833-377-7325

MILD Procedure
Peak Spine & Sports Medicine offers the MILD Procedure for lumbar spinal stenosis in Marlton and Collingswood, NJ. Call (833) 377-7325.

MILD Procedure in Marlton and Collingswood, NJ | Minimally Invasive Lumbar Decompression

Lumbar spinal stenosis can make ordinary movement feel limited, painful, and frustrating. Walking, standing, shopping, traveling, exercising, or getting through a normal day may become difficult when narrowing in the lower spine places pressure on nearby nerves.

The MILD Procedure, also called minimally invasive lumbar decompression, is a treatment option for certain patients with lumbar spinal stenosis. It is designed to remove small portions of thickened ligament tissue that are helping cause narrowing in the spinal canal, helping create more room around compressed nerves.

At Peak Spine & Sports Medicine, the MILD Procedure may be recommended for carefully selected patients whose lower back, buttock, hip, or leg symptoms are related to lumbar spinal stenosis and have not improved enough with conservative care. The goal is to help patients walk farther, stand longer, move more comfortably, and return to more of the routines that make life feel normal.

Our method focuses on opioid-free, interventional pain care with a strong focus on education, outcomes, and restored quality of life. Patients are cared for by Dr. Milind Patel, Dr. Jill Kalariya, and our interventional pain management team through a concierge, white-glove model designed to restore quality of life without opioids. Relief should not feel like another complicated medical process. Our team works to reduce delays, simplify following steps, and help patients move toward a clear plan for less pain and better function.

To learn more about the MILD Procedure in Marlton and Collingswood, NJ, call Peak Spine & Sports Medicine at (833) 377-7325 or conveniently request an appointment online today. Telehealth consults are available for convenience when appropriate. We proudly serve patients in Marlton, Haddonfield, Collingswood, Cherry Hill, Medford, Moorestown, Mount Laurel, Voorhees, Philadelphia, and surrounding communities.

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The MILD Procedure is a minimally invasive treatment for lumbar spinal stenosis caused in part by thickened ligament tissue in the lower spine.

Lumbar spinal stenosis occurs when the spinal canal narrows in the lower back. This narrowing can place pressure on the nerves that travel through the spine and into the legs. One common contributor is thickening of the ligamentum flavum, a ligament inside the spinal canal. As this ligament becomes enlarged, it can reduce the space available for the nerves.

The MILD Procedure uses specialized instruments and imaging guidance to remove small amounts of excess ligament and bone through a very small incision. By reducing that tissue, the procedure may help create more space in the spinal canal and reduce pressure on irritated nerves.

The MILD Procedure may help patients with:

  • Lumbar spinal stenosis
  • Neurogenic claudication
  • Low back pain with leg symptoms
  • Buttock, hip, thigh, or leg pain while walking or standing
  • Leg heaviness, cramping, numbness, or tingling
  • Pain that improves when sitting or leaning forward
  • Difficulty walking longer distances
  • Symptoms that interfere with shopping, travel, errands, exercise, or daily activity
  • Pain that has not improved enough with conservative care
  • Patients who want a less invasive option before considering open spine surgery, when appropriate

The MILD Procedure does not place implants in the spine. It also does not treat every cause of back or leg pain. It is most appropriate when imaging and symptoms suggest that lumbar spinal stenosis due to thickened ligamentous tissue is a meaningful part of the problem.

The MILD Procedure works by removing a small amount of tissue that is playing a role in narrowing in the lumbar spinal canal.

In many patients with lumbar spinal stenosis, the ligamentum flavum becomes thickened. This thickened ligament can compress the spinal canal and increase pressure on the nerves. When those nerves are irritated or compressed, patients may feel pain, heaviness, weakness, numbness, tingling, or cramping in the lower back, buttocks, hips, thighs, or legs.

During the MILD Procedure, the physician uses imaging guidance to access the affected area through a small incision. Specialized instruments are used to remove small portions of thickened ligament and, when appropriate, small amounts of bone that are causing the narrowing.

This is intended to create more space in the spinal canal and reduce pressure on the nerves.

The MILD Procedure does not fuse the spine. It does not place hardware or implants. It does not replace open decompression surgery when open surgery is clearly needed. Instead, it may be an option for selected patients whose symptoms and imaging findings are suitable for the procedure.

The goal is to reduce stenosis-related nerve pressure enough for patients to walk, stand, and move with less limitation.

