A hemorrhagic stroke is typically the most deadly and debilitating form of stroke, occurring in nearly two million people every year. Historically, it’s been treated by allowing the brain to bleed until hemorrhaging has subsided, leaving few recovery options for patients. About half of the individuals who suffer a hemorrhagic stroke die within 30 days.

But that could be changing—all thanks to a leading-edge stroke treatment that’s giving patients new hope.

After several years of the ENRICH (Early MiNimally-invasive Removal of ICH) trial, neurosurgeons were able to show positive results with improved outcomes for hemorrhagic stroke patients, and the results were shared at the 2023 American Association of Neurological Surgeons (AANS) annual meeting. The results were presented by representatives from Emory University and the NICO Corporation. Four current Goodman Campbell physicians, led by Dr. Charles G. Kulwin, participated in the trial. It involved 300 stroke patients at 37 treatment centers across the United States.

During the trial, the BrainPath device—a tool used to help surgeons get to the site of bleeding—carefully moved through the delicate folds and fibers of the brain. The BrainPath gently shifts the tissue to create a path to the site of the bleeding. Once there, the Myriad device, an automated suction and resection tool, can remove clotting.

These results were part of a stroke treatment trial in which surgeons hoped to improve the standard of care for hemorrhagic strokes beyond just waiting out the bleed.

“Goodman Campbell was one of the earliest sites and one of the largest contributors to the study,” said Dr. Kulwin. “Our hope is that this will finally take a difficult problem … and provide solid evidence that there is a correct way to manage it surgically.”

“Only a quarter of survivors get back to independence in the months following the stroke. A safe and effective way of operating on a hemorrhage by minimally invasive means has the potential to change the way we give care and save lives.”

We are proud to be part of this historical moment in stroke treatment, and we look forward to using this method to help save and improve the lives of our patients. We also look forward to continuing to find new, innovative ways to advance the field of neurosurgery. You can read more about the clinical trial here.

Goodman Campbell started way back in 1972, with the incorporation of the Indianapolis Neurosurgical Group established by Drs. Julius Goodman and John Russell.

Since then, we’ve pioneered new techniques in Indiana, such as the first microscopic discectomy, the first intracranial tumor embolization, and the first endoscopic placement of a VP shunt.

We’ve transformed ourselves by adding new disciplines—like interventional stroke care, minimally-invasive spinal surgery, interventional pain management, physical therapy, research, and education. We’ve steadily grown both our practice and our reputation, and we’ve never once looked back.   

That is, until now.

This year, Goodman Campbell is turning 50 years old. Reaching that milestone has made us pause and reflect on our first half-century—and we could use your help documenting it.

If you’ve got photos, we’d love to see them. If you’ve got cards or notes, we’ll be glad to read them. If you have recordings, we’d be thrilled to hear them. If you’ve got videos, we can’t wait to watch them. Basically, if you’ve got anything at all that will help us expand our historical archives, we’ll be grateful for your assistance.

Visit our 50^th Anniversary page now to submit your digitized photos or videos—or just to type in a favorite memory.

Don’t have access to a scanner? We’re still interested in what you have to share. Give us a call at 317.396.1300, and we’ll do what we can to make your Goodman Campbell memories last forever.

Until last August, Kelli McLaughlin of Carmel was living her life like normal. She was raising her four children with her husband, Ryan, volunteering for different causes, and managing two locations of her boutique shop, Clothes With a Cause, which donates proceeds to different charities throughout the year. 

That month, Kelli started noticing odd, neurological symptoms and sensations in her body. She took a trip to the ER in early September and doctors didn’t find anything then. She returned later that month with her husband on their anniversary, because the sensations she was experiencing were very strong and interfering with normal tasks. 

The sensations would be diagnosed as focal seizures, so brain scans were taken and they revealed Kelli had a tumor. Goodman Campbell neurosurgeon Dr. Troy Payner was assigned to Kelli’s case, and after close examination and tests, he delivered the news that she had glioblastoma, a rare brain cancer with no known cure. Ironically, Dr. Payner treated her father for several meningiomas 16 years ago.

“It took me about a month to wrap my head around my new situation. I was in complete disbelief because there were no warning signs whatsoever,” said Kelli. “But Dr. Payner and I instantly hit it off—I liked him when I met him years ago, and I like him now! My entire care team has been wonderful; they are great advocates and have helped me navigate every aspect of this process.”

Glioblastoma, a cancerous and incurable brain tumor, occurs in 3 out of 100,000 United States citizens annually. The median age of those diagnosed is 64.

Goodman Campbell treats roughly 50 cases each year. Symptoms and their severity vary with each person, but in general they include: headaches, seizures, nausea/vomiting, difficulty with speech, blurry vision, weakness on one side, confusion, or lethargy—more on signs, symptoms, and treatments here.

“Glioblastoma is the most common primary tumor to occur in the brain and it’s unfortunately cancerous. Despite tremendous research being done, we don’t have a cure. The goal of all treatments is to control the tumor as long as possible,” said Dr. Payner. 

After the initial removal of the tumor, Kelli elected to start chemotherapy and radiation treatments, and wears an FDA-approved cap that helps slow tumor cells from replicating. Dr. Payner describes her as “an extremely ambitious woman who has an unflappable positive mental attitude.” Kathy Butz, a nurse on her care team, says that Kelli is very involved in her health care decisions, is open about her disease, and has a service-oriented heart.

