Spinal Pain Management – Non-invasive & Invasive
Non-invasive treatment for back & neck pain may include one or more of the following:
- Activity modification: bed rest, job restrictions, exercise
- Medications: analgesics, steroids, muscle relaxants
- Education
Invasive techniques include the following types of injection therapy:
Epidural Steroid Injection: The injection of steroid or “cortisone-like” medication into the spinal canal in order to decrease inflammation and pain in the area of pinched nerves, ruptured discs, or bone spurs.
Trigger Point Injections: The injection of local anesthetics and anti-inflammatory medication into muscles to relieve tight, achy muscles.
Bursa Injection: The injection of anesthetic and/or steroid in the small fluid filled sacs that provide cushion around joints in the body.
Joint Injection: The injection of anesthetic and/or steroid into a joint that is causing pain.
Facet Injection: The injection of steroid medications into the joints between the vertebrae.
Selective Nerve Blocks: The injections of local anesthetics and/or steroid medication in the vicinity of nerves in order to decrease pain from an area of the body. These can be therapeutic or diagnostic.
Medial Branch Block: The injection of numbing medicine around some tiny nerves near the spine. These nerves transmit pain signals from the facet joints in the back. This procedure is typically done as a test, to make sure the patient would benefit from a Radiofrequency Ablation.
Radiofrequency Ablation (Rhizotomy): This non-surgical procedure is used to “turn off” the nerves that supply the facet joints in the back, using localized heat to inhibit the ability of nerves to transmit pain signals. This typically lasts longer than a regular injection, usually 12-18 months.
Discogram: This procedure is performed to determine if an abnormal disc is causing a patient’s pain. Fluid is injected into discs in the back where a patient’s pain is localized. If the disc is abnormal, this will mimic the patient’s usual pain. The fluid is seen under x-ray and it can be determined if a disc is the source of pain for a patient.
Spinal Cord Stimulator: This implantable medical device is used to treat chronic pain. An electrical impulse generated by the device near the spinal cord provides a “tingling” sensation that can block out the patient’s pain. A trial is usually done before the permanent device is placed, using a temporary lead connected to an external control. The patient controls the level of stimulation to cover their pain.
General Information
A majority of the procedures are done under x-ray guidance, which allows the physician to see the bony anatomy of a patient.
A local anesthetic is used to numb the skin for all procedures.
The type of steroid used varies with every procedure and is not used with all procedures. They are cortisone-like medications that last a long time.
For a majority of procedures the patient will be asked to lay on a table for the procedure. This allows the physician to easily x-ray the spine. The staff will try to make the patient as comfortable as possible.
We ask that the patient stay for a few minutes after the procedure to make sure they are feeling well before leaving the surgery center.
Injections won’t stop all low back and leg pain, but they can reduce pain and break the pain cycle. This cycle may begin when back pain makes it difficult to perform everyday activities. A decrease in movement can then slow down healing. By assisting you in becoming active again, injections can help speed patient recovery. Some individuals may feel more relief from an injection than others. And some individuals may need more than one injection to get relief.