The MILD Procedure is most often used for symptoms related to lumbar spinal stenosis and neurogenic claudication.

Patients may benefit from an evaluation for the MILD Procedure if they have:

  • Lower back pain with buttock, hip, thigh, or leg symptoms
  • Leg heaviness or fatigue when walking
  • Cramping, aching, numbness, or tingling in the legs
  • Pain that worsens with standing or walking
  • Symptoms that improve when sitting down
  • Symptoms that improve when leaning forward, such as over a shopping cart
  • Difficulty walking through stores, airports, parking lots, or neighborhoods
  • Reduced standing tolerance
  • Lumbar spinal stenosis shown on imaging
  • Thickened ligamentum flavum causing constriction
  • Symptoms that have not improved enough with therapy, medication, injections, or conservative care

The MILD Procedure is not the right treatment for every type of back or leg pain. Pain from a herniated disc, irritated nerve root, facet joint arthritis, SI joint dysfunction, hip arthritis, peripheral neuropathy, vascular disease, or muscle-related pain may require a different approach.

Peak Spine & Sports Medicine begins with a careful evaluation, rather than assuming every patient with back and leg pain needs the same procedure.

A good candidate for the MILD Procedure is usually someone with lumbar spinal stenosis caused in part by thickened ligament tissue.

Patients often have symptoms that worsen when standing or walking and improve when sitting or bending forward. Many patients describe needing to sit down during errands, lean on a shopping cart, pause while walking, or limit activities because their legs feel painful, heavy, tired, numb, or weak.

A patient may be a candidate for the MILD Procedure if they have:

  • Lumbar spinal stenosis
  • Thickened ligamentum flavum on imaging
  • Neurogenic claudication symptoms
  • Trouble walking or standing because of back, buttock, or leg symptoms
  • Symptoms that improve with sitting or forward flexion
  • Minimal relief from conservative treatment
  • A desire for a minimally invasive option when appropriate
  • No major spinal instability that requires a different type of treatment
  • No severe structural issue that clearly requires surgical evaluation

Some patients are better suited for epidural steroid injections, nerve root blocks, facet joint injections, medial branch blocks, SI joint injections, physical therapy referral, orthopedic or neurosurgical evaluation, or another treatment option. A consultation helps determine whether the MILD Procedure is the right next step.

The MILD Procedure is designed to treat lumbar spinal stenosis related to thickened ligament tissue.

It may be considered for:

  • Lumbar spinal stenosis
  • Central canal stenosis
  • Neurogenic claudication
  • Ligamentum flavum hypertrophy
  • Walking limitation caused by lumbar stenosis
  • Standing limitation caused by lumbar stenosis
  • Lower back, buttock, hip, or leg symptoms related to spinal canal narrowing
  • Symptoms that have not improved enough with conservative care

The MILD Procedure does not correct every spinal problem. It does not treat major spinal instability, severe deformity, infection, fracture, tumor, or every type of nerve compression. It also does not treat peripheral vascular disease, peripheral neuropathy, hip arthritis, or other non-spine causes of leg pain.

If those issues are suspected, additional evaluation may be needed before a treatment plan is recommended.

Before the MILD Procedure, patients are evaluated to determine whether their symptoms and imaging findings match the type of lumbar spinal stenosis this procedure is designed to treat.

The consultation may include a discussion of symptoms, walking tolerance, standing tolerance, medical history, prior treatments, prior injections, medications, imaging results, and goals. The provider may examine the spine, assess movement, review nerve-related symptoms, and determine whether other sources of pain could be involved.

At Peak Spine & Sports Medicine, the evaluation is designed to connect the treatment plan to the patient’s actual life. For some patients, that may mean walking farther. For others, it may mean standing through work, traveling, shopping, golfing, exercising, or playing with grandchildren with less interruption.

Imaging is especially important. MRI findings may help show whether thickened ligament tissue is causing spinal canal constriction. The team may also consider whether other issues, such as a disc herniation, instability, nerve root compression, or hip-related pain, may be exacerbating symptoms.

If the MILD Procedure appears appropriate, the team will explain what the procedure is designed to do, what it will not do, what recovery may involve, and how progress will be measured.

The MILD Procedure is typically performed as an outpatient procedure.

