Lower back pain—it affects millions of Americans every year and its causes can be numerous and often complex. Usually, we refer to lower back pain as exactly that, but the true medical term for this condition is lumbago. In actuality, medical professionals coined this moniker for lower back pain around 400 years ago. Like many terms of great antiquity, lumbago derives from Latin, roughly translating to weakness in the lower back.
Great philosophers and enlightened sages may suggest that lower back pain is an offshoot of existence itself. Perhaps, there is a grain of truth in such a statement. Most likely, you have either experienced lower back pain or will in the future. In fact, doctors believe that as many as 80% of the workforce experiences lower back pain on a weekly basis. It is widely accepted that the ubiquity of lumbago stems from our progression into a more modern, sedentary civilization. In fairness, there is a correlation of evidence for such a claim. That being said, lumbago is also caused by underlying conditions, such as arthritis and other degenerative diseases. If your lower back pain is affecting your daily activities, then it is time to consider a medical consultation.
Lumbago Risk Factors
Everyone has a slightly different body structure. Simply put, some people are more affected by certain triggers than are others. Sadly, there is no litmus test for these predispositions, so it is best to avoid any unnecessary strain on the body. Examples of such risk factors include:
- Psychological Stressors: It is commonly accepted that stress makes pain worse, but in some cases, stress itself leads to back pain. Typically, stress is manageable through lifestyle changes and therapy. In other scenarios, the stress is chemically induced and must be remedied through medication and monitoring. In either situation, however, stress-induced pain may happen and it is very real.
- Sedentary Lifestyle: Many modern jobs require people to sit at desks for prolonged periods of time. This causes extra strain on your back and greatly increases your chance of developing lumbago. Additionally, sleeping in awkward positions produces similar risk susceptibility.
- Improper Lifting Technique: Even if this doesn’t lead to lumbar damage immediately, it will over time. Using the back to bear weight instead of the legs and twisting the body the wrong way are two of the most common lifting mistakes.
- Obesity: This is just a natural consequence of physics. If the spine has to support more weight, it will become more susceptible to wear-and-tear.
- The Natural Aging Process: The structures within the body deteriorate over time, which may lead to lumbar degenerative disc diseases.
- Repetitive Physiological Stress: Repetitive activities will put stress on bodily structures over time. For example, lengthy or intense bouts of jogging may lead to lumbar back pain as running is a repetitive impact activity.
Conditions That Lead to Lumbago
Lower back pain is interesting in the sense that it is both a condition and a symptom. A person may have chronic lower back pain, or they may have a problem that causes it. The following conditions may lead to pain in the lumbar area:
- Lumbar Degenerative Disc Disease: This condition occurs when the lumbar spinal discs deteriorate naturally as we age. To an extent, everyone experiences some degree of disc degeneration. However, doctors only use this term when the degeneration leads to pain.
- Lumbar Herniated Disc: In the most basic terms, the spine is an alternating column of discs and vertebrae. Vertebrae are the bones that compose your spine and discs are the softer material between them. Over time, these discs may wiggle out of alignment or rupture, which is what doctors refer to as a herniated disc.
- Lumbar Spinal Stenosis: There are many passageways surrounding the spine through which nerves must travel. When these passageways are narrowed, it puts pressure on these nerves and causes lumbar radiculopathy (aka, a pinched nerve in the lower back). However, not all cases of spinal stenosis lead to pinched nerves or sciatic nerve pain. In fact, sometimes this condition has no negative symptoms at all. That said, the condition may also worsen with time.
- Facet Hypertrophy: The facet joints exist at every level of the spine to provide flexibility and support. Sometimes, the body responds to spinal degeneration by enlarging these joints as a countermeasure to stress. (Think of it as building up a callous.) This “hypertrophy” may put pressure on nearby nerves, causing lumbago.
- Lumbar Spondylolisthesis: This condition occurs when stress fractures from a vertebral injury lead to structural weakness. When the spine weakens like this, the vertebra may slip out of place causing spondylolisthesis.
Symptoms of Lumbago
Pain is much more broad and nebulous than people typically realize. We often imagine pain in a very isolated sense, like a sharp cut or a bruise, but it doesn’t end there. For example, lumbar back pain may be nociceptive, neuropathic, or psychogenic, etc. However, doctors usually categorize pain as acute or chronic first.
