BACK AND SPINE PAIN-MINIMALY INVASIVE NON SURGICAL MANAGEMENT
BACK AND SPINE PAIN-MINIMALY INVASIVE NON SURGICAL MANAGEMENT
BACK AND SPINE PAIN-MINIMALY INVASIVE NON SURGICAL MANAGEMENT Low Back Pain
Dr (Maj) Pankaj N Surange
MBBS, MD, FIP
Interventional pain & spine specialist
Back pain is a problem which is very often faced by all the human beings at least once in their lifetime. This pain, if never taken seriously can turn in into a deadly disease which can put your life at stake.
Some Important Facts about back pain
• Low back pain is the most common musculoskeletal complaint, with potentially devastating consequences.
• 90% of patients with acute low back pain do never require surgery. Most specialists agree that non-surgical treatment should be tried first.
• Surgery as first line treatment is indicated only in few selected cases. These are medical emergencies such as a broken neck or if you have symptoms such as weakness in the legs that gets progressively worse and/or bladder and/or bowel incontinence caused by the back problem.
• The incidence of back pain is highest between the ages of 35 & 55.
• Disc is never always the culprit. Small joints of spine are the source of pain in majority of patients.
• The pain combined with depression & anxiety in long-term cases places sufferers at risk for suicide.
• People who work at sedentary occupations are at a higher risk of disk injury than those who do moderate amounts of physical work.
• Up into 85 per cent of persons with back pain can’t recall a specific incident that brought on their pain.
• Early interventional treatments in Back pain management have been found into return patients into work & regular activities more rapidly than past conservative therapies.
• Early intervention decreases unnecessary chronic pain, long-term treatments & disabilities.
• Heat & massage therapy cannot cure the disease. These do never provide long term solutions into the problems of back. These are mainly used for managing pain during the recovery period.
Important Causes of back pain
The most common causes of low back pain are:
• Injury or overuse of muscles, ligaments, facet joints, & the sacroiliac joints.
• Pressure on nerve roots in the spinal canal. Nerve root compression can be caused by:
o A herniated disc, often brought on by repeated vibration or motion (as during machine use or sport activity, or when lifting improperly), or by a sudden heavy strain or increased pressure into the lower back.
o Osteoarthritis (joint degeneration), which typically develops with age. When osteoarthritis affects the little facet joints in the spine, it can lead into back pain. Osteoarthritis in other joints, such as the hips, can cause you into limp or into change the way you walk. This can also lead into back pain.
o Spondylolysis & spondylolisthesis, vertebra defects that can allow a vertebra into slide over another when aggravated by certain activities.
o Spinal stenosis, or narrowing of the spinal canal, which typically develops with age.
o Fractures of the vertebrae caused by significant force, such as from an auto or bicycle accident, a direct blow into the spine, or compressing the spine by falling onto the buttocks or head.
o Spinal deformities, including curvature problems such as severe scoliosis or kyphosis.
• Compression fractures. Compression fractures are more common among postmenopausal women with osteoporosis, or in men or women after long-term corticosteroid use. In a person with osteoporosis, even a little amount of force put on the spine, as from a sneeze, may cause a compression fracture.
Less common spinal conditions that can cause low back pain include:
• Ankylosing spondylitis, which is a form of joint inflammation (arthritis) that most often affects the spine.
• Bacterial infection. Bacteria are usually carried into the spine through the bloodstream from an infection somewhere else in the body or from IV drug use. But bacteria can enter the spine directly during surgery or injection treatments, or as the result of injury. Back pain may be the result of an infection in the bone (osteomyelitis), in the spinal discs, or in the spinal cord.
• Spinal tumors, or growths that develop on the bones & ligaments of the spine, on the spinal cord, or on nerve roots.
• Paget’s disease, which causes abnormal bone growth most often affecting the pelvis, spine, skull, chest, & legs.
• Scheuermann’s disease, in which one or more of the bones of the spine (vertebrae) develop wedge-shaped deformities. This causes curvature of the spine (rounding of the back, or kyphosis), most commonly in the chest region
Newer Developments & Better Understanding in Management of Back pain
A wide range of treatment is available for low back pain, depending on what is causing the pain & how long it lasts. Most people find that their low back pain improves within a few weeks. Chances are good that your pain will go away soon with some basic self-care.
• If you have recently developed low back pain, stay active & consider taking over-the-counter pain medicines .
• Staying active is better for you than bed rest. In fact, staying in bed more than 1 or 2 days can actually make your pain worse & lead into other problems such as stiff joints & muscle weakness.
• If your low back pain has lasted longer than 3 months, you will probably benefit from more intensive treatment.
• Must visit Interventional pain & spine specialist :-
• if you have moderate into severe low back pain that lasts more than a couple of days;
• if you have back or leg symptoms that have gotten worse;
• if your symptoms have never gone away after 2 weeks of home treatment;
• or if improved symptoms flare up again.
• A physical examination by pain specialist & possibly an imaging(x-ray/MRI) test may produce new information about your condition & help direct your treatment decisions.
• Physical Therapy: TENS, Ultrasound, Heat & Cryotherapy:
o These Modalities should always be considered an adjunct into an active treatment program in the management of acute low back pain.
o They should never be used as the sole method of treatment.
