There is at least an eight out of 10 chance that you will experience low back pain at some point during your life. Currently, approximately 20% of individuals are experiencing back pain right now. So it is an extremely common condition, and most of the time it goes away without any treatment. However, for those who end up with chronic back pain, here are four minimally invasive pain management treatments to achieve pain relief while avoiding risky surgery.
1. Facet Injection
The first is a steroid injection into the painful facet joints. The facet joints are the thumbnail size joints at each level of the spine on both sides. They may suffer from arthritis and pain with age.
When a facet injection is performed, a Phoenix pain management doctor will use fluoroscopy, a real-time form of x-ray, to place the needle inside the facet joint. Once accurate placement is achieved, steroid medication along with numbing medicine is injected, similar to how an injection is performed in the hip or the knee joint. This injection is performed as an outpatient and each level takes just a few minutes. A recent review from Pain Physician showed that there is a fair amount of research that backs up the effectiveness of facet injections directly into the joint.
2. Medial Branch Block
Each joint in the spine receives sensation, and that is how it is able to feel pain. The nerve supply comes from medial branch nerve endings, and that is what the injection is designed to block. The first purpose of a medial branch block is to help the pain doctor understand where exactly the pain generator is in the spine.
Thankfully, a medial branch injection works very well for this diagnostic purpose. In addition, the review in Pain Physician showed that the medial branch block also works well as a therapeutic injection for pain relief. The average duration of pain relief with a medial branch block injection is four months. When these injections are performed, the needle does not actually enter the facet joint, but is placed into areas just behind the joint where the medial branches enter.
When the medial branch block wears off and the pain returns, it can easily be repeated with the expectation that similar pain relief will be achieved subsequently.
This procedure has been a godsend in pain management, as the amount of pain relief achieved is substantial and the duration may be upwards of two years. If a regular medial branch injection procedure works well and then wears off, radiofrequency ablation procedures often alleviate the pain for 6 to 18 months. This can lessen the need for narcotic medications, get a patient back to work, and overall has been a revolutionary technology.
Multiple studies have looked at outcomes with RFA procedures. If the pain relief wears off, a repeat RF procedure has almost the same effect as the initial with excellent pain relief for an extended duration
4. Sacroiliac Joint Injection
When you look at where back pain comes from, almost 20% of the time it is coming from one of the sacroiliac joints. It’s almost like the proverbial forgotten stepchild, where it may be seen as an afterthought as a pain generator in the low back. However, it is so common to have referred pain into the low back from a sacroiliac joint problem that it should always be evaluated.
For those individuals who have suspected pain in the sacroiliac joint, then an injection into
the joint can be performed as an outpatient. Pain management doctors in Arizona should use fluoroscopy for this procedure, as these joints are irregular in shape and may be difficult to enter properly.
For a successful sacroiliac injection, it may be necessary to use separate entry points to achieve adequate penetration. If the injection works and then wears off, it is becoming more common to perform an SI joint radiofrequency ablation to obtain extended relief. A study presented last year at a major pain meeting showed over 50% pain relief from three to six months with these procedures
These four procedures and provide exceptional pain relief for those with chronic low back pain. Undergoing low back surgery for spinal arthritis is a risky proposition, so the pain relief can be achieved with one of these options it is ideal. In fact, most of the time it can be for an extended duration.
If you or a loved one is experiencing chronic back pain in the greater Phoenix & Scottsdale areas, let Arizona Pain Specialists help you. The Phoenix pain clinics offer assistance at four Valley locations, including Phoenix, Scottsdale, Glendale and Chandler.
For one number scheduling, call (602) 507-6550 today!