of the lumbar spine typically causes pain with bending, standing, and walking. Pain that worsens at night or is associated with fever or chills should be reported immediately. Degenerative lumbar issues at L4-5 and L5-S1 can refer pain into the hip or knee, making diagnosis more complex. Pelvic and sacroiliac joint dysfunction can also contribute to low back pain. Referred pain comes from another structure, while sciatica results from nerve compression due to disc herniation, bone spurs, or stenosis. Abdominal or pelvic conditions such as diverticulitis, colitis, hernias, IBS, or infections can also cause low back pain. Scar tissue from abdominal or spinal surgeries can restrict movement and contribute to pain as well.
There are diagnostic only injection used to determine which degenerated, inflamed, arthritic, or traumatized joints are causing your pain. These injections are very helpful in determining effective longer lasting treatment strategies. Medical branch blocks are performed to assess Neck or Low Back pain.
If you respond well to these injections, we may recommend facet joint injection, radiofrequency ablation or PRP injection. It is important to know that insurance rules for pain management procedures are everchanging.
For most insurance, we must obtain insurance authorization prior to the procedure. We can certainly help you understand how these rules apply to you.
The medication used with medical branch blocks consist of Lidocaine & Marcaine which can yield up to 8 hours of temporary relief. During this testing period, you will need to complete a post block pain diary.
We do require you to have a driver drive you home from the medical brain block procedure, as you may experience temporary numbness. We do utilize a small amount of X-ray contrast prior to the injection. Please notify use in advance if you have a contrast allergy so that we can send in a Radin Prep to your pharmacy.
During your first appointment at the Barr Center, we will ask you to describe your pain, its history, and any suspected causes. A physical exam, x-rays, and imaging studies will follow. MRI or CT scans may be needed to clarify the root cause of your pain and guide treatment. Depending on your insurance plan, we may need to document six weeks of conservative therapy and obtain x-rays before an MRI is approved.
If you have low back pain, you are not alone. The CDC estimates that 70 to 85 percent of people will experience back pain during their lifetime. Back pain is the most common cause of limited activity and is the fifth most common reason for all physician visits. It is also a leading cause of lost productivity at work, costing employers more than $62 billion per year. Back pain may originate from the discs, joints, muscles, bones, nerves, ligaments, or other structures in the spine.
Increased risk of low back pain has been associated with body mass index (BMI), mechanical loading, genetics, collagen structure, proteins, vitamin D receptors, cartilage composition, and inflammatory markers. Smoking is also linked with accelerated disc degeneration due to inflammation, decreased blood supply, structural changes, and impaired nutrient distribution to the disc.
The spine is a complex network of nerves, discs, joints, muscles, tendons, and ligaments, all of which can generate pain. Large nerves that originate in the spine supply the legs and arms, causing radiating pain when irritated.
The spine is composed of vertebrae stacked on top of each other: seven cervical vertebrae, twelve thoracic vertebrae, five lumbar vertebrae, the sacrum, and the coccyx. Together, they form an S-shaped column supported by muscles and ligaments. The spine supports body weight, maintains posture, and allows for bending, twisting, and rotation. Between each vertebra is an intervertebral disc which acts as a spacer and shock absorber. The spine also protects the spinal cord and nerves, which supply sensation and movement to the limbs and organs.
The degenerative cascade: The spine is designed to withstand daily stresses, but excessive strain or injury can overstretch muscles and ligaments, damage discs, and narrow joint spaces, leading to nerve compression. As we age, discs lose height and hydration, progressing to degenerative disc disease. The Kirkaldy-Willis degenerative cascade describes three phases: Phase 1 (Dysfunction) involves annular fissures and tears that weaken the disc. Phase 2 (Instability) involves internal disc disruption and mechanical instability. Phase 3 (Stabilization) involves fibrosis, narrowing of disc spaces, and bone spur formation. Your location within this cascade guides your treatment plan.
Who is most affected by back pain? Back pain is most common in adults, especially men. However, children are increasingly affected due to heavy backpacks and sedentary lifestyles. People who sit for long periods, drive extensively, or operate vibration-emitting machinery are also at increased risk. The American Medical Association has stated that prolonged sitting is more dangerous to overall health than smoking.
What causes back pain? Back pain may be acute (sudden trauma) or chronic (long-term). Common causes include traumatic injuries, repetitive stresses, disc degeneration, arthritis, poor posture, and genetics.
Characteristics of back pain: Back pain may be constant or intermittent, localized or radiating, dull or sharp, and may cause weakness, numbness, or tingling. Pain may radiate into the legs or feet depending on nerve involvement.
How is back pain diagnosed? Diagnosis includes reviewing your pain history and assessing the location, duration, and radiation of symptoms; pain with coughing or sneezing; night pain; past injuries; aggravating and relieving factors; posture; range of motion; and areas of tenderness or restriction.