“I don’t want to quit, I want to live. I’m committed to tackling this head-on, because I don’t see any other options,” Kelli said. “I feel like my purpose here is to make this place better than I found it, and help the next family that experiences something like this.”

All of that shows in Kelli’s drive to help her community, despite her diagnosis and side effects from treatments. Along with her support network of friends and family, she recently organized the first “Kegs ‘N Eggs 5K” fundraising event. In addition to raising awareness for this disease, they successfully collected over $50,000 to help connect families going through a similar situation to available resources and treatments.

“I am so thankful for the great turnout and beautiful weather we had for the First Annual Kelli’s Kegs N Eggs 5K! Glioblastoma research is one of the most under-funded of all cancers, and it is my goal to change this,” said Kelli. “We want to raise awareness of this horrible disease and raise funds to ensure that other families do not have to suffer this terrible blow as we had to. It can be done and I firmly believe that there is a cure on the horizon.”

Jay and his family live in Indianapolis in a house that’s been in the family for several generations. Though his kids have grown, Jay looks back on a life in which sports and physical activity—whether on his own, with friends or with his wife and kids—have played a huge role.

Being active has been important not only physically and socially for Jay, but also mentally. When he’s not able get out and move regularly, it takes an emotional toll. “I need to be active, or I’m no fun to be around,” he said.

Because he’s been so active, he’s had his share of injuries; After battling back trouble on and off for years, Jay had gone six years with no significant problems when suddenly, while sitting on the sofa with his dog Agnes, his right leg went numb, became weak and wouldn’t wake back up.

He sought help from Dr. Mobasser at Goodman Campbell. “Dr. Mobasser sent me for an MRI and X-rays of my back to assess my spine,” Jay said. “It was a wreck. He said I needed to have this surgery, as I was developing nerve damage in my right leg. Dr. Mobasser made it clear that my condition was irreversible without surgery and would continue to get progressively worse. I was facing the rest of my life with a brace on my foot.”

Dr. Mobasser fused five vertebrae and freed up all the nerves being compressed at each of these levels. Having had some experience with knee surgeries, Jay was expecting a tough recovery, and Dr. Mobasser himself warned Jay that the recovery process from a multi-level lumbar spine surgery could be extremely difficult for the first few post-operative months.

His experience, however, was anything but difficult. “I feel incredibly lucky,” Jay said. “I never really had any pain. I sat right up and walked to a chair; I was walking the halls that same afternoon.”

He was in the hospital for less than two days. “The follow-up was great,” Jay said, “though it turned out I didn’t need it. They called once a week, just to make sure I was doing okay, and the next time I saw Dr. Mobasser was at my one-month checkup.”

“I’m back to living a normal life,” Jay said. “I’m biking, I’m walking, I’m playing with the dog. But you know, beyond that, it’s all the little things. Sleeping through the night. Getting dressed without having to contort myself. Even now, more than a year later, I’ll find myself doing something that used to be painful or difficult or impossible before the surgery, and it’s just such a relief to have that part of my life back. I credit Dr. Mobasser and Goodman Campbell with making that happen.”

Goodman Campbell Brain and Spine is pleased to welcome Dr. Merle S. Rust, to our team of fellowship-trained neurosurgeons. Dr. Rust will care for patients in Terre Haute, Indiana, where he joins Dr. Josue Ordaz in providing advanced neurosurgical care and expanding access to specialized brain and spine services for the Wabash Valley and surrounding communities.

Dr. Rust’s path to medicine began long before medical school. While in high school, he volunteered with his local community ambulance service, gaining firsthand experience in emergency medicine and the hospital environment. Those early experiences sparked a passion for patient care and surgery that only grew stronger over time.

“Before starting medical school, I already knew I wanted to pursue a surgical specialty,” Dr. Rust said. “During my first semester at the University of Illinois, I developed a deep appreciation for neuroanatomy, neurophysiology and the diseases affecting the nervous system. That’s when I knew neurosurgery was the right path for me.”

For Dr. Rust, joining Goodman Campbell was a natural next step in his career.

Dr. Rust treats a broad range of brain and spine conditions and believes every patient deserves an individualized treatment plan that begins with the least invasive option whenever appropriate.

“I remain passionate about caring for patients with both brain and spine disorders,” he said. “My goal is always to provide thoughtful recommendations that optimize outcomes, whether that involves conservative treatment or surgery.”

He is especially excited about the collaborative culture at Goodman Campbell, where physicians regularly share knowledge, discuss complex cases and continue learning from one another.

“Medicine is constantly evolving,” Dr. Rust said. “Throughout medical school and residency, I learned the importance of embracing new techniques, technologies and perspectives. I’m looking forward to collaborating with my colleagues through case discussions, operating room observations and shared learning opportunities that ultimately benefit our patients.”

Looking ahead, Dr. Rust remains optimistic about the future of neurosurgery.

“Continued advances in research and education will shape the future of our specialty,” he said. “At the same time, it’s important that we continue to strengthen and sustain the practice of neurosurgery as healthcare continues to evolve.”

Outside of work, Dr. Rust enjoys reading, following developments in aviation safety and spending time mentoring his son, Drew, who is currently completing his neurology residency.

As he begins this new chapter, Dr. Rust is eager to serve the Terre Haute community and continue building strong relationships with patients and referring providers.