The patient is positioned carefully, and the treatment area is cleaned. Local anesthetic and other comfort measures may be used based on the treatment plan and provider recommendations. Using imaging guidance, the physician accesses the affected area through a very small incision.

Specialized instruments are used to remove small portions of thickened ligament and tissue. The goal is to decompress the area without open spine surgery, fusion, or implanted hardware.

During the procedure, the team keeps the process calm, precise, and organized:

  • Patients are positioned carefully, so the treatment area can be accessed safely.
  • The skin is cleaned using sterile technique.
  • The treatment area is numbed.
  • Imaging guidance is used to identify the proper target.
  • A small incision is made.
  • Specialized instruments are used to remove small portions of thickened ligament tissue.
  • The physician confirms the treatment area throughout the procedure.
  • Patients are monitored before going home with clear aftercare instructions.

The procedure is designed to address a specific structural contributor to lumbar spinal stenosis. The planning behind it is highly specific, even though the experience is typically much less invasive than open spine surgery.

Recovery after the MILD Procedure is usually more manageable than recovery after open spine surgery, but instructions vary based on the patient and treatment plan.

Many patients go home the same day. Some soreness near the treatment site can happen. Patients may be asked to take it easy for a short period and to avoid strenuous activity, bending, lifting, or twisting, as directed by the provider.

Some patients notice improvement in walking or standing tolerance within a short period. Others improve more gradually as irritation decreases and activity increases. Because lumbar spinal stenosis can limit mobility for months or years, patients may need time to rebuild strength, confidence, and endurance.

Physical therapy or strengthening may be recommended after pain improves, especially if lumbar stenosis has led to weakness, stiffness, balance concerns, guarded movement, or reduced activity. Peak Spine & Sports Medicine does not provide in-house physical therapy, but the team may refer patients to outside providers when strengthening, mobility, gait mechanics, posture, or functional restoration are part of the plan.

The team may ask patients to track:

  • Walking distance
  • Standing tolerance
  • Leg pain, heaviness, numbness, or tingling
  • Low back, buttock, hip, or thigh symptoms
  • Ability to shop, travel, exercise, work, or handle daily routines
  • Medication use
  • Any symptoms that feel new or concerning

These details help our physician determine how well the MILD Procedure is helping and whether additional care is needed.

Relief from the MILD Procedure varies from patient to patient.

Some patients experience meaningful improvement in walking tolerance, standing tolerance, leg symptoms, and daily activity. Others may have more modest relief depending on the severity of stenosis, other spine problems, nerve health, strength, mobility, and overall medical condition.

The MILD Procedure is designed to treat a specific cause of lumbar spinal stenosis by removing small amounts of tissue that are narrowing the spinal canal. Because it addresses a structural contributor to stenosis, relief may last longer than temporary medication-based treatments for some patients.

However, it is not a cure for every spine problem. Arthritis, disc degeneration, nerve irritation, or other spinal changes may still contribute to symptoms over time. If symptoms return or do not improve as expected, our physician may reassess the diagnosis and determine whether another treatment option is appropriate.

The MILD Procedure and epidural steroid injections are different treatments for different goals.

Epidural steroid injections place anti-inflammatory medication near irritated spinal nerves. They may help reduce inflammation and provide relief for some patients with nerve-related back or leg pain.

The MILD Procedure is designed to remove small portions of thickened ligament tissue that are causing lumbar spinal stenosis. Instead of placing medication near irritated nerves, it helps create more room in the spinal canal.

Some patients may try epidural steroid injections before considering the MILD Procedure. Others may be evaluated for MILD when symptoms continue despite injections or when imaging suggests that thickened ligament tissue is a major contributor to stenosis.

The right option depends on the pain pattern, imaging findings, previous treatment response, medical history, and patient goals.

The MILD Procedure is less invasive than open spine surgery, but it is not the same as a surgical decompression.

Open decompression surgery may involve a larger incision, direct visualization of the spinal structures, and removal of more bone or tissue. In some cases, surgery may also involve fusion or stabilization when instability is present.

The MILD Procedure uses a small incision and imaging guidance to remove targeted portions of tissue without implants or fusion. It may be an option for selected patients who are not ready for open surgery, are not ideal surgical candidates, or want a less invasive approach when appropriate.

Patients with severe instability, deformity, progressive neurologic deficit, fracture, infection, tumor, or advanced structural disease may still need surgical evaluation.

