DWD 81.07(5)(b)1.1. All of the following guidelines apply to trigger point injections: DWD 81.07(5)(b)1.b.b. Maximum treatment frequency is once per week if there is a positive response to the first injection at that site. If subsequent injections at that site demonstrate diminishing control of symptoms or fail to facilitate objective functional gains, then trigger point injections shall be redirected to other areas or discontinued. Only 3 injections per patient visit. DWD 81.07(5)(b)2.2. All of the following guidelines apply to facet joint injections or facet nerve blocks: DWD 81.07(5)(b)2.b.b. Maximum treatment frequency is once every 2 weeks if there is a positive response to the first injection or block. If subsequent injections or blocks demonstrate diminishing control of symptoms or fail to facilitate objective functional gains, then injections or blocks shall be discontinued. Only 3 injections or blocks per patient visit. DWD 81.07(5)(b)3.b.b. Maximum treatment frequency may permit repeat injection no sooner than 2 weeks after the previous injection if there is a positive response to the first injection. No more than 3 blocks per patient visit. DWD 81.07(5)(b)4.b.b. Maximum treatment frequency is once every 2 weeks if there is a positive response to the first injection. If subsequent injections demonstrate diminishing control of symptoms or fail to facilitate objective functional gains, then injections shall be discontinued. Only one injection per patient visit. DWD 81.07(5)(c)(c) For purposes of this paragraph, “lytic or sclerosing injections” include radio frequency denervation of the facet joints. These injections may only be given in conjunction with active treatment modalities directed to the same anatomical site. All of the following guidelines apply to lytic or sclerosing injections: DWD 81.07(5)(d)(d) Prolotherapy and botulinum toxin injections are not necessary in the treatment of neck problems. DWD 81.07(6)(6) Surgery, including decompression procedures and arthrodesis. DWD 81.07(6)(b)(b) In order to optimize the beneficial effect of surgery, postoperative therapy with active and passive treatment modalities may be provided, even if these modalities had been used in the preoperative treatment of the condition. In the postoperative period the maximum treatment duration with passive treatment modalities in a clinical setting from the initiation of the first passive modality used, except bedrest or bracing, is as follows: DWD 81.07(6)(b)1.1. Eight weeks following decompression or implantation of a spinal cord stimulator or intrathecal drug delivery system. DWD 81.07(6)(d)(d) The surgical therapies in subds. 1. and 2. have very limited application and require a personality or psychosocial evaluation that indicates the patient is likely to benefit from the treatment. DWD 81.07(6)(d)1.1. Spinal cord stimulator may be necessary for a patient who has neuropathic pain and has had a favorable response to a trial screening period.