Please join us in welcoming Merle S. Rust, MD, to Goodman Campbell Brain and Spine! We are excited to have him on our team and look forward to the compassionate, patient-centered care he will provide to patients throughout western Indiana.

Parkinson’s disease is a progressive neurological condition that affects how the brain controls movement. It develops when dopamine-producing cells in a small but critical region of the brain (the substantia nigra) begin to decline. Dopamine helps regulate smooth, coordinated motion, so as levels decrease, movement becomes more difficult to control.

This leads to the hallmark symptoms patients often hear about: tremor (often starting on one side at rest), rigidity, slowed movement, postural instability, voice changes, and facial masking.

The good news? While the condition is serious, there are a range of Parkinson’s disease treatment options designed to help patients maintain function and quality of life over time.

Early in the condition, Parkinson’s disease treatment options typically begin with medications that help replace or mimic dopamine, improving symptoms such as tremor, stiffness, and slowed movement. Many patients also benefit from structured physical, occupational, and speech therapy, along with regular exercise and lifestyle modifications to help preserve mobility, balance, communication, and independence.

As the disease progresses, medications may become less effective or begin to cause fluctuations in symptom control and involuntary movements (dyskinesias). When this occurs, patients living in or near Indiana may begin exploring advanced Parkinson’s disease treatment in Indianapolis. A neurosurgical evaluation becomes an appropriate next step—not because earlier treatments have failed, but because the condition has evolved and additional treatment options may provide better symptom control.

This progression reflects the nature of movement disorder treatment: Care adapts over time to match each patient’s needs, with the goal of addressing the underlying neurological dysfunction as effectively as possible. For appropriately selected patients, advanced therapies such as deep brain stimulation (DBS) can improve symptom control, reduce medication-related fluctuations, and help maintain quality of life.

Surgical evaluation is often appropriate when nonsurgical approaches no longer provide the level of control needed for daily life. This is not a last resort; rather, it is a proactive step toward a higher level of care. A thorough neurological evaluation, combined with advanced imaging, helps determine whether neurosurgery for Parkinson’s is the right fit.

Deep brain stimulation has become one of the most established and effective surgical options for Parkinson’s disease. DBS for Parkinson’s disease has been performed for over 30 years, with dramatic technological advancements in the last decade that have significantly improved precision, safety, and patient experience.

DBS works by placing thin electrodes into precise areas of the brain responsible for movement control. These electrodes connect to a small generator implanted near the collarbone, which delivers controlled electrical impulses to regulate abnormal signals that cause symptoms such as tremor and rigidity.

Goodman Campbell’s approach to functional neurosurgery reflects the most advanced standard of care. Before surgery, we perform detailed MRI imaging to precisely map the brain. During the procedure, we use an asleep DBS surgery technique, meaning patients are fully under anesthesia. While older approaches required patients to be awake during surgery, advanced computer imaging now allows us to achieve the same level of precision with the patient fully anesthetized, making asleep DBS the modern standard.

Immediately following placement, we confirm positioning with a CT scan before the patient wakes up. Most patients stay one night in the hospital. Within the following weeks,  the generator is placed in an outpatient setting, and the system is later activated during a follow-up visit, typically with the patient’s neurologist.

This modern, image-guided approach allows us to deliver precise results while improving comfort and overall experience. For many patients wondering when to consider DBS, the answer often comes down to whether symptoms are interfering with quality of life despite appropriate nonsurgical care.

We understand that exploring surgical care is a significant decision. Our goal is to make that process clear, supportive, and grounded in expertise every step of the way.

At Goodman Campbell Brain and Spine, we are a global leader in brain and spine care known for our neurosurgical training and clinical research. Patients who come to us gain direct access to one of the most experienced, progressive neurosurgical teams in the country — right here in Indiana.

If you’re ready to learn more about Parkinson’s disease treatment options or deep brain stimulation in Indianapolis, we’re here to help. Appointments with Goodman Campbell functional neurosurgeon Mark Hoeprich, MD, take place at Ascension St. Vincent – Indianapolis Functional Neurosurgery. To request an appointment with Dr. Hoeprich, call 317-338-9660.

For many patients exploring essential tremor treatment in Indianapolis, the goal is simple: Find an approach that improves daily function while aligning with personal preferences and long-term goals. The right path forward depends on how much your tremor affects your quality of life and how your condition responds to supportive care.

Not every patient with essential tremor will need surgical intervention. In earlier stages, or when symptoms are still manageable, nonsurgical care can play an important role in maintaining independence and confidence in daily activities.

Physical and occupational therapy are often part of this approach. Occupational therapists focus on strategies and tools that make daily activities such as eating, writing, and dressing easier, while physical therapists may address balance, mobility, and movement challenges. While these therapies do not treat the neurological root cause, they can meaningfully improve function and quality of life.

For many patients, essential tremor management begins with medications that can help reduce tremor severity and improve function. Commonly used medications may include propranolol or primidone, along with other options that may be considered based on a patient’s symptoms, overall health, and treatment goals.

Medications do not eliminate essential tremor for everyone, and some patients may continue to experience symptoms that interfere with daily activities despite medical therapy.

Patients with essential tremor may benefit from occupational therapy, particularly when tremor begins to interfere with daily activities such as eating, writing, dressing, or work-related tasks. Occupational therapists can provide strategies, adaptive tools, and techniques to help patients maintain independence and improve quality of life.