Further testing may include x-rays, CT scans, MRI, bone scans, myelogram, EMG, nerve conduction studies, epidural steroid injections, nerve blocks, or discograms.
Most back pain improves within a few weeks without medical intervention. Pain relievers, heat, and ice may help. Bed rest is discouraged, and excessive pain relievers may slow healing. If symptoms persist, your doctor may recommend stronger medications or targeted therapy. The Barr Center focuses on restoring function and reducing medication use whenever possible.
Medications
Physical Therapy
Surgery performed by spine surgeons includes:
How can I prevent back pain?
Back pain in children can be reduced by:
Call us at 757-578-2260 or email info@barrcenter.com to get started on relieving your back pain. To learn more about back anatomy and causes of pain, explore our related articles below.
Other pain management conditions we treat include: Neck Pain, Shoulder Pain, Hip Pain, and Knee Pain. We often use Regenerative Medicine and sometimes combine physical therapy with our treatments.
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“I came in bent over and could barely move because of my back spasms. I was given an injection in my back and it was like a miracle. It is still doing great 6 months later. Now I am being seen for my knee and my shoulder.” Patient
Dr. Lisa Barr is a leading pain management physician in Virginia Beach with over 35 years of experience diagnosing and treating spine, joint, nerve, and musculoskeletal pain. As a Board Certified PM&R specialist, she focuses on whole-body, non-surgical solutions that uncover the true root cause of pain. She is also the international bestselling author of Outsmart Your Pain and one of the region’s most experienced experts in regenerative medicine, PRP, and advanced biologic therapies.
The Barr Center for Innovative Pain and Regenerative Therapies, led by Dr. Lisa Barr, is dedicated to helping people in pain. With over forty years of experience, Dr. Barr and her staff offer a range of evaluation and treatment options, including osteopathic assessment, trigger point injections, prolotherapy, and regenerative therapies. They prioritize a caring atmosphere and involve patients in their own care, ensuring they understand the recommended treatments. If necessary, they collaborate with other professionals to provide a comprehensive approach. Dr. Barr’s expertise has been recognized with the Top Doc award for thirty years.
Our approach to patient care at Barr Center is always focused on establishing a positive doctor-patient relationship that leads to enhanced function and quality of life. We strive to use non-medication-based therapies as our goal is to get you moving again and medication-free.
Dr. Lisa Barr discusses what to expect during an initial visit to the Barr Center. Patients are encouraged to fill out new patient paperwork beforehand to help identify potential causes of pain. Upon arrival, patients will be processed and taken to an exam room for a history and physical examination. The goal is to identify root causes and triggering events that may be contributing to the pain. A comprehensive treatment plan will be developed based on the findings.
The cold laser has been called “The Therapy” of the 21st century. In over 1,700 publications, there have been no recorded negative side-effects. This versatile tool is totally safe, non-toxic, and easy to use.
Over the past thirty years of using cold laser therapy, it has become one of the most versatile conjunctive tools we have ever used. It has potent synergistic effects with regenerative and nutritional therapies. It is both doctor and patient friendly. This promising tool is called the cold laser, the soft laser, the low-power laser, or the low-level laser. The term laser is an acronym for Light Amplification by Stimulated Emissions of Radiation.
All lasers emit coherent, focused light that travels in a narrow beam in one direction. High Power, “hot” lasers have shorter wavelengths, which have catabolic effects that can deliberately destroy tissue in cauterizing and surgical applications. Low Power, “soft”, “cool”, or “cold” lasers have longer wavelengths that have anabolic effects that promote rapid reduction of pain, accelerate healing time, and accelerate growth and repair.
Cold lasers or low-level laser therapy (LLLT) have stimulative effects rather than destructive ones. Clinical applications of the cold laser have included acute and chronic pain reduction from many etiologies, inflammation reduction, enhanced tissue healing, and cell regeneration. The results have shown very rapid pain reduction and accelerated recovery times, far exceeding conventional methods.
The Barr Center lasers made history by becoming the first to receive FDA market clearance for the treatment of chronic pain and increasing range of motion, proven through two double blind IRB studies.
Our Erchonia Lasers are the most advanced lasers on the market, with their sleek revolutionary design, patented line generated beam, and the ability to program independent frequencies in all of their family of lasers. It has been found to be extremely beneficial for enhancing and accelerating wound healing and reducing acute inflammation.
Unlike high power lasers that use heat and destroy tissue, low energy lasers affect the cellular energy of the underlying tissue. Hot lasers have a thermal effect and have an output of 1MW or above. Cold (or) Low Level Lasers do not have a thermal effect on tissue: lasers that stimulate biological function have an output below 10mw- milliwatts (ten- one thousandths of a watt).
With over 200 clinical studies – many of which are double-blind, placebo-controlled – and in excess of 2,000 published articles on LLLT (low-level laser therapy), this innovative technology has a well-documented research and application history. Having grown far beyond its distant Institutional Review Board (IRB) and experimental treatment status, LLLT is now being considered a therapy of choice for difficult pain management challenges such as fibromyalgia and myofascial pain.
