Back Pain Treatment
Back pain is a common complaint. Four out of five people experience low back pain at least once during their lives. It’s one of the most common reasons people go to the doctor or miss work. Simple treatment at home, some lifestyle modifications to have proper body mechanics and simple exercises will often heal your back within a few weeks and keep it functional for a long time. You need to contact your physician immediately when you have constant unrelieved pain, pain going in legs especially below the knee, causing weakness & numbness, or loss of bowel/bladder control, follows fall or trauma, associated with abdominal pain or fever or associated with unexpected weight loss.
Slipped Disc or Disc Prolapse
The intervertebral discs are protective cushion-like shock-absorbing pads between the two bones of the spine called vertebrae. The hard, tough outer layer called the annulus surrounds a mushy, moist center termed the nucleus. When a disc herniates or ruptures, the soft nucleus spurts out through a tear in the annulus. This starts an inflammatory process near a nerve root and can compress a nerve root and cause pain either around the damaged disc or anywhere along the area controlled by that nerve. The nature of the pain is frequently electric shock-like pain or burning pain. This pain may be associated with some numbness, tingling sensations and sometimes some muscle weakness. Sciatica is a frequently used term both by doctors and patients. It is a symptom and not a disease. Sciatica is defined as any pain that is starting in the low back and is going towards the legs. A slipped disc is one of the most common causes of sciatica.
Facet Joint: A leading cause of back pain
The joints between vertebrae in the spine are called Facet Joints. There is one joint on each side (right and left). Facet joints are hinge-like and link vertebrae together. They are located in the posterior half of the spine. Facet joints are synovial joints. These joints allow flexion (bend forward), extension (bend backward), and twisting motion. Certain types of movement are restricted. These joints interlock with the adjacent vertebrae and provide stability to the spine.
Amongst the common causes for your back pain may be facet joint or herniated intervertebral disc (slipped disc). Other Causes may be.
- Canal stenosis – It can lead to narrowing of the space around the spinal cord. This can cause back & leg pain.
- Structural irregularity – Your spine may have abnormal curvature either side to side or excessive curve in front/ back.
- Osteoporosis can cause vertebra fracture & can cause back pain. common in old age.
- Rare causes include Cancer, infection, cauda equina syndrome.
FOR BACK PAIN SUFFERERS, INTERVENTIONAL PAIN MANAGEMENT TECHNIQUES CAN BE PARTICULARLY USEFUL. THERE IS LESS HOSPITAL STAY, MORE ECONOMICAL, QUICK RECOVERY, VERY LITTLE CHANCE OF SIDE EFFECTS, AND NO CHANCE OF FAILED BACK SURGERY SYNDROME- THE MOST FEARSOME COMPLICATION OF OPEN SURGERY. IN ADDITION TO THOROUGH MEDICAL HISTORY AND PHYSICAL EXAMINATION, INTERVENTIONAL PAIN MANAGEMENT PHYSICIANS HAVE A WIDE ARRAY OF TREATMENTS THAT CAN BE USED INCLUDING THE FOLLOWING:
Selective Nerve root blocks:
Injections are done to determine if a specific spinal nerve root is the source of pain. Blocks also can be used to reduce inflammation and pain.
Medial Branch block or Facet joint injections & Radiofrequency Ablation:
An injection used to determine if the facet joints are the source of pain. These injections can also provide pain relief. Radiofrequency Ablation (RFA) is used for therapeutic long term treatment for facet joint pain.
Is done to mimic the pain or to see the disc structural integrity and to determine if disc is the source of a patient’s pain. In this dye is injected into a disc and patient is examined while injecting dye as well examined using x-ray or CT Scan.
Pulsed Radiofrequency Neurotomy (PRFN):
A minimally invasive procedure that neuromodulates spinal nerves and prevents them from transmitting pain signals to the brain.
A procedure in which pain signals are “turned off” through the use of heated electrodes that are applied to specific nerves that carry pain signals to the brain.
Spinal cord stimulation:
The use of electrical impulses that are used to block the pain from being perceived in the brain.
A surgically implanted pump that delivers pain medications to the precise location in the spine where the pain is located.
A procedure in which tissue is removed from the disc through a small-bore in order to decompress and relieve pressure. It is stitch-less surgery, just a single day stay, minimally invasive, quick recovery.
Surgery for spine pain is the last resort therapy and can be avoided in the majority of patients with interventional pain procedures.
Interventional pain management physicians often include other treatments such as physical therapy, occupational therapy, and lifestyle modification (such as exercise, diet, and smoking cessation) to further enhance these procedures.
The main symptom of back pain is an ache or pain anywhere in the back, and sometimes all the way down to the buttocks and legs.
Some back issues can cause pain in other parts of the body, depending on the nerves affected.
The pain often goes away without treatment, but if it occurs with any of the following people should see their doctor:
- weight loss
- inflammation or swelling on the back
- persistent back pain, were lying down or resting does not help
- pain down the legs
- pain that reaches below the knees
- a recent injury, blow or trauma to the back
- urinary incontinence
- difficulty urinating
- fecal incontinence, or loss of control over bowel movements
- numbness around the genitals
- numbness around the anus
- numbness around the buttocks