- Chronic Pain: A persistent pain that lasts for a very long time. Usually, doctors consider pain as chronic if it lasts for 3-6 months or longer. Chronic pain has varying levels of intensity, but it is always persistent.
- Acute Pain: Basically, the opposite of chronic pain, acute pain is sharp and sudden. Usually, it has a specific underlying cause and it does not last longer than 6 months. In most cases, it resolves and does not return. Many people believe this is worse than chronic pain in severity, but that is case dependent.
- Nociceptive Pain: This classification is quite broad and breaks down into many subcategories, but there is a common thread. Nociceptive pain occurs when sensory nerve fibers receive stimuli that exceed a certain level of intensity. Usually, this pain is associated with inflammation, extreme temperatures, and mechanical damage.
- Neuropathic Pain: When the nervous system is diseased or damaged, it causes this type of pain. Medical experts describe this pain as a tingling or ‘pins and needles’ sensation.
- Psychogenic Pain: Mentioned earlier in the risk factors section, this pain results from mental and emotional factors. Some insist that this pain is not real, but that is simply not the case—as anyone who suffers from fibromyalgia can attest.
Lumbago doesn’t always just end at pain. In some cases, lower back pain causes muscle spasms, nausea, and fevers. And, in the most extreme cases, a patient may even lose control over his or her bowels/bladder.
How to Relieve Lower Back Pain
There are both conservative treatment options as well as minimally invasive spine surgeries that alleviate back pain. In most cases, a doctor will exhaust conservative options first before considering surgery. If conservative treatments do not provide adequate pain management, then the doctor will consider surgery. General conservative treatment options include:
- Chiropractic & Physical Therapy
- Pain medication (prescription or over the counter NSAIDs)
- Lower back exercises
- Posture correction
- Heat application
These are just a few examples of the viable conservative treatment options for lumbago. Because lumbago is so broad, the best treatment will depend on the specifics of your case. In order to figure out the best treatment plan for you, good communication with your healthcare provider is key.
Surgical Treatments for Lumbago
As with conservative treatments, there are many minimally invasive procedures that alleviate lumbago. Your doctor will present you with options that are best suited for treating your specific case. In more severe cases, your doctor may need to replace minimally invasive procedures with more traditional methods. Some common minimally invasive procedures for lumbago include:
- Epidural Steroid Injection: The doctor uses fluoroscopic guidance to inject a needle through the skin and at the affected site. Doctors almost always use a local anesthetic for this procedure, with mild sedation being optional at some centers.
- Laminectomy: If spinal stenosis is causing your lumbago, a doctor may suggest a laminectomy. During this procedure, the surgeon removes a portion of the affected lamina (backside of the vertebrae). This creates more space around the compressed nerves, thus alleviating your pain.
If you are suffering from lower back pain, consider contacting our team of back pain doctors today. Orthopedic Laser and Spine Surgery employs only the most highly skilled spine specialists. Our team of doctors will work tirelessly to craft a treatment plan that suits your individual needs.
Think back to your carefree days as a child. Remember when you fell at a park and scraped your knee? Within a week or two, the wound was only a distant memory. Your body, more specifically your blood, has intuitive healing powers to treat injuries and other conditions. By harnessing your body’s natural healing abilities, doctors and researchers are discovering new ways to speed up this process.
Platelet-Rich Plasma (PRP) Therapy has gained popularity as a relatively safe, cost-effective way to promote healing in the soft tissues and joints. Recently, professional athletes like Tiger Woods and pro football players have praised the healing effects of this procedure.
By using the healing factors in your own blood, doctors can create a concentrated injection that can assist with joint pain and other conditions. Use this guide to understand how your blood works and how it can be used to help you manage pain and stimulate healing.
Understanding Your Blood and Platelets
Your blood accounts for 7 to 8 percent of your body weight. Blood serves a vital role in your body’s functioning. It delivers oxygen and other nutrients to your organs and tissues. Blood also brings cells and antibodies to infected areas. In addition, it carries waste products to the kidneys and liver for filtering. Blood clotting prevents excessive blood loss for cuts and other injuries.
Your blood has four main components:
- Plasma: The liquid portion of blood, made of water, sugar, proteins, fat, and salts. Plasma transports other blood cells as well as nutrients, antibodies, hormones, and proteins throughout the body.
- Red Blood Cells: Accounting for up to 45 percent of the blood, these cells help carry oxygen to the body and return carbon dioxide to the lungs to be exhaled.
