I believe patients should never leave their doctors office without a clear understanding of their diagnosis. Many patients are not clear that most spinal conditions have an array of treatment options to choose from before making a decision regarding surgery. I try to give each patient a structured program and team approach. This may include therapy,pain management injection,medications,and surgery as a last resort. Patient are confused and using a full set of resources gives them time to learn about their conditions. Should surgery become necessary, less invasive procedures now exist.i am still amazed how many get injections without complete understanding of outcomes to be expected.Severe spinal stenosis is a real area for misunderstandings. If injections fail,surgical decompression can be quite rewarding.