Low Level Laser Therapy for pain is FDA-cleared to successfully treat many conditions such as acute and chronic pain reduction, repetitive use disorders like carpal tunnel syndrome, soft tissue strains and sprains, inflammation reduction, enhanced tissue wound healing, and cell regeneration.
Barr Center cold laser therapy for pain is low risk and has a high therapeutic benefit. Find out how cold laser therapy for pain may be helpful to you!
Contact us via email at info@BarrCenter.com or call 757-578-2260.
Dr. Lisa Barr provides an instructional video on how to use handheld lasers, explaining the process of turning on the laser, logging in, and accessing settings. Dr. Barr demonstrates how to navigate the screen and select the desired mode as well as reviewing the preprogrammed settings for different conditions and the laser’s ability to boost healing after regenerative medicine treatments.
Scar tissue can create an abnormal electrical signal in the autonomic nervous system. This signal is then transmitted through the autonomic nervous system throughout your body.
This is why a scar in one part of your body can cause pain in another area that is not even in close proximity to the scar.
Interference fields have lower electrical potentials than surrounding tissue. Electrical currents will flow from areas of higher voltage to areas of lower. Because of the disruption in electrical activity due to the presence of scar tissue, mixed signals are sent through the body’s nervous system. As a result, the body will react in ways that can lead to chronic pain and/or illness.
Cells in interference fields have an abnormal electrical charge on the cell surface. This results in abnormal signals being sent from the nerves to the brain (abnormal afferent signals). These signals then trigger abnormal autonomic nervous system responses. Local anesthetics affects the cells by stabilizing the membrane and normalizing the electrical charge. Even if the effects last for a short time, it allows for improved cellular metabolism, creating a healthier cellular environment and helping to stabilize the system. The improved cellular metabolism allows toxins to leave the cells and nutrients to enter, thereby reducing pain.
The injections are done using a very fine needle directed just below the skin (subcutaneously) into scars, nerves, acupuncture points, glands and trigger points. Sometimes deep injections are performed into the ganglia (a cluster of nervous tissue) or into a plexus (a network of nerves). The injections are done to eliminate the interference and restore the body’s natural energy flow.
After injecting the scar, sometimes a small amount of local anesthetic is injected into a vein, which helps stabilize the nervous system. Also, at times we inject small “blebs” of local anesthetic in a segmental fashion over other areas of the body where interference patterns or areas of abnormal electrical activity are found.
Dr. Lisa Barr of the Barr Center for Innovative Pain and Regenerative Therapies explains that spinal injections are performed in the fluoroscopy suite to address various pain issues. Barr Center uses X-ray equipment to accurately identify and target painful structures, injecting a combination of local anesthetic and steroids. The suite is used for diagnostic injections to pinpoint the source of pain and prescribe appropriate treatment. Epidural injections and radiofrequency ablation procedures are also performed in the fluoroscopy suite to alleviate chronic pain caused by arthritis. The goal of Barr Center is to help patients become pain-free.
Rejuvenation means boosting the body’s natural ability to heal itself. Regenerative medicine holds the promise of definitive, affordable health care solutions that heal the body from within. At the Barr Center we believe that under the right set of conditions the body has the capacity to heal itself. Regenerative therapies are a set of tools that we can use to reduce inflammation and facilitate healing in injured and degenerated joints, tendons and ligaments.
Dr. Barr and her staff have been at the forefront of regenerative medicine. She was the first physician to implement PRP, bone marrow-derived stem cells and fat grafting into practice in Hampton Roads over 20 years ago. She has successfully treated many patients, including professional golfers, with a variety of regenerative therapies for spinal, joint and tendon issues. Dr. Barr monitors the latest advances in regenerative medicine by regularly attending international conferences on
Regenerative Medicine, and she enjoys bringing back to our area the newest proven technologies. To complement her experience in regenerative medicine, she has advanced training in musculoskeletal ultrasound and interventional spinal injections. This is a key component to our success since these are mostly non-surgical treatments and the key to maximizing treatment outcomes for any regenerative therapy is optimal needle placement. Regenerative Medicine is ever-expanding. New concepts of managing inflammation and promoting tissue healing are being developed. Once we determine the best treatment option for you, be it PRP (Platelet Rich Plasma), Prolotherapy, Prolozone Therapy, Bone marrow concentrate, fat grafting, amniotic stem cells or a combination of modalities, we can perform the procedure in our office on the same day. The injections are performed using a small needle, cold spray and local anesthesia. To ensure optimal needle placement and maximize treatment outcomes, all regenerative therapies are performed at the Barr Center under image guidance using either ultrasound or x-ray. The entire process can take as little as 60 minutes. Within several days of undergoing most regenerative therapies, you can return to normal activities within 4-7 days.