At Peak Spine & Sports Medicine, the goal is to recommend the right level of care for the patient’s condition, not simply the most aggressive option.

A good result is usually measured by function.

Patients may notice that walking feels easier, standing lasts longer, leg heaviness is reduced, or errands feel less interrupted. Some patients may be able to shop, travel, exercise, golf, work, or spend time with family with fewer breaks.

The goal is not necessarily zero pain. The goal is meaningful improvement that helps the patient move better and rely less on medication when appropriate.

For some patients, the improvement is substantial. For others, it is more moderate but still valuable. The best results allow patients to participate more fully in daily life, therapy, movement, and normal routines.

Why Choose Peak Spine & Sports Medicine for the MILD Procedure?

Peak Spine & Sports Medicine was built around a simple standard: this should be the kind of pain management practice we would want our own family members to visit.

Initial consultations at Peak Spine & Sports Medicine are designed to be thorough, personal, and highly focused. The team takes time to understand the source of the pain, how it affects daily life, what has already been tried, and which activities the patient needs to return to.

For one patient, the priority may be walking through a grocery store without stopping repeatedly. For another, it may be standing through work, traveling through an airport, playing golf, exercising, sleeping better, or keeping up with children or grandchildren. Those details matter because lumbar spinal stenosis does not affect every patient the same way.

Peak Spine & Sports Medicine offers:

  • Concierge, white-glove pain management care
  • A non-opioid approach to pain care
  • Ivy League-trained professionals
  • Double board-certified pain management physicians
  • Cutting-edge interventional techniques and technology
  • Image-guided minimally invasive spine procedures
  • MILD Procedure evaluation for appropriate candidates
  • Thorough review of imaging and symptoms
  • Telehealth consults when appropriate
  • A helpful staff that works to reduce the burden on patients
  • Insurance access for eligible PPO/POS patients with out-of-network benefits

Care is led by Dr. Milind Patel and Dr. Jill Kalariya, double board-certified pain management physicians who perform advanced interventional procedures in the outpatient surgery center. Brian Brown, PA supports patients through conservative care, diagnostic workups, imaging coordination, therapy recommendations, and follow-up planning, helping each patient navigate care with clarity.

The MILD Procedure calls for careful diagnosis and planning. At Peak Spine & Sports Medicine, the team evaluates the patient’s symptoms, MRI findings, walking tolerance, prior treatments, activity goals, and overall spine health before recommending this procedure or another treatment option.

Our practice is selective with insurance because the model is built around quality, not volume. We work for the patient, not the insurance company. That gives the team more time to listen, explain, coordinate care, and work for the patient rather than designing the visit around an insurance company’s schedule.

Visit our Why Choose Us page to learn more.

How Much Does the MILD Procedure Cost in Marlton and Collingswood, NJ?

The cost of the MILD Procedure depends on the treatment plan, imaging guidance, facility, insurance coverage, medical necessity requirements, and whether additional evaluation or treatment is needed.

Peak Spine & Sports Medicine primarily works with patients who have PPO or POS insurance plans with out-of-network benefits. The practice is out-of-network for most insurance plans, allowing the team to maintain a smaller, more personalized model with longer visits, more education, and less pressure to rush patients through care.

Many patients are surprised to learn that out-of-network care with PPO/POS plan benefits are typically much more accessible than they expected. The Peak Spine & Sports Medicine team can help review benefits, explain the process, and determine whether the practice is a good fit.

Peak Spine & Sports Medicine does not participate with EPO, HMO, Medicare, or Medicaid plans. This allows our office to quickly see both new and existing patients.

Patients visit Peak Spine & Sports Medicine in Marlton and Collingswood from Cherry Hill, Medford, Moorestown, Mount Laurel, Voorhees, Philadelphia, and surrounding areas because they want high-level interventional pain care without an opioid-first approach.

The MILD Procedure is generally considered minimally invasive, but every procedure carries some risk. Possible risks include soreness, bruising, bleeding, infection, nerve irritation, dural puncture, headache, temporary worsening of pain, weakness, numbness, allergic reaction, or lack of meaningful improvement.

Safety depends on careful patient selection, sterile technique, imaging guidance, accurate diagnosis, appropriate treatment planning, and follow-up. At Peak Spine & Sports Medicine, the MILD Procedure is recommended only after the team evaluates the patient’s symptoms, medical history, imaging findings, prior treatments, activity goals, and suspected source of pain.