Therapy is most helpful as part of a coordinated treatment plan. For patients with moderate-to-severe tremor or symptoms that significantly impact daily function, surgical treatment for essential tremor may offer more consistent symptom relief.

For patients whose tremor significantly interferes with daily life, surgical options may be the next step. These decisions are never one-size-fits-all. A thorough evaluation helps determine which approach aligns best with your condition, anatomy, and goals.

At Goodman Campbell, we offer two primary approaches:

Deep Brain Stimulation (DBS)

Deep brain stimulation essential tremor treatment has been a trusted clinical approach for more than 30 years. The procedure involves placing thin electrodes in a targeted area of the brain. These electrodes are connected to a small generator near the collarbone. The system delivers controlled electrical pulses to regulate abnormal signals. Because it can be adjusted over time, DBS offers flexibility as symptoms change.

Focused Ultrasound (MRgFUS)

Also referred to as “MRI-guided focused ultrasound,” this incisionless, noninvasive treatment option uses focused ultrasound energy to precisely target the area responsible for tremor. The procedure takes place inside an MRI scanner, allowing real-time monitoring while the patient remains awake. Many patients experience improvement in tremor symptoms following the treatment, and no implanted device is required. 

Both DBS and focused ultrasound can provide meaningful tremor reduction, but the patient experience differs.

DBS involves placement of an implanted device that delivers electrical stimulation to targeted areas of the brain. Because stimulation settings can be adjusted over time, DBS offers flexibility as symptoms change and may be particularly beneficial for patients with bilateral tremor or evolving treatment needs. Stimulation can be modified, turned off, or adjusted as needed.

Focused ultrasound, by contrast, is an incisionless treatment that does not require implanted hardware, making it an appealing option for patients who prefer to avoid implants or who may not be candidates for implant-based surgery. Focused ultrasound is typically performed on one side of the brain at a time, which may be an important consideration for patients with tremor affecting both sides of the body. In patients who may benefit from treatment on both sides, a second procedure may be considered after recovery and follow-up, commonly around nine months or more after the initial treatment. 

Choosing between these options is not a decision to make independently. Rely on your care team to help guide you to the best decision for your case.

We provide access to an experienced essential tremor care team focused on individualized treatment planning.

Goodman Campbell is a global leader in brain and spine care. For over 50 years, we have been treating adult and pediatric conditions of the brain, spine, and nervous system. Our neurosurgeons bring a depth of expertise that directly impacts outcomes across all treatment options.

We treat both straightforward and complex cases, and patients do not need to be at an advanced stage to benefit from a consultation. Every patient is evaluated individually, ensuring recommendations are tailored to their specific condition, lifestyle, and goals, rather than being limited by a single approach.

Patients and referring providers also benefit from direct access to their care team. For many individuals and families across Indiana and beyond, access to our high level of specialized, research-driven care provides confidence that they’re exploring the most advanced, appropriate treatment options available.

To learn more about essential tremor and your treatment options, visit goodmancampbell.com/conditions/brain/functional/essential-tremor/, or request an appointment with Goodman Campbell functional neurosurgeon Mark Hoeprich, MD, by calling 317-338-9660.deep expertise in neurological conditions to every patient we see.

Our team includes highly specialized surgeons experienced in both straightforward and complex cases. Essential tremor patients don’t need to be at an advanced stage to benefit from evaluation; we see individuals at many points along their care journey.

If you’re searching for a doctor for an essential tremor specialist in Indianapolis who provides the best surgical options, request an appointment with us. Goodman Campbell functional neurosurgeon Mark Hoeprich, MD, see patients at Ascension St. Vincent – Indianapolis Functional Neurosurgery. To get started with our team, call 317-338-9660. Learn more about essential tremor options at Goodman Campbell today.

Essential tremor is a neurological disorder that causes involuntary, rhythmic shaking — most often in the hands, but it can also affect the head or voice. While it is sometimes confused with Parkinson’s disease, it is a distinct condition with different causes and treatment approaches. Because it originates in the nervous system, choosing the right specialist plays a critical role in accurate diagnosis and effective care. However, many patients begin their search unsure of where to start or which specialist is best equipped to help.

So, what type of doctor treats essential tremor? Let’s take a look. 

Most patients begin with a primary care physician, who can recognize the symptoms of essential tremor, evaluate for other possible causes, and often diagnose straightforward cases. If tremor interferes with daily activities, primary care physicians can also start first-line medications, when appropriate. Patients with an uncertain diagnosis, persistent symptoms, or medication-resistant tremor are typically referred to a neurologist (particularly a movement disorder specialist) for further evaluation and management. 

Treatment usually begins with conservative, nonsurgical approaches. For most patients, this means medication, while occupational or physical therapy and adaptive strategies may also help improve function. Surgery is reserved for people with disabling tremor that does not respond adequately to medication. 

Most essential tremor treatment options begin conservatively, with the goal of improving daily function and quality of life.

Essential tremor is diagnosed primarily through a detailed medical history and neurological examination. A movement disorder neurologist will evaluate when the tremor occurs, how it affects daily activities, and whether there is a family history of tremor. During the exam, you may be asked to complete simple tasks such as drawing a spiral, writing, or holding your arms outstretched so the neurologist can observe the tremor’s characteristics.