- White Blood Cells: These cells help the body to fight infection. Your blood consists of about 1 percent of these cells.
- Platelets: These fragments of cells help the blood to clot. They are also a natural source of the body’s growth factors.
Platelets and Growth Factors
The various growth factors stored in platelets serve a key role in wound healing and the body’s rebuilding process. PRP has seven different proteins. These include:
- Platelet-Derived Growth Factors: These activate cell membrane receptors which signal proteins to start certain functions such as healing.
- Vascular Endothelial Growth Factor: Aids in new blood vessel formation from existing blood vessels.
- Epidermal Growth Factor: Assists in stimulating cell growth and differentiation.
- Transforming Growth Factor: Allows cells to communicate and alter behavior in nearby cells.
- Adhesive Proteins: Vitronectin, fibronectin, and fibrin—allowing the cells to bind and the cell matrix to enable healing and other functions.
The interaction of these growth factors initiates and sustain different phases of tissue repair.
The premise of PRP therapy is that by adding more platelets to the blood’s plasma, one can speed up the healing process of soft tissues, bones, and joints.
How Does Platelet-Rich Plasma Therapy Work?
Doctors take a small amount of your blood—usually a teaspoon to a couple tablespoons. They put the blood in a machine called a centrifuge. This device spins the blood and separates it into three layers. The first spin, known as the hard spin, separates plasma that is low in platelets from the rest of the blood. The next “soft spin” separates plasma high in platelets from the red blood cells. The concentrated platelets in plasma are usually 5 to 10 times higher than normal blood.
The platelet-rich plasma is then prepared for injection. Using an ultrasound or x-ray guidance, the doctor then injects the PRP into the affected area. PRP may be injected into damaged tissues following a surgery to reduce scarring and promote soft tissue repair.
This relatively simple procedure usually takes about an hour. Depending on your condition, multiple injections of PRP may be advised.
Who Can PRP Therapy Help?
Platelet-Rich Plasma Therapy has been used to treat a variety of conditions. Here are some of the common conditions and situations in which PRP has shown some success:
- Acute Injuries: Athletes and others who suffered a recent injury to the muscles or ligaments. These could include a muscle strain or sprain such as a pulled hamstring.
- Tendon Injuries: The thick bands of soft tissue that connect the muscle to bone have shown some of the most success for PRP therapy. This includes those with tennis elbow, Achilles tendinitis, and rotator cuff tendinitis.
- Postsurgical Repair: When a tendon or ligament is so damaged it needs surgical repair, doctors may use PRP during surgery to speed up the healing process. In addition, PRP can decrease scar formation by healing the wound faster.
- Knee Arthritis: When the cartilage on the ends of bones starts to wear away, it creates a painful condition where joints lose their strength. This is especially true for the knees which tend to bear a lot of the body’s movements. A recent study found that treatment with platelet-rich plasma had significantly higher success in reducing pain and physical functioning than a placebo. Effects of this treatment usually lasted about six months.
- Bone Grafts: Sometimes a piece of bone is needed to fill the space to help other bones fuse together. Recent research indicates that incorporating PRP into a bone graft procedure can accelerate the healing process. The growth factors in platelets can improve graft adhesion and minimize movements allowing for a more successful bone graft.
What are the Side Effects of PRP Therapy?
Since you are using your own blood and its components, side effects, if any, are usually very mild. Some patients report pain at the injection site. In addition, as with any injection treatment, there is a risk of bleeding, infection, and nerve damage. These risks are rare.
Some may experience small amounts of pain after the procedure. However, it is important to avoid anti-inflammatory medications like Aleve or Motrin to treat this pain. These drugs may affect the healing process. If you feel like you need pain medication, Tylenol is a good option.
How Effective is PRP Therapy?
PRP Therapy is still considered an experimental therapy due to the relatively small amount of scientific data. The PRP centrifuge device, however, was approved by the Food and Drug Administration (FDA).
There are many cases of anecdotal evidence. For instance, the professional athletes who reported faster recovery times after injury. Scientific studies have shown data suggesting the beneficial effects of PRP in clinical procedures. Some of these studies, however, have a limited sample size, animal testing, or no controls.
Still, many doctors throughout the country are using platelet-rich plasma therapy will relative success. In an article published by Scientific American, a doctor stated about 60 percent of his patients showed favorable results.