Patients with infections, certain bleeding risks, unstable medical conditions, spinal instability, progressive neurologic deficit, or pain that requires another type of urgent treatment may not be candidates. A consultation is needed to determine safety and appropriateness.

At Peak Spine & Sports Medicine, we do not use opioids as a shortcut for pain care.

Our practice focuses on interventional procedures because many pain problems are focal. Lumbar spinal stenosis, irritated nerves, painful joints, disc problems, facet joints, SI joints, and muscle-related pain often require a targeted solution. Medication taken by mouth circulates through the whole body. That can mean higher doses, more side effects, limited benefit, and no clear endpoint.

Interventional pain management is different. It is designed to identify the source or pathway of pain and treat it directly. For the right patient, the MILD Procedure can provide meaningful non-opioid relief, help restore more comfortable movement, and support a broader path toward improved function and quality of life.

Schedule a MILD Procedure Consultation in Marlton or Collingswood, NJ

Lumbar spinal stenosis can limit far more than the lower back. It can affect walking, standing, travel, sleep, work, independence, exercise, family time, and quality of life.

The MILD Procedure may be an option for patients who have not found enough relief with medication, therapy, injections, or other conservative treatments. A consultation can help determine whether the pain pattern, imaging findings, prior treatment response, and goals make this treatment appropriate.

For the MILD Procedure in Marlton and Collingswood, NJ, contact Peak Spine & Sports Medicine at (833) 377-7325 or schedule a consultation online today. Our team will help determine whether the pain pattern, goals, and insurance benefits make our concierge interventional pain model the right fit. We proudly serve patients in Marlton, Haddonfield, Collingswood, Cherry Hill, Medford, Moorestown, Mount Laurel, Voorhees, Philadelphia, and surrounding communities.

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MILD Procedure Marlton, NJ – FAQs

The MILD Procedure treats lumbar spinal stenosis, in part, caused by thickened ligament tissue. It may help patients with back, buttock, hip, thigh, or leg symptoms that worsen with standing or walking and improve with sitting or leaning forward.

No. Epidural steroid injections place anti-inflammatory medication near irritated spinal nerves. The MILD Procedure removes small portions of thickened ligament tissue to help create more space in the spinal canal.

No. The MILD Procedure is less invasive than open spine surgery and does not involve fusion or implants. However, it is still a procedure and should be recommended only after careful evaluation.

Good candidates often have lumbar spinal stenosis, neurogenic claudication, thickened ligamentum flavum on imaging, and symptoms that limit walking or standing. A consultation is needed to determine candidacy.

The MILD Procedure is commonly performed without general anesthesia, although the exact approach depends on the patient, provider, and treatment plan.

The procedure is typically performed in an outpatient setting. Timing varies depending on the patient, treatment area, and provider’s plan.

Some patients notice improvement within a short period, while others improve gradually as they resume movement and nerve irritation decreases. Results vary.

Relief varies. Some patients experience meaningful improvement in walking and standing tolerance for an extended period, while others may have more modest benefits depending on the severity of stenosis and other spine conditions.

This depends on the patient’s anatomy, prior treatment, imaging findings, and symptoms. If pain returns or does not improve as expected, our physician will reassess the diagnosis and discuss appropriate next steps.

Some patients benefit from physical therapy or strengthening after the procedure, especially if lumbar spinal stenosis has led to weakness, reduced walking tolerance, stiffness, or guarded movement. Peak Spine & Sports Medicine may refer patients to outside physical therapy when appropriate.

If the MILD Procedure does not provide meaningful improvement, that information is still useful. The team may reassess whether symptoms are coming from another source, such as a disc, spinal nerve root, facet joint, SI joint, hip joint, vascular issue, or another condition.

The MILD Procedure is minimally invasive, but risks can include soreness, bleeding, infection, nerve irritation, temporary increased pain, weakness, numbness, dural puncture, headache, allergic reaction, or lack of meaningful improvement. The team will review risks during the consultation.

In many cases, yes. Telehealth consults may be available to speed up the evaluation, review symptoms, discuss prior treatments, and determine whether an in-person exam or procedure consultation is appropriate.

Peak Spine & Sports Medicine accepts insurance and primarily works with PPO and POS plans that have out-of-network benefits. The practice does not participate with EPO, HMO, Medicare, or Medicaid plans. The team can help patients determine whether their benefits may apply.