Low back and neck pain are very common health problems worldwide and are a major cause of disability affecting performance at work and general well-being. Neck and low back pain can be acute, sub-acute, or chronic. Though several risk factors have been identified (including occupational posture, depressive moods, obesity, body height and age), the causes of the onset of low back pain can be straight forward but at times can be obscure, frustrating and making the diagnosis difficult to establish.
The lifetime prevalence of non-specific (common) low back pain is estimated at 60% to 70% in industrialized countries.
Any tissue of the neck and low back can be a source of pain the most common being the discs, joints and nerves.
Disc hernias may press on the nerves of the spine causing sciatica or shooting pain, tingling and numbness into the arms and hands. The discs themselves can be a source of pain.
The joints, ligaments and muscles of the spine may also be as source of pain.
Pain may be localized, referred to other parts of the body (joint pain), and when the nerves are involved, the pain may radiate to the arms, legs or ribs.
Determining the source of pain can be straight forward or quite challenging and in some cases the cause if not always determined.
INTERVENTIONAL PAIN MANAGEMENT
There are several ways of treating and managing spine pain. Some of these techniques can be used to establish the cause of spine pain.
Epidural Injections – nerve and disc pain.
Epidural injections are procedures where medications are injected into the spine with the goal of alleviating nerve and disc pain. The injections are performed using x-ray guidance and can be performed with local anesthetic or light sedation.
Facet joints injections and radiofrequency ablation – joint pain
The joints in the neck, mid and low back, also known as “facet joints” may also be a source of pain. Facet injections can be performed to alleviate spine pain. Facet “blocks” are performed to test whether or not the facet is the source of pain. If the facet block helps alleviate the pain, it is then concluded that the facet is the source of the pain.
Radiofrequency ablation is a medical procedure where heat is applied to the facet joint nerve which results in long term pain relief.
Spinal cord stimulator therapy – low back and nerve pain.
This therapy consists of the introduction of insulated electrodes into the spine to alleviate pain in the spine, arms and legs.
Intrathecal Pump Therapy
This type of therapy consists of the direct delivery of medication in to the spine through a pump. These therapies can help patients with chronic low back pain. Baclofen can be administered through these pumps to help manage spasticity following strokes, spinal cord injury, and multiple sclerosis.
Trigger point injections help alleviate pain from painful muscle spasms secondary to injury.
Ask your physician if you are a candidate for any of these forms of treament.