Since PRP therapy and injections use the healing factors produced by your body, this is a relatively safe procedure you may want to ask your doctor about. As more studies are conducted, only time will tell how PRP therapy can become a common tool for treating muscle and bone issues.
Finding PRP Therapy Treatment
If you’re interested in discovering how PRP Injections can help your painful conditions, Orthopedic & Laser Spine Surgery is ready to help. We offer PRP injections for a variety of conditions.
By scheduling an appointment at Orthopedic & Laser Spine Surgery, you are assured a caring team of dedicated spine professionals ready to accurately diagnose and treat your symptoms. Using the latest research and technology, our expert doctors suggest the most appropriate, effective treatments for the neck, back, hip, and joint pain.
If you’re experiencing pain in the hips, lower back, buttocks, or legs, it could be due to an issue with the sacroiliac joint. This sometimes overlooked joint may be responsible for up to 30 percent of lower back pain.
Use this guide to understand the sacroiliac joint and how it causes your pain. Then explore some of the common treatments proven to provide relief.
What is the Sacroiliac Joint?
The sacroiliac (SI) joints connect each hip bone to the sacrum—a triangular bone at the bottom of the spine. A network of ligaments and muscles stabilizes this area. This joint has some mobility, but not very much when compared to other joints.
The SI joint supports the weight of the upper body. It transfers this weight and absorbs shock between the upper body and legs. In addition, it limits the stress between the lower spine and hip during weight-bearing activities.
Common Causes of Sacroiliac Joint Pain
As we age, the SI joint begins to change. Walking and other activities cause these once flat joints to develop angles and curves. Pregnancy and injury can play a role in changing these joints. Structural changes can lead to spondyloarthropathy—a class of diseases that affect the joints of the vertebral column—as well as other joint issues.
Sacroiliitis occurs when an SI joint becomes irritated and inflamed. Several factors can cause this condition. During pregnancy, for example, the SI joints stretch and loosen to prepare for childbirth. This change, along with the added weight from carrying a child, puts extra stress on the joint leading to inflammation.
In addition, different forms of arthritis such as osteoarthritis and ankylosing spondylitis can inflame the joints. A fall or car accident may also damage the joints leading to sacroiliitis.
Symptoms of sacroiliitis include pain in the buttocks or lower back. Pain can also affect the groin, legs, and feet. This is especially true when running, climbing stairs, or bearing weight unevenly in the legs. In addition, pain and stiffness usually occur when sitting for a long time or after getting out of bed in the morning.
Sacroiliac Joint Dysfunction
This condition involves too much or little motion in the SI joint. These abnormal hip movements affect the way in which the SI joint works.
Risk factors for sacroiliac joint dysfunction include aging, pregnancy, previous lower back surgeries, and contact sports. Even simply walking can cause dysfunction if your gait puts uneven pressure on your pelvis.
Symptoms are similar to sacroiliitis, however, pain is typically felt on one side of the lower back, buttocks, or legs. In addition, you may feel instability in the pelvis and lower back. It may feel like the pelvis will “give out” when walking, standing, or rising from a chair.
Diagnosing these conditions can be tricky because the symptoms often mimic other conditions such as lumbar disc herniation or sciatica. Furthermore, there is no single test to accurately detect these conditions. To be accurately diagnosed, a doctor should discuss your medical history and conduct a complete physical exam. Diagnostic imaging like MRIs, CT scans, or x-rays also helps with diagnosing SI joint pain.
Treating Sacroiliitis and Other SI Joint Issues
Once you determine your pain involves issues with the SI joint, several treatment options are available. Here are some of the common ways to treat sacroiliitis:
Resting the Area
If you just started feeling sacroiliac joint pain, try resting the area. Taking a day or two away from normal activities can help to reduce minor symptoms. Resting the area too long, however, may cause additional stiffness and weakening of the joint.
Applying ice or heat to the affected areas can help with muscle tension and pain. Consider icing your lower back and pelvis. Then, slowly introduce heat to the area around the joint.
Over-the-counter medications like acetaminophen or ibuprofen can help mild to moderate joint pain. If you’re experiencing a sudden burst of severe pain, a doctor may prescribe muscle relaxers or narcotic painkillers.
As with any prescribed medications, research the risks and benefits. Some of these drugs can have unpleasant side effects or lead to dependence. Make sure you talk to your doctor about any concerns you may have.
