Minimally Invasive Lumbar Discectomy Surgery – Is it Better?

Posted on January 23, 2012 by daveman

Spinal discectomy surgery is one of the most common back surgeries in existence. At any one point in time, approximately 1% of the US population is dealing with a herniated lumbar disc.

The first thing to understand is that there is only a small percentage of people dealing with sciatica who actually end up needing a lumbar discectomy. If it does become necessary, the question is are there significant benefits to having the surgery done minimally invasively as opposed to traditionally?

It does seem very attractive when someone says I’m doing your surgery minimally invasively. There are visions of having of pinhead sized incision, minimal blood loss, and being able to get up and walk right after the surgery. The reality is that only part of that is true.

The concept of minimally invasive surgery began about a decade ago and the surgery has gone through numerous improvements over the years. There are some plastic tubes that spine surgeons can operate through which involve spreading the muscles around the spine rather than cutting right through them. Surgeons may use headlights to look down those tubes and there are actually suction devices that double as retractors to save space. It all sounds great in theory and even looks great but does it actually work better?

The studies to date looking at minimally invasive spine surgery have shown that blood loss is pretty much equivalent to the traditional types of surgery. Also, there has not been a statistically significant improvement in recovery time with the minimally invasive type of surgery. There have been some trends in the data, but it is not been definitively shown. Along with this, surgery time has not really changed with minimally invasive surgery, and in fact may actually take longer because it can be difficult to see through the tube.

The concept of minimally invasive surgery of the back is here to stay. It is a relatively new type of surgery and the hope is that larger studies will show that it truly does benefit patients in many aspects of outcomes. It really does make sense when you look at the problems with having such an open type of surgery. Having said that, the actual incision size for spinal discectomy done traditionally is not much larger than that done in a minimally invasive to fashion.

Prior to undergoing any type of discectomy surgery, patients should exhaust conservative therapies such as with a chiropractor Scottsdale or a chiropractor Mesa AZ, and the results with either type of discectomy surgery have been shown to be excellent even though there are some small but real risks associated with both.

If you are dealing with sciatica and have not attempted significant conservative treatment yet, for pain center is a comprehensive pain management Phoenix Center that can help you with multiple treatment options. We have pain management doctors in Arizona who are Board Certified and Fellowship Trained.

Call today at 602-507-6550 to get started with your treatment.

Looking At Some Of The Myths Of Pain Management at an AZ pain center

Posted on January 17, 2012 by daveman

Pain management is a very large business. There are in excess of 100 million people in the US suffering every year from chronic pain, and pain management cost of this exceeds $500 billion annually. A lot of myths exist in pain management, and here are some of them.

1. Opiates are always bad. Every year, there are over 15,000 overdose deaths from narcotics and there is lots of bad press on a regular basis regarding “pill mill” medical practices. So a significant amount of the general population looks at narcotics as always being a bad thing when prescribed by pain management doctors in Arizona.

However, opiates do have a place in pain management phoenix. In an patient who has cancer for example they can make the end-of-life very tolerable as opposed to enduring constant pain for months.

And those patients who are not candidates for surgery and are handling chronic pain, opiates as a treatment may folks to continue enjoying a functional life, working, playing with their kids. Also treatment with a chiropractor Scottsdale may help tremendously along with Phoenix Physical Therapy.

So opiates do have a place in the treatment dealing with acute and some types of chronic pain.

2. MRI will always give a diagnosis for back pain. Even with the most highly trained medical doctors, currently it is only possible half of the time to give people a real definitive diagnosis for what is causing their back pain.

This includes those who have had a detailed workup including a history and physical, radiographs, and even an MRI.

3. Back surgery fixes all back pain. A lot of the time there is not really a surgical cure for a person’s lumbar pain. Spinal fusion surgeries have increased 15 times over the past decade and the population in the US has not gone up nearly that much. The results have not improved over that time, so back surgery is not always the answer.

4. Only 3 steroid injections are allowed annually. Pain management Phoenix doctors are not in agreement with how many shots are ok. Research has not shown what is the best number. So some people say 4 injections per year and others say a lot more is okay.

With the steroid being injected in one are, the cortisone stays in that area and very little of gets into the bloodstream. So more than 3 can be done each year, we just don’t know exactly what’s okay.

5. All pain management involves narcotic medications. This is truly a myth. A comprehensive approach to back pain is now recommended for back pain. This includes such treatments as physical therapy, Tempe chiropractic treatment, along with interventional Phoenix pain management such as epidural injections, facet injections, or potentially trigger point injections. This approach allows pain relief without narcotics.

Preferred Pain Center has pain management doctors in Arizona along with chiropractors Phoenix and Phoenix physical therapy. A One Stop Shop!

Call (602) 507-6550 to make your appointment today.

FAQ’s – Facet Injections with Pain Management Doctors in Arizona

Posted on January 15, 2012 by daveman

Exactly what is a facet joint injection?

Injection into a facet is a procedure where steroid is placed into the thumbnail size joints on either side of the spine that are causing pain.

What is the purpose of a facet injection?

These joints develop arthritis like any other joint, and arthritis is one of the biggest problems in the US. As individuals age arthritis develops or it may set in after a traumatic incident, and if arthritis develops in one facet typically it develops in several.

If a person has facet joint arthritis, surgery is not the best option since there is no surgery which effectively replaces the facet joint and replicates its native motion. Therefore, an injection may give people substantial symptomatic relief similar to an injection into the shoulder, knee, or hip. Also treatment with chiropractors Glendale may help a lot.

How long does the injection take?

Typically when a patient receives a facet joint injection they are receiving it into several painful joints. Each one may only take a few minutes, but when you add up several joints being injected the entire procedure may take 30 minutes or so.

What exactly is being injected with a facet injection?

When the facet injection is performed the pain management doctors in Arizona will often include a numbing medication like lidocaine in addition to the steroid. There are several steroids that the specialist at an Arizona pain clinic will use and typically it’s due to their personal preference. Options include methylprednisolone, Celestone, or triamcinolone.

Does a facet block hurt?

A needle is put through the skin to do a facet block at a Phoenix pain center. So that does hurt slightly, however AZ pain doctors will typically put in some numbing medicine just under the skin as well as in the track down to the joint for pain relief. Therefore the injection should not be overly painful. Individuals can also receive IV sedation for the procedure which may help considerably.

Typically people do not need IV sedation for a facet injection. However, if the person has issues with claustrophobia or anxiety, it may be prudent to include IV sedation.

How’s the injection done?

Typically patients are on their bellies for the procedure. Typically a fluoroscopy machine is used for the procedure.

The injection area is sterilized and the person has vital signs monitored during the procedure, especially if sedation is being used. Afterwards, the individual is watched for a while. The individual is then permitted to go home and if sedation was received they will need a ride home.

Can people go back to work the next day?

Most patients will be able to resume work the next day after a facet block. If sedation is not used, the person could actually go back to work the same day if they want.

How long will the pain be relieve afterwards?

Pain relief with a facet block at an AZ pain center is extremely variable. It may last several months, or may only last a few days. There really is no excellent method to predict the duration of pain relief. If treatment with a chiropractor phoenix is included it may boost the pain relief.

Can the procedure be repeated?

The answer is yes. If therelief wears off after a few months and comes back injection can be repeated. A radiofrequency ablation may then be indicated which can provide pain relief for over a year.

Preferred Pain Center is a comprehensive Arizona pain center providing the best pain management doctors in Arizona. Call (602) 507-6550 to make your appointment today.