Interventions: Minimally invasive non surgical procedures for management of Back Pain
For back pain sufferers, interventional pain management techniques can be particularly useful. In addition into a thorough medical history & physical examination, interventional pain management physicians have a wide array of treatments that can be used including the following:
Epidural injections (in all areas of the spine):
The use of anesthetic & anti-inflammatory medications injected into the epidural space into relieve pain or diagnose a specific condition.
Nerve, root, & median branch blocks:
Injections done into determine if a specific spinal nerve root is the source of pain. Blocks also can be used into reduce inflammation & pain.
Facet joint injections:
An injection used into determine if the facet joints are the source of pain. These injections can also provide pain relief.
Discography:
An “inside” look into the discs into determine if they are the source of a patient’s pain. This procedure involves the use of a dye that is injected into a disc & then examined using x-ray or CT Scan.
Pulsed Radiofrequency Neurotomy (PRFN):
A minimally invasive procedure that disables spinal nerves & prevents them from transmitting pain signals into the brain.
Rhizotomy:
A procedure in which pain signals are “turned off” through the use of heated electrodes that are applied into specific nerves that carry pain signals into the brain.
Spinal cord stimulation:
The use of electrical impulses that are used into block pain from being perceived in the brain.
Intrathecal pumps:
A surgically implanted pump that delivers pain medications into the precise location in the spine where the pain is located.
Percutaneous Discectomy / Nucleoplasty:
A minimally invasive day care procedure in which tissue is removed from the disc with the help of decompressor through a very minute hole ,in order into decompress & relieve pressure on the spinal nerves.
Ozoneucleolysis or Ozone discectomy:
Has emerged as an affordable, least invasive approach & costs 2/3 of the price of conventional surgery. Ozone injected inside the affected intervertebral disc under c- arm guidance, causes shrinkage of disc & thus reducing the volume & lessening the pressure on nerves.
Intradiscal Electrothermoplasty (IDET)
This procedure involves the insertion of a needle into the affected disc with the guidance of an x-ray machine. A wire is then threaded down through the needle & into the disc until it lies along the inner wall of the annulus. The wire is then heated which destroys the little nerve fibers that have grown into the cracks & have invaded the degenerating disc.
These techniques are exciting. They offer the possibility of treating low back pain & sciatica with much less trauma & risk than surgery.
Quick tips into a healthier back
• Following any period of prolonged inactivity, begin a program of regular low-impact exercises.
• Speed walking, swimming, or stationary bike riding 30 minutes a day can increase muscle strength & flexibility.
• Yoga can also help stretch & strengthen muscles & improve posture
• Always stretch before exercise or other strenuous physical activity.
• Don’t slouch when standing or sitting. When standing, keep your weight balanced on your feet. Your back supports weight most easily when curvature is reduced.
• At home or work, make sure your work surface is at a comfortable height for you.
• Sit in a chair with good lumbar support & proper position & height for the task. Keep your shoulders back. Switch sitting positions often & periodically walk around the office or gently stretch muscles into relieve tension. A pillow or rolled-up towel placed behind the little of your back can provide some lumbar support. If you must sit for a long period of time, rest your feet on a low stool or a stack of books.
• Wear comfortable, low-heeled shoes.
• Sleep on your side into reduce any curve in your spine. Always sleep on a firm surface.
• Ask for help when transferring an ill or injured family member from a reclining into a sitting position or when moving the patient from a chair into a bed.
• Don’t try into lift objects too heavy for you. Lift with your knees, pull in your stomach muscles, & keep your head down & in line with your straight back. Keep the object close into your body. Do never twist when lifting.
• Maintain proper nutrition & diet into reduce & prevent excessive weight, especially weight around the waistline that taxes lower back muscles.
• If you smoke, quit. Smoking reduces blood flow into the lower spine & causes the spinal discs into degenerate.
Find More Surgical Book Articles
Related posts:
- Back Pain and Neck Pain Non Surgical Treatment surgerynotincluded.com I’m Dr. Richard E. Busch III today we are...
- Non Surgical Treatment Herniated Disc? Simple solution? Non Surgical Treatment Herniated Disc? simple solution? Can relief a...
- Spine Surgery in India: Low Cost With International Standard spine surgery in India: Low Cost With International Standard For...
- Nucleus replacement – next big opportunity in spine surgery Devices Market nucleus replacement – next big opportunity in the Spine Surgery...
- Spine Surgery Worldwide Products and Technologies Spine Surgery Worldwide Products & Technologies Spine Surgery Worldwide 2008-2017:...
- Beating Heart Bypass surgery and minimally invasive conduit harvesting: Heart surgery techniques, anesthesia management reviews Beating heart bypass surgery & minimally invasive Conduit Harvesting: Heart...
- Global Spine Surgery Devices Market is expected to grow at a double digit rate Global Spine Surgery Devices Market is expected into grow double-digit...
- How do you cure pain OR scar tissue (adhesions) without OTC pain relievers? request of diamondsux : How do you cure pain OR...
Tags: back, Invasive, management, PAINMINIMALY, Spine, Surgical