Sacroiliac Joint Injections
When oral medications don’t provide relief, sacroiliac joint injections can reduce pain by delivering medication directly to the source. A combination of a local anesthetic and anti-inflammatory medication can provide a period of pain relief. This will help you receive other treatments or get back to your daily activities.
If your joint pain is caused by an inflammatory condition such as ankylosing spondylitis or rheumatoid arthritis, your body may have high levels of Tumor Necrosis Factor (TNF). Healthy individuals block this substance naturally. Those with inflammatory conditions have higher levels of TNF in the blood.
TNF inhibitors can reduce inflammation and slow disease progression. They are usually given by injection or IV treatment. Sometimes medications are administered by professionals, but you may also be able to do it on your own.
While some patients notice a change in two or three doses, others may take up to three months to feel the drug take effect.
TNF inhibitors increase the risk of infection from tuberculosis and fungus. Those with conditions like multiple sclerosis or heart failure should not use them.
A physical therapist evaluates your condition and provides an individualized treatment program based on your needs. Physical therapists can also give insights into how your daily routines are affecting your sacroiliac joint. They also offer ideas for adaptations to prevent further irritation to the area.
Treatment from a physical therapist usually involves manual therapy to help with soft tissue tension, pelvic alignment, and joint mobilization. You also learn how to strengthen and improve flexibility in the area with targeted routines, including hip flexion exercises.
In some cases, a physical therapist may recommend wearing a sacroiliac belt to provide support and stability to your joints.
When pain medications and physical therapy don’t provide the relief you need, more aggressive approaches may be necessary. One common procedure involves implanting an electrical device into the sacrum. This device blocks the nerves from sending pain signals to the brain by using electrical pulses.
This minimally invasive procedure uses radiofrequency waves to heat a small needle which burns the nerve. The heat lesion disrupts the nerve’s ability to send pain signals to the brain.
Using a small incision, the doctor guides a tiny needle into the affected nerve. With the guide of a live x-ray, the surgeon finds the targeted nerve and numbs it. Radiofrequency waves heat the tip of a needle to create a lesion. The procedure generally takes about an hour.
Pain relief usually occurs in two or three weeks. Eventually, the nerve starts to grow back, which may or may not cause the pain to return. For most successful radiofrequency ablation procedures, pain relief can last about a year.
SI Joint Fusion
In some of the most severe cases, surgery may be the best option. If non-surgical treatments haven’t helped with your pain and daily functioning, SI joint fusion may the next option. This elective surgery is usually recommended after 2 or 3 months of trying non-surgical treatments.
Advances in medical technology have made an SI joint fusion a minimally invasive procedure. Using a small incision, usually on the side of the buttock, the surgeon inserts a bone graft into the joint and secures it with screws and pins. This allows the sacrum and hip bone to fuse together, thus decreasing excess motion.
The procedure usually takes about an hour. You may return home the same day. Since it takes time for the bones to fuse together, recovery time can be up to six months. During the recovery process, a physical therapist will work with you to restore strength and flexibility in the area.
Getting the Help You Need
If you’re experiencing pain due to SI joint issues, you want to get the help from an expert orthopedic team who is familiar with this condition. Orthopedic & Laser Spine Surgery will help pinpoint your source of pain and find the most appropriate treatments based on your unique situation.
Orthopedic & Laser Spine Surgery specializes in minimally invasive techniques designed to reduce complications and speed up recovery time. Our comprehensive program uses the latest research and technology for both non-surgical and minimally invasive procedures. We want to help you return to the life you desire, so schedule an appointment today!
In general terms, spinal stenosis involves the narrowing of the spinal canal. Because the spinal canal houses the spinal cord and nerve roots, these components can easily become compressed. Most of the time, this problem occurs in the neck and the lower back.
Additionally, spinal stenosis is caused by age-related spinal degeneration and wear-and-tear changes related to osteoarthritis. With age, bone spurs, swollen ligaments, and herniated disc material may begin to crowd the spinal canal. In less common cases, some people are born with narrow spinal canals. These people are more prone to developing the condition at a younger age.
There are three basic types of spinal stenosis and they are mainly categorized by the region of the spine that is affected.