There is no single blood test or imaging study that confirms essential tremor. Instead, additional tests, such as blood work or, less commonly, brain imaging, may be ordered when needed to rule out other conditions or if the symptoms are atypical. This comprehensive evaluation helps ensure an accurate diagnosis before treatment begins.

A functional neurosurgeon who specializes in essential tremor becomes involved when symptoms begin to significantly interfere with daily activities — such as eating, writing, dressing, or working — and when nonsurgical treatments are no longer providing sufficient relief.

At this stage, patients are often referred to a neurosurgeon for tremors who specializes in addressing the neurological source of the condition. Functional neurosurgeons focus on treatments that target the underlying brain pathways responsible for tremor, rather than simply managing symptoms.

Importantly, this step is not reserved for only severe cases. We evaluate patients thoughtfully to determine whether surgical intervention may help before the quality of life declines further.

For appropriate candidates, two primary surgical approaches are available:

Both options are designed to address the root neurological cause of tremor and are carefully considered based on each patient’s specific condition.

At Goodman Campbell, we provide essential tremor care in Indianapolis as part of one of the nation’s leading neurosurgical practices. As a global leader in brain and spine care and a recognized epicenter for neurosurgery training and research in the United States, we bring deep expertise in neurological conditions to every patient we see.

Our team includes highly specialized surgeons experienced in both straightforward and complex cases. Essential tremor patients don’t need to be at an advanced stage to benefit from evaluation; we see individuals at many points along their care journey.

If you’re searching for a doctor for an essential tremor specialist in Indianapolis who provides the best surgical options, request an appointment with us. Goodman Campbell functional neurosurgeon Mark Hoeprich, MD, see patients at Ascension St. Vincent – Indianapolis Functional Neurosurgery. To get started with our team, call 317-338-9660. Learn more about essential tremor options at Goodman Campbell today.

If you’re living with chronic back pain, neck pain, or ongoing spine pain, it’s natural to wonder whether you need interventional pain management vs. spine surgery. Many patients we see are stuck in the middle, unsure if their current treatment is enough or if it’s time to consider something different.

The decision between pain management or spine surgery isn’t about choosing the “least invasive” option. Rather, it’s about identifying the root cause of your spine condition and matching it with the right solution.

An interventional pain management physician focuses on reducing pain through minimally invasive procedures. These include epidural steroid injections, nerve blocks, radiofrequency ablation, and spinal cord stimulation, all designed to interrupt pain signals and reduce inflammation.

These interventional pain management services can be highly effective for managing symptoms. However, it’s important to understand their role: They are not a structural spine compression treatment to change the physical makeup of your spine. Such structural conditions include a pinched nerve, cervical myelopathy, or spinal cord compression. Interventional pain management treatments are also not appropriate for conditions involving significant nerve damage or spinal cord involvement.

Interventional pain management for back pain works best when the underlying anatomy is stable. Examples of this type of situation include:

In these cases, nonsurgical treatments can reduce pain and improve function, allowing the patient to heal without the need for immediate back surgery. Many patients benefit from a combination of injections, guidance from a physical therapist, and time.

Deciding when to undertake spine surgery comes down to structure. Neurosurgery is the right option when a physical problem, such as compression, cannot be resolved any other way.

At Goodman Campbell, we treat a vast range of back and spine conditions such as:

Procedures like microdiscectomy, a common spine surgery for herniated disc, directly relieve pressure on the nerve. Remember that surgery is a structural solution, not a last resort, and frequently what is needed to help obtain the right diagnosis. It is also, oftentimes, the most direct path to lasting relief, with a defined recovery time and measurable outcomes.

Certain symptoms signal it’s time to move beyond conservative care and ask the question, “Do I need back surgery?” These include:

These are not symptoms to wait on, but rather, indicate the need for a timely evaluation by a spine specialist.

The most important first step is an accurate, comprehensive diagnosis — one that includes advanced imaging and a thorough clinical evaluation by a spine specialist who can assess both surgical and nonsurgical paths. Without that level of clarity, it’s difficult to make an informed decision. 

At Goodman Campbell, our collaborative, comprehensive approach allows us to evaluate you, diagnose your condition, and guide you to the right treatment path that best fits your needs and goals.

Depending on your symptoms and diagnosis, your care may begin with interventional pain management focused on reducing pain, improving function, and helping identify the source of your symptoms through diagnostic and therapeutic injections. In other cases, you may first meet with a spine surgeon if imaging and clinical findings suggest that surgery should be considered as part of your treatment plan.

Because our providers work together, many patients benefit from both specialties during their care. A spine surgeon may refer a patient to pain management for diagnostic nerve blocks, therapeutic injections, or nonsurgical treatment. Likewise, a pain management specialist may refer a patient to a spine surgeon when symptoms, imaging findings, or treatment response suggest that a surgical evaluation is appropriate.

The advantage of this integrated approach is that you don’t have to determine which specialist you need before seeking care. Whether you begin with a spine surgeon or an interventional pain management physician, our team can coordinate the next steps and ensure you receive the right treatment at the right time. 

Yes. Physical therapy is often part of both nonsurgical and surgical care. 

Before back surgery, physical therapy may help improve strength, flexibility, posture, and overall function. For some patients, it can reduce symptoms enough to avoid or delay surgery. Even when surgery is ultimately recommended, participating in physical therapy beforehand can help prepare the body for recovery and improve postoperative outcomes.

