Low Back Injury
A back injury can range from a strain that will heal quickly to a permanent injury that could lead to chronic pain.
When the muscles around the spine are stretched too far or lift too much weight, small tears may occur, resulting in a back strain. When muscles or ligaments tear, there is usually a small amount of bleeding into the muscle that causes swelling and muscle spasms.
Without effective treatment, low back muscles can be weakened by injury, compromising their ability to stabilize and support the spinal column correctly.
Other contributing factors to low back pain include incorrect posture, a lack of exercise, being overweight and enduring emotional stress.
Information comes courtesy of Back.com.
Kyphoplasty is a procedure used to treat painful compression fractures in the spine where the vertebrae has collapsed due to physical trauma or long-term conditions including multiple myeloma cancer. The treatment entails placing a needle into the fractured vertebral section of the patient’s spine, using real time X-ray imaging to guide the physician to the correct area. A balloon is then inflated within the spine to expand the vertebral space before placing methylmethacrylate, a type of bone cement, into the area to stabilize it.
Spinal Cord Stimulator
Spinal cord stimulation is a form of electrical neurostimulation designed to reduce chronic pain felt by patients in their back and limbs as a result of various conditions including failed back surgery syndrome, reflex sympathetic dystrophy, and peripheral neuropathy. Rather than directly targeting the source of chronic pain, SCS interferes with the transmission of pain signals from certain nerves, preventing the brain from fully recognizing sensations of pain. The implantation of a spinal cord stimulator comprises three stages. The first is a psychological evaluation, which is required by insurance. The purpose is to resolve any psychological contraindications to the procedure beforehand. The second stage is a trial phase lasting typically between five and seven days. In this phase, electrodes are implanted in the epidural space using a technique very similar to a standard epidural injection. The electrodes are then activated to determine whether the stimulation is effectively relieving the pain. If the trial stage is successful, the patient returns to have the electrodes removed. A permanent device is then implanted through a simple outpatient surgical procedure. The strength of electrical stimulation can be changed by the attending physician or patient to adjust to shifting pain levels, providing adaptive, optimal pain relief in the process. For more information visit http://www.medtronic.com/patients/chronic-pain/living-with/index.htm
Facet Nerve Block
A facet nerve block entails administering anti-inflammatory injections into the facet joints of a patient to relieve swelling and promote body movement as a therapeutic treatment, or to identify a source of pain as a diagnostic treatment. The procedures is performed using x-ray guidance down to the nerves that innovate the affected facet joint(s). Facet joints are located between vertebrae in the spine, allowing them to move against each other for an effective range of motion. Patients experiencing chronic neck and back pain, from conditions such as arthritis and whiplash, are leading candidates for facet nerve block treatment. Patients may be given a pain diary to determine whether nerve blocks applied to a certain area have helped to relieve a patient’s pain over the three days following treatment. If the blocks provide relief for a few hours only, the patient may be a candidate for radiofrequency ablation of the nerves to the facet joint. This procedure would typically provide 12 months of relief, if successful.
Transforaminal Epidural Injection
A transforaminal epidural is another way to introduce saline, local anesthetic and steroid medication into the spine to reduce the inflammation of spinal nerve roots and their surrounding tissues. The transforaminal epidural is a well-renowned treatment for its ability to accurately pinpoint a specific spinal nerve root level. In this procedure, a needle is guided into the foramen section of a patient’s spine using fluoroscopic imaging. The foramen is the hole on the side of the spine, through which nerves extend to a patient’s arms, neck, legs and lower back. The local anesthetic administered usually takes effect immediately, while a steroid solution can take between three and five days to provide anti-inflammatory benefits, which can last up to several months.
Lumbar and cervical rhizotomy (radiofrequency ablation) refers to the selective destruction of nerves in the facet joints of the cervical, thoracic and lumbar sections of the spine to alleviate the pain originating from the facet joints. Facet joint nerves are targeted and destroyed using a probe that emits heat via radio frequency waves. The nerves slowly regenerate over a time frame of between five months and one year, providing long term pain relief until the nerve has fully recovered and the procedure is repeated if necessary.
Lumbar and Cervical Epidural
An epidural is the therapeutic injection of a pain relieving drug or steroid which is injected into the epidural space of the spinal canal. Lumbar and cervical epidurals can be administered at any place along the spine, from the cervical (neck) area, to the thoracic (middle) section and lumbar (lower) region. Similar to nerve blocks, epidural injections decrease the inflammatory factors located in a patient’s spine. The treatment usually requires two to three days to take effect, peaking within seven days and providing up to two months of consistent relief before the numbing effect subsides. The lengthy effect of the epidural makes it an effective means of managing chronic pain among long-term sufferers.
Image-guided Nerve Blocks and Injection Therapies
Image-guided nerve blocks and injection therapies allow specialists to treat pain in a specific part of the body, such as an organ or a limb. Targeting an isolated group of nerves that carry the pain sensation from the affected area, a needle is inserted in the spine and guided to the area where the nerve or nerve cluster is irritated. Using the imaging technique of fluoroscopy to track the needle’s movement, local anesthetic is then administered to numb acute pain. Steroids can also be used to control nerve inflammation. Nerve blocks can be used for different reasons associated with chronic pain. While therapeutic nerve blocks control pain associated with various conditions, Diagnostic and Prognostic nerve blocks help to determine the source of a pain and predict the outcome of certain treatment respectively. Preemptive nerve blocs are also used before certain procedures to prevent ensuing discomfort.
Chronic Pain Management
Chronic pain refers to any pain lasting in excess of six months. There is no clear cause, as the term applies to any long-term discomfort arising from an initial injury. Chronic pain can occur in virtually any part of the human body and often contributes to other residual health problems including fatigue, decreased appetite, mood swings, and a lack of mobility. These difficulties negatively affect a person’s ability to lead a comfortable lifestyle. Many advances in modern medicine are helping people to manage their chronic pain more effectively to reduce suffering and enhance a patient’s quality of life and functionality. We will fully evaluate your condition and design a holistic, individually tailored plan to help you return to your life.