Spinal Stenosis Locations
There are two main ways in which doctors categorize spinal stenosis types. The first way breaks down these types by their location:
- Lumbar Spinal Stenosis: Lower back region
- Thoracic Spinal Stenosis: Middle back region
- Cervical Spinal Stenosis: Upper back region
Additionally, doctors may categorize SS types by the part of the spinal column that the condition narrows:
- Foraminal Stenosis: Narrowing occurs in the small openings that allow nerve roots to exit the spinal column
- Lateral Recess Stenosis: Narrowing occurs in the back of the spinal canal where the nerve roots initially branch off
- Central Canal Stenosis: Narrowing occurs in the main spinal canal, which protects the spinal cord
The common thread between these conditions are debilitating symptoms and chronic pain. Sometimes, SS does not cause pain, but it will in cases that result in nerve compression. In these cases, patients should always seek professional treatment.
This type of spinal stenosis is the most commonly occurring type. Sometimes, doctors or medical experts may refer to foraminal stenosis as lateral spinal stenosis. In the back of the spine, there are side holes that nerve roots exit through. Experts refer to these anatomical structures as neuro-foramen. In the neuro-foramen, bone spurs that have developed from a degenerating disc or arthritic facet joint can press on these nerve roots. As a result, the narrowing space traps the emerging nerve roots. Speaking visually, this type of spinal stenosis literally pinches the nerves.
Central Canal Stenosis
A membranous sheath of dura mater known as the thecal sac surrounds the spinal cord. Narrowing of the central canal in the lumbar area leads to compression of this spinal component. This narrowing can cause pressure on the nerve bundle located at the end of the spinal cord (known as the cauda equina). Additionally, this narrowing may also lead to the compression of the individual nerves located within the thecal sac.
Far Lateral Stenosis
In some cases, narrowing occurs beyond the neuro-foramen. Usually, this development stems from bone spurs (which form bulging discs), the facet joints, herniated discs, and ligamentum hypertrophy. When this narrowing occurs to the side of the neuro-foramen, experts call it far lateral stenosis. With spinal stenosis, there is generally a combination of far lateral and foraminal stenosis.
Spinal Stenosis Causes
Spinal stenosis usually results from the gradual deterioration of the spinal anatomy. That being said, the condition may also be associated with a back or neck injury. Under normal circumstances, the spinal cord travels from the brain through the spinal canal. Individual nerve roots branch off of the spinal cord and extend into the body. The canals protect nerves from damage, but there are multiple ways that lead to constriction over time:
- Formation of bone spurs
- Inflammation of nearby surrounding soft tissue
- Herniated or bulging discs that put pressure on the spinal canal
- Calcification of the spinal ligaments
- Spinal misalignment caused by vertebrae slipping out of place
- Other issues, such as tumors, diseases, or infections
Spinal structures will naturally degrade over time. While this is the case, chronic pain and other debilitating symptoms will only appear in cases where the nerves are pressured.
Spinal Stenosis Symptoms
Symptoms of spinal stenosis will vary by the location and other individual factors, however, there are many blanket symptoms that all types share. Some of the most commonly experienced symptoms of spinal stenosis include:
- Burning sensations
- Loss of fine motor skills
- Limited mobility
- Muscle weakness
- Local and traveling pain
- Numbness and tingling
It is important to note that a person may have evidence of spinal stenosis on an MRI or CT scan but are unaffected in any meaningful way. In such cases, symptoms sometimes gradually appear and worsen with time. Therefore, it is important to recognize the signs of spinal stenosis and seek professional medical care when necessary.
If you experience neck or back pain that lasts for more than a few days, then you should consider visiting your primary care physician. Additionally, it is not uncommon to experience anxiety involving this process, but this can be alleviated by taking it slow and asking questions. Generally speaking, reaching a diagnosis for most conditions involves three important steps:
- Symptom Discussion & Medical History: In most cases, a diagnosis starts with a question-and-answer session between you and your doctor. Your doctor will ask you to describe the symptoms you are experiencing, as well as a variety of other factors. This may include facts about your lifestyle, your diet, previous treatments, and other pre-existing medical conditions. Additionally, your doctor may ask you questions about your family’s medical history. This is because many conditions that cause back and neck pain are inheritable.
- Physical Examination: To better understand the source of your symptoms, your doctor will apply pressure around your neck and back. Furthermore, they will also test your range of motion and attempt to identify areas of pain to further understand the source of your symptoms. Unfortunately, this process is usually uncomfortable, but it provides your physician with valuable information.