After surgery, working with a physical therapist can support healing, restore mobility, rebuild strength, and help patients safely return to daily activities.

While physical therapy is highly effective for many spine conditions, it cannot correct certain structural problems, such as significant nerve compression or spinal instability. In those cases, surgery may be necessary to address the underlying cause, while physical therapy remains an important part of the overall treatment and recovery process.

Your primary care provider plays an important role, but spinal conditions often require a specialist. A spine specialist can assess imaging, symptoms, and function together to determine whether you need continued conservative care or escalation.

At Goodman Campbell, we offer a key advantage: Both interventional pain management specialists and neurosurgeons practice within the same organization. This allows for an integrated, team-based approach to care with seamless internal referrals when needed. Rather than navigating separate systems, your evaluation is coordinated across specialties, ensuring recommendations are based on your specific diagnosis and the full range of appropriate treatment options. 

We are one of North America’s most accomplished back and spine specialty practices. Just as important, we draw on extensive patient outcomes data and a strong foundation of clinical research to guide decision-making, ensuring that recommendations are grounded in evidence, not guesswork. Patients and referring providers also have direct access to our team, ensuring clear communication and continuity of care.

If you’re asking when to see a spine surgeon, the answer is simple: when you’re unsure what’s actually causing your pain.

The best next step is a diagnostic evaluation. Call our team or request an appointment at:
https://www.goodmancampbell.com/contact/request-appointment/

You’re not committing to surgery. You’re getting clarity — and a path forward that’s built around the real cause of your pain. 

If you’re at a point when injections stop working for back pain or neck pain, it can be frustrating. If you’re in this kind of situation, you might have already tried epidural steroid injections, facet joint injections, or other interventional pain management services, only to find that the relief is becoming shorter or has stopped altogether.

It’s important to know that this is a common and well understood stage of many spine conditions. Most importantly, be assured that this does mean you have no other options.

Facet joint injections — and interventional injections broadly — are designed to reduce inflammation and interrupt pain signals. For many patients, they deliver real but temporary relief.

The problem isn’t the injection itself. Conditions such as facet joint pain, spinal stenosis, herniated disc, and advanced arthritis are structural problems. Over time, joint degeneration and underlying damage can progress. As that happens, injections may provide less significant relief, and the duration of benefit may shrink.

This doesn’t mean your care has failed. It means your condition has evolved, and your treatment plan may need to evolve with it.

Our interventional pain management specialists use injections to target inflammation and calm irritated nerves. But these treatments do not correct the root cause of structural spine issues.

If joint injections don’t work as effectively as you want or facet joint injection fails to meet your expectations, it can be a signal that the underlying cause — such as nerve compression or spinal narrowing — has progressed beyond symptom-focused care.

Rather than viewing this as a dead end, we should instead recognize it as an important turning point. It’s time to consider alternative treatment options that address the problem more directly.

Patients recognize this transition through a few key patterns:

Recognizing these signs can be empowering. It helps you move forward with clarity, rather than continuing treatments that no longer provide longer-lasting relief.

When exploring alternative treatments, we typically move step by step.

Physical therapy, guided by experienced physical therapists, improves overall spinal health and supports long-term function. Even for patients who have been through injections, structured movement-based care continues to play an important role.

For facet joint pain specifically, radiofrequency ablation may provide longer-lasting relief by disrupting the specific pain pathways tied to those joints. This is a targeted minimally invasive procedure that goes further than an injection without requiring surgery.

When structural issues are clearly identified, we may recommend minimally invasive procedures that directly address the source of compression, such as a microdiscectomy for a herniated disc or a laminectomy for spinal stenosis.

In select cases where nerve-related pain persists despite other treatments, additional options such as spinal cord stimulation may be considered as part of a broader interventional pain management approach.

These alternative treatments focus on resolving the structural problem, not just masking symptoms, helping patients move toward a more pain-free life.

When conservative treatments and injections are no longer effective, your interventional pain management physician may recommend a consultation with a spine surgeon, such as a neurosurgeon, to further evaluate your condition. 

A neurosurgical evaluation can help determine  whether a structural problem, such as disc herniation, bone spurs, or spinal canal narrowing, is the root cause of persistent pain and whether addressing that issue surgically may provide meaningful relief. 

In some cases, the solution can be relatively straightforward and minimally invasive. Certain procedures, such as a microdiscectomy to relieve a pinched nerve, are designed specifically to target the exact source of pain with a focused approach and often involve smaller incisions and quicker recovery times than patients expect. 

Neurosurgeons receive more extensive training in spinal anatomy and nerve function than any other type of surgeon, including orthopedic surgeons. This expertise allows our Goodman Campbell neurosurgeons to evaluate both straightforward and complex causes of spine pain, including neck pain and leg pain.

At Goodman Campbell, our interventional and neurosurgical teams work together. This means you don’t have to start over. We guide you seamlessly from one level of care to the next, always focused on the best back pain treatment options for you.

We are proud to be a global leader in back and spine care, clinical research and neurosurgery training, as well as a trusted destination for spine pain management in Indiana. Patients come to us because we treat both simple and complex spine conditions under one roof and focus on identifying and treating the root cause, not just symptoms. You don’t need to wonder whether your case is serious enough before making an appointment.

Our outcomes data and clinical research leadership inform every treatment plan we recommend, and patients have direct access to their care team throughout their experience with us. 

