Different treatments for different types of pain

Back pain is one of the most common pain in people.

And has many causes, read what is necessary to do to identify them:

Back pain is one of the most common pain in people and can have many causes. To identify these causes it is necessary to make a diagnosis. Discography is one of the most common. This is an invasive diagnostic procedure that is performed under fluoroscopic control. With an intervertebral disc puncture, radiological contrast is introduced into the nucleus pulposus. Discography allows the evaluation of the disc with respect to its volumetric and manometric capacity, its radiological image and the response to the provocation test. Through a discography a physician can detect whether there is a disc abnormality in the spine that is causing the back pain.

Treatments for spinal and axial pain

Once the cause of the back pain is detected through the discography, treatments can be started to combat it, depending on the results. Some of these treatments are as follows:

Epidural steroid injections​

  • An epidural steroid injection (ESI) may be performed to relieve neck, back, arm and leg pain caused by spinal stenosis (a narrowing of the spinal column), spondylolysis (stress fractures), disc herniation or other conditions. During this minimally invasive procedure, medication is injected into the spinal nerve through the area between the protective covering of the spinal cord and vertebrae. While the effects of an epidural steroid injection are temporary — lasting anywhere from several days to several years — the goal is to help patients resume their daily routine and begin a physical therapy program, if recommended. The effectiveness rate is really high, but side effects occur at a minimal rate of 0.1% to 0.5% and include infection, dural puncture, bleeding, and nerve damage.

  • Spinal Cord Stimulation (SCS) – When the inflammation in and around the affected nerves is too big for an epidural injection, SCS is an excellent and effective treatment option that can eliminate the pain without surgery. In SCS, an electrical pulse is delivered directly to the spine, blocking certain neuron fibers’ access to the brain and consequently the brain’s ability to sense the previously perceived pain.

Epidural scar lysis of adhesions​

When scar tissue restricts the normal movement of nerves, an individual can experience persistent pain. Epidural scar tissue lysis is a procedure designed to remove excess scar tissue in the epidural space (the area between the inside of the spine and the protective layer around the spinal cord). Using a fluoroscope to visualize the affected area, the physician injects a medication that disperses the scar tissue and applies steroids to decrease inflammation and boost pain relief. This treatment is also used to treat pain caused by infections and even cancer. Some things that may be necessary following this treatment include the use of medications, physical activity, and sometimes physical therapy sessions.

Intra-articular facet injections​

Facet joints are small joints, located at each segment of the spine, which provide stability and enable the vertebrae to bend and twist. Degeneration of these lubricated connections can occur from everyday wear and tear, arthritis of the spine, a back injury or other stress to the back, and can cause pain in the spinal cord. Injection of a steroid medication into the cervical (neck), thoracic (upper back) or lumbar (lower back) region anesthetizes the facet joints and blocks the pain. Pain relief from this procedure is intended to help a patient better tolerate physical therapy during rehabilitation for a back condition or injury.

Medial branch nerve blocks ​

A medial branch nerve block is a procedure in which an anesthetic is injected near small medial nerves connected to a specific facet joint. Typically several levels of the spine are injected in one procedure.  This procedure has a fairly low level of execution complexity and a very low incidence of complications.

Medial branch radiofrequency ablation​

A radiofrequency neurotomy is a type of injection procedure in which a heat lesion is created on the nerve that transmits the pain signal to the brain. The goal of a radiofrequency neurotomy is to interrupt the pain signal to the brain, while preserving other functions, such as normal sensation and muscle strength. This procedure is regularly used to treat pain in the lower back, buttocks, hips, and groin.

Transforaminal epidural steroid injections​

  • During a transforaminal injection, a small-gauge blunt needle is inserted into the epidural space through the bony opening of the exiting nerve root.

  • These steroid injections buy time to allow healing to occur and/or as an attempt to avoid surgery after other conservative (non-surgical) treatment approaches have failed.

Trigger points injections​

A trigger point injection is an outpatient procedure designed to reduce or relieve the back pain caused by trigger points. These small knots can form in muscles or in the fascia tissue leading to myofascial pain.

And these are some of the most effective treatments for spinal and axial pain.  If you have any complications and want to know more about these treatments we invite you to contact us to provide you with all the information you need.

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