- Medical Imaging: In order for your doctor to make an accurate diagnosis of spinal stenosis, he or she will often resort to medical imaging. Usually, this comes in the form of an MRI or CT scan, which provides an inside view of the spinal column. These imaging tests will show the exact cause of the narrowing, such as herniated disc material or bone spurs.
Once you have received your diagnosis, your doctor will work with you in order to develop an personalized care plan. Generally, many spinal stenosis patients are actually able to return to normal activities without having to resort to surgery. The reason for this is because a range of more conservative treatment usually brings more meaningful relief from symptoms.
Commonly used conservative methods are:
- OTC and prescription pain medication
- Physical therapy
- Massage therapy
- Low-impact exercise
- Hot and cold compresses
- Corticosteroid injections
- Chiropractic adjustments
- Intermittent rest
Minimally Invasive Surgery
Minimally invasive spine surgery is a safer and effective alternative to traditional open back procedures. There are two main types of minimally invasive spinal procedures: decompression and stabilization. Both types can be used to treat SS, however the best option for you will depend on your individual case.
This type of minimally invasive surgery is primarily used to treat mild and medium cases of spinal stenosis. Most stenosis patients fall within this category. The two most commonly used minimally invasive decompression surgeries for spinal stenosis are the laminotomy and foraminotomy. With decompression surgery, the common goal is to remove the diseased portion of the spine. This may be a bone spur, a herniated disc, or some other abnormality that compresses nerve roots.
A surgeon can typically perform the procedure through a small, 1-inch incision. The smaller incision allows for faster recovery time, less scarring, and less damage to surrounding muscles. Once the incision is made, the surgeon removes the infected portion of the spine and the nerve decompresses. Because this procedure is performed as an outpatient procedure, patients usually return home the same day the surgery is done.
Stabilization surgery is used for more severe cases of spinal stenosis, and may be required to treat chronic symptoms and pain. This procedure is performed through a small incision in the back, side, or neck. The access point depends on the location of the patient’s spinal stenosis. In order to access the affected area, the surgeon will carefully move aside the surrounding muscles to avoid unnecessary damage. Once the spine is accessible, the surgeon then removes the affected area, which is usually a vertebrae or disc. Once your doctor has removed the area, an implant takes its place in order to stabilize the spine. Common examples of minimally invasive stabilization surgery includes transforaminal lumbar interbody fusion and anterior cervical discectomy fusion.
If you have pain in your neck or back lasting for more than a few days, please contact us at (855) 853-6542 or fill out a form online. At the OLSS, we understand that the medical needs of each patient are different. We will work tirelessly to ensure that you receive the personalized care plan you need for your case.
Lower back pain affects nearly one-quarter of the population. If you suffer from chronic back pain, then you know how it can impact your life. Pain prevents you from doing the things you love. It keeps you from working and enjoying time with your family and friends.
You’ve tried to deal with the pain on your own. Over-the-counter medications aren’t helping. You don’t want to continually use dangerous and addictive prescriptions. You just want to wake up in the morning without that awful reminder that something is not right with your back.
When managing your chronic pain requires more aggressive treatment, you may need to seek the help of a pain management specialist. These professionals are specifically trained to treat complex, chronic pain.
Use this guide to learn more about pain management specialists, who they help, and the treatments they use to battle chronic pain.
What is a Pain Management Specialist?
Individuals with chronic pain often require a comprehensive approach to treat the condition. Advances in medicine have given doctors and other professionals better insights into the physiology of pain. Moreover, continuous research provides medical professionals with more and more tools to treat pain.
A pain management specialist has special training and experience to treat complex, chronic pain issues. Doctors specializing in pain management undergo extra training to get board-certified in this area. After they complete their medical degree, they enter into a fellowship program. This in-depth program allows for a higher level of study and practice, making them experts in the field.
Fellowship programs usually require at least one year of intensive training. Those entering a pain management fellowship often study anesthesiology, neurology, physiatry, and physical medicine. After the fellowship is completed, they become eligible for board certification in their particular area of pain management.
How is a Pain Management Specialist Different from a Typical Doctor?
Board-certified pain management specialists have a deeper understanding of the complexities of pain. They are better qualified to diagnosis painful conditions accurately. Their vast knowledge of different medications allows for safer and more accurate prescriptions that reduce pain. In addition, they develop skills to perform pain management procedures like the ones mentioned later in this article.
What Back Pain Conditions Can These Specialists Help?