If injections are no longer providing lasting relief, it may be time to explore what comes next. Request an appointment at Goodman Campbell today at goodmancampbell.com/contact/request-appointment/. We’re here to help you move forward with clarity, confidence, and a plan built around you.

We are excited to welcome the newest resident of the Ascension St. Vincent Indianapolis Neurological Surgery Residency Program team, Dr. Pratheek Makineni! Joining current residents, Drs. Geoff O’Malley and Anthony Dragun, he becomes the third resident in our growing program and will train alongside the physicians of Goodman Campbell Brain and Spine.

As Dr. Makineni begins this next chapter, we asked him more about his journey to neurosurgery, what drew him to our program, and what excites him most about the future of the field.

For many physicians, the path to medicine begins with a single experience that sparks curiosity. For Dr. Makineni, that journey began in high school. Through volunteer work at a local hospital and a summer research position at the Oregon Primate Research Center, he was introduced to the world of medicine early on. While he always found the brain fascinating, it was his time volunteering in a Neuro ICU that solidified his future.

“Seeing firsthand how neurosurgeons care for and heal patients with serious neurological conditions was instrumental in my decision to pursue this career path.”

That experience helped transform an interest in neuroscience into a commitment to becoming a neurosurgeon.

Choosing a residency program is one of the most important decisions in a physician’s training, and several factors made the Ascension St. Vincent program, led by Goodman Campbell Brain and Spine, stand out.

He was particularly impressed by the program’s exceptional surgical volume and abundant opportunities for residents to gain meaningful operating room experience early in training. Just as important, however, was the culture he experienced during the interview process.

This close mentorship between residents and attending surgeons is a hallmark of the program and creates an environment where learning and professional growth thrive.

When asked about the areas of neurosurgery that interest him most, two specialties immediately came to mind: spine deformity and functional neurosurgery. Dr. Makineni is eager to bring curiosity, innovation, and a passion for research to the program while contributing to advancements that improve patient outcomes. His excitement extends beyond current practice and into the future of the field itself.

“The future of neurosurgery is incredibly exciting, particularly with the growing integration of artificial intelligence.”

From optimizing patients before surgery to identifying new genetic targets for cancer treatment and advancing our understanding of brain function, he sees tremendous potential for technology to enhance patient care and expand what is possible in neurosurgery.

While medicine occupies much of his time, Dr. Makineni also values staying active and pursuing a variety of interests outside of work.

Whether he’s running, playing pickleball or basketball, or hitting the ski slopes during the winter, he enjoys finding ways to stay active year-round. He also considers himself a foodie and enjoys exploring new restaurants and experimenting with new recipes in the kitchen.

As our residency program continues to grow, we are thrilled to welcome another talented physician who shares our commitment to excellence, innovation, and compassionate patient care.

We look forward to supporting Dr. Makineni’s training, watching his growth as a neurosurgeon, and seeing the impact he will make on our patients, our program, and the future of neurological surgery.

Welcome to Indianapolis, we’re excited to have you here!

If you’ve been living with chronic pain and still don’t have clear answers, you’re not alone. Many patients come to us after trying physical therapy or other treatments without lasting relief. That’s where interventional pain management and our interventional pain management services can make a real difference, not just by easing symptoms, but by helping identify the exact source of your pain.

At Goodman Campbell, nerve blocks are part of a precise, evidence-based diagnostic process. Our aim is to uncover the root cause of your pain, not merely mask it.

A diagnostic nerve block is a targeted nerve block injection used as a diagnostic tool. Instead of simply providing pain relief, it serves as a diagnostic tool that helps your care team determine which nerve, joint, or spinal structure may be causing your symptoms. 

In many cases, a spine surgeon may recommend a diagnostic nerve block when imaging studies and physical examination findings do not tell the full story. The information gained from the injection can help confirm whether a specific area is responsible for your pain and may play an important role in treatment planning, including determining whether surgery is likely to address your symptoms. 

Using imaging guidance, an interventional pain management physician places a small amount of local anesthetic at a precise injection site, near a specific nerve or affected nerve. If your pain improves, it tells us that the nerve is likely responsible for sending those pain signals.

A therapeutic nerve block is designed to provide longer-lasting pain relief and help reduce inflammation.

A diagnostic nerve block, on the other hand, is about clarity. It helps answer questions such as:

Often, both approaches work together as part of a larger treatment plan.

Pain doesn’t always originate where you feel it. For example, nerve pain in the hip may actually stem from the spinal column. By temporarily interrupting pain messages along a particular nerve, we can see how your body responds. If your symptoms improve, we’ve likely identified the exact source.

This is especially helpful in chronic back pain diagnosis, where multiple structures, such as discs, joints, or peripheral nerves, may be involved.

Your nerve block results guide the next steps:

Either way, the information moves your care forward.

There are several types of nerve blocks we use in interventional spine care, including:

Each is chosen based on your symptoms and suspected pain conditions.

These procedures are performed on an outpatient basis, so you can go home the same day. We’ll ask you to track your symptoms closely. Specifically, we want to understand how much relief you feel, how long it lasts, and how it affects your daily activities. This feedback is critical in shaping your treatment options.

This information is an important part of the diagnostic process. Your response to the injection helps confirm whether a specific nerve, joint, or other spinal structure is responsible for your pain and helps guide the most appropriate treatment plan. 

In some cases, we may recommend additional nerve blocks to confirm findings or further refine your spine pain diagnosis.