Unlike strains or sprains in the back, chronic back pain is more challenging to treat. When conservative treatments like over-the-counter medications, physical therapy, and changing personal habits aren’t successful, a pain management specialist can help.
Common conditions that can require more aggressive pain management include:
- Failed back surgery syndrome: If there is no relief after one or several back surgeries, the source of the pain may be difficult to pinpoint. It can be due to scar tissue, arthritis, or nerve damage.
- Fibromyalgia: This disorder causes various levels of pain throughout the body. Pain can be widespread or migrate to different regions of the body. Fibromyalgia can be devastating to a person’s physical, mental, and social well-being. There is no known cure for this condition. So, the best course of treatment involves managing your symptoms.
- Neuropathy: Most pain signals start from the source of a trauma and travel through the nerves to the brain. Neuropathy is a distinct type of pain that originates in the nerves. The nerves send faulty pain signals to the brain. This condition can be caused by an injury, diabetes, infection, or substance abuse.
Treatments for Chronic Back Pain
A pain management specialist uses a variety of treatments to help your chronic back pain. Treatments can reduce or even eliminate symptoms. In addition, these treatments may reduce reliance on strong, often addicting, medications. Common pain management techniques for the lower back include:
Intraspinal drug delivery supplies pain and anti-inflammatory medications right to the source of the problem. Injections of corticosteroid medications cause a nerve block, which prevents pain signals from reaching the brain.
A pain specialist numbs the area where the injection takes place. Then the specialist uses live x-ray guidance to inject medications into the epidural space of the spine. This space is the outermost part of the spinal canal, which houses spinal nerve roots and other tissues. The corticosteroid helps to shrink swelling, which can cause pain and pressure around the nerve roots.
This minimally invasive procedure freezes the outer layer of nerves to disrupt pain signals that would otherwise travel to the brain. During the procedure, a specialist inserts a tiny probe—about the size of an IV needle—into the affected area. At the top of the probe is a tiny ball of ice. It is cooled to around 3 degrees Farenheit by pressurized gas. This intense cold causes a freezer burn on the surface of the nerve. A recent study found patients receiving this treatment experienced a significant reduction in pain for up to six months.
Repeated cryoneurolysis treatments may be necessary as the nerve begins to regenerate.
Similar to cryoneurolysis, this procedure uses a probe to disrupt the nerve’s pain signals. Instead of using cold, however, radio frequency waves heat the tip of the probe. Using live x-rays, the specialist numbs the affected nerves. Then, your doctor will create a lesion on the nerve with the heated probe.
This minimally invasive procedure usually takes around an hour. Patients often return home the same day. However, pain relief may take up to 10 days to reach full impact.
Spinal Cord Stimulation
By inserting a spinal cord stimulator (SCS) into the back, it helps to mask pain signals before they can reach the brain. Similar to a pacemaker used in the heart, an SCS delivers electrical pulses to the spinal cord. The pulses modify the way in which your nerves dispatch pain signals to the brain.
Pain specialists use a two-stage process for spinal cord stimulation. The initial, trial SCS determines if this procedure will benefit you in the long run. The trial phase usually lasts from 4 to 7 days. Then you will return to the doctor’s office to discuss any relief of symptoms. If the trial stage shows a significant decrease in pain, a permanent SCS will be implanted.
This procedure involves placing electrode leads into the affected site. Specialists use small incisions to reach these areas. A small part at the back of your vertebrae is removed to make room for the leads. The leads are then secured with sutures in the epidural space.
Once the leads are secured, wires are tunneled through the back and attached to the pulse generator. Your doctor will insert the device into the skin just below the waistline. Once your doctor has connected everything, he or she will close the incision.
The goal of spinal cord stimulation is a 50 to 70% reduction in pain. The procedure doesn’t work for everyone. This is why the trial stage is necessary. Some studies show long-term pain relief in up to 80% of patients.
Finding Treatment for Your Chronic Back Pain
All the treatment options for chronic pain can be overwhelming. You just know you’re dealing with pain and you want it to go away.
Consulting with our experts at Orthopedic & Laser Spine Surgery may be the game changer for managing your chronic pain. Our award-winning surgeons and medical staff specialize in pinpointing the source of your pain. Using the latest research, technology, and treatments, we help people, just like you, who struggle with pain every day.
The first step to successfully managing your pain is setting up an appointment. Don’t hesitate to find out how our wide range of treatments can help you get your life back.