Yes. In some cases, diagnostic nerve blocks are used to help determine whether surgery is likely to address the source of a patient’s symptoms. 

If a nerve block provides significant relief, it can help confirm that a specific nerve root, joint, or spinal structure is the pain generator. This information gives your care team greater confidence in recommending the most appropriate treatment, whether that involves continued conservative care, interventional pain management, or surgery. 

Precision matters.

Our interventional team has highly specialized training in the neck, spine, and nervous system, providing extensive, focused expertise. We understand how every structure in the spine connects and can contribute to pain.

We’re also proud to offer world-class neurosurgery expertise right here in Indiana, meaning that you don’t have to travel far for advanced care. As a global leader in back and spine care, we treat everything from straightforward cases to complex spine conditions. Our approach is backed by proven patient outcomes and efficacy data, and because you have direct access to our team, your care stays coordinated, clear, and focused on results.

If you’re ready to move beyond uncertainty and understand what’s truly causing your pain, Goodman Campbell is here to help. Request an appointment with our spine team to take the next step toward answers and lasting relief.

If you’ve been living with chronic pain and searching for answers, you may have come across spinal cord stimulation (SCS) as a potential treatment option. However, many patients we meet are unsure whether they’re even a spinal cord stimulation candidate.

At Goodman Campbell, our goal is to make that clearer. Through our interventional pain management services, we help patients understand when this advanced option may be appropriate — and when it’s not. Our team combines the expertise of interventional pain management physicians and neurosurgeons to evaluate both simple and complex spine-related conditions.

Spinal cord stimulation is a form of neuromodulation that works by interrupting pain signals before they reach the brain. A small device, called a spinal cord stimulator, delivers gentle electrical impulses to the nervous system, helping reduce the perception of pain.

Rather than masking symptoms, SCS targets how pain signals are processed. It’s typically considered only after more conservative treatments — such as physical therapy, nerve blocks, and injections — have not provided lasting pain relief.

When you meet with an interventional pain physician at Goodman Campbell, we take a comprehensive look at your medical history, treatment history, and overall health. We evaluate your pattern of chronic pain symptoms, the type of persistent pain you’re experiencing, and how it affects your daily life.

A psychological evaluation is also part of the process, ensuring that a candidate for spinal cord stimulation is well positioned for success. These steps help us determine if we recommend spinal cord stimulation and whether it aligns with your goals for chronic pain relief.

Viable candidates for spinal cord stimulation can find themselves in a variety of circumstances before considering the procedure. Below are five common situations.

Spinal cord stimulation is not a first step. Most patients we see have already worked through more conservative treatments, including physical therapy and injection-based therapies (e.g., epidural steroid injections, nerve blocks, etc.)

If you’ve exhausted conservative treatment options without meaningful or lasting improvement, you may be a stronger spinal cord stimulation candidate. At Goodman Campbell, our team ensures that appropriate nonsurgical options have been fully explored before moving forward.

Conditions like failed back surgery syndrome (FBSS) — persistent pain following spinal surgery — are among the most common reasons we recommend spinal cord stimulation.

Also known as post-laminectomy syndrome, this type of refractory pain often involves ongoing chronic back pain, sciatica, or leg pain after surgery. In many cases, additional surgery does not resolve the issue. Spinal cord stimulation offers a minimally invasive procedure that can provide meaningful pain relief without reopening the spine. When structural issues remain, Goodman Campbell may perform a microdiscectomy, but generally, SCS is utilized to address cases where further surgery isn’t the right next step.

Spinal cord stimulation is particularly effective for neuropathic pain, which originates from nerve damage.

This includes conditions such as:

These conditions often involve numbness, tingling sensations, and abnormal pain signaling. Because SCS works directly on those pain signals, it can be a powerful tool when other treatments fall short.

At Goodman Campbell, we commonly use SCS for failed back surgery syndrome, CRPS, peripheral neuropathy, sciatica, peripheral neuropathy, and other forms of chronic pain that are not amenable to further surgical correction.

When persistent pain begins to control your life — affecting sleep, work, movement, or social activities — it may be time to consider a different approach.

The goal of spinal cord stimulation isn’t just to reduce discomfort. It’s also to restore function, improve quality of life, and help you get back to the activities that matter most to you.

One of the most unique aspects of SCS is the spinal cord stimulator trial.

Before any permanent implantation, patients undergo a 5-10 day trial period (or trial run) using temporary leads placed in the epidural space. This allows you to experience the potential benefits firsthand.

If the trial is successful — meaning you achieve meaningful pain relief — we move forward with permanent placement. If not, the leads are removed. This built-in evaluation step makes SCS a lower-risk option and a strong indicator of long-term success.

If you’re wondering whether you might be a candidate for spinal cord stimulation, that curiosity is a great place to start. At Goodman Campbell, our interventional pain physicians work closely with our neurosurgeons to ensure every patient receives a thoughtful, individualized evaluation. Just as important, both patients and referring providers have direct access to their Goodman Campbell care team, making it easier to ask questions, stay informed, and feel confident every step of the way.

We’re also proud to be a national leader in SCS research, including active trials in neuromodulation and leading enrollment in the Abbott T2P study across seven national sites — bringing advanced pain management options directly to our patients.

If you’re ready to take the next step, call us or request an appointment here:
https://www.goodmancampbell.com/contact/request-appointment/