Tag Archives: spinal fusion

Why is Surgery Usually a Bad Idea for Spinal Arthritis?

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Currently, there are more spine surgeries being performed in America than ever before. In fact, in the years 2002 to 2007 the amount of complicated spine surgeries (involving fusions) increased 15 fold. I can guarantee you in those 5 years the population of American did not increase that much. Here’s a look at spine surgery for arthritis.AZ pain centers

As an individual shifts in to their 40s and 50s, degenerative arthritis begins to potentially become a problem. Unfortunately, in the spine there are over 20 sets of facet joints, which are the thumbnail size joints containing cartilage allowing spinal movement.

With each joint containing cartilage, the potential for degenerative arthritis at each one is significant. Essentially, most individuals end up with arthritis at more than one level of their neck or back.

This brings us to the main point here. Performing a spinal fusion of one or two levels may work well for a short time period. When you fuse a level, it can no longer absorb any stress that the body sees. Those stresses either go up or down and may contribute to accelerated arthritis at the adjacent levels. At that point, the patient may be facing an Avoiding Spinal Fusionadd-on fusion surgery, which will continue to escalate as a problem moving up and down the spine.

So it’s a very different scenario than simply performing a hip or a knee replacement, since there’s only one of those on each side of the body. When an individual has spinal instability or degenerative scoliosis due to arthritis, surgery may in fact be extremely helpful.

What is being referred to here is simple degenerative arthritis that is painful. There is no acceptable facet joint replacement like there is for the hip or the knee. Because of this, it is better to exhaust all options with conservative management. This may include physical therapy and chiropractic treatment, spinal decompression therapy, acupuncture treatment, and tens units. There are plenty of research studies showing the benefits of thesePain doctors in Scottsdale treatments for osteoarthritis conditions.

Medication management includes over-the-counter anti-inflammatories and Tylenol. For periods of exacerbation, short-term narcotic medications may be helpful. Over the long-term though, the risks of opiates began to outweigh the benefits.

Interventional pain treatments for degenerative arthritis of the spine have been the best options going. This may include medial branch blocks, facet injections or radiofrequency ablation. These treatments may provide 6 to 18 months of pain relief, and then may be repeated once the pain relief wears off.

There are new treatments coming out for the spine including regenerative medicine injections. These may include platelet rich plasma treatment or stem cell injections. While not widely available, there is ongoing research on their potential.

radiofrequency ablationSpinal fusions for strictly degenerative arthritis have never been shown in published studies to be better than conservative treatments. And there are significant risks associated with operative treatments that do not exist with conservative management.

Therefore all attempts at conservative treatment should be undertaken prior to ever considering an elective spinal surgery. The exceptions to this would be, as mentioned, instability or significant scoliosis, and also spinal stenosis.

If you or a loved one is suffering from chronic back or neck pain due to arthritis, Arizona Pain Specialists offers comprehensive nonoperative pain management treatments. These include Board Certified Arizona pain management doctors and chiropractors offering Pain doctors in Glendale AZmedication management, interventional procedures, spinal decompression therapy, acupuncture, spinal manipulations, tens units and more.

With over 50 insurance plans and 4 locations, there is no better AZ pain clinics to obtain first rate treatment. Call today at (602) 507-6550 for scheduling!

Overview of Degenerative Scoliosis Pain Management Treatment

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Degenerative scoliosis in adults can be extremely painful and cause pain that is in the lower back or possibly radiates down through the buttock region into the legs. How does it occur and what are the treatments for adult degenerative scoliosis?

There are two ways that a person in their adult years develops degenerative scoliosis. The first is if the individual had scoliosis as an adolescent. Studies degenerative scoliosishave shown that if a person has adolescent scoliosis in excess of 35 to 40°, then through adulthood it can worsen at a rate of 1° per year.

This may not sound like a lot, but over a period of 30 years, a person may end up with in excess of a 70° curvature. As scoliosis is typically a three-dimensional curvature problem, the end result may be that the individual tilts off to one side, and also tilts significantly forward.

The second way that a person develops degenerative scoliosis as an adult is through severe arthritis. Anyone who has arthritis in one knee that is much worse than the other knows that arthritis is not often symmetric. What can happen in the spine is that one side can be much more arthritic than the other and the person can start to develop breakdown of that side and a curvature can start to develop.

As the breakdown continues, biomechanics kick in as the angles get severe and can actually make the situation much worse. As the spine continues to angle, nerves that are on the concave side of the curve start to get pinched and that is where the individual can have pain radiating down the buttock and the leg from that compression. so in essence the back pain occurs from the arthritis that has made the curvature worsen, and the leg pain occurs

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X-ray of adult scoliosis

from nerve pinching which is termed spinal stenosis.

What nonsurgical treatment is available for degenerative scoliosis?

Unlike adolescent scoliosis, bracing is of no help for adult scoliosis. Typically the curve is not flexible as arthritis has caused it to worsen and it is what is called a structural problem. So bracing does nothing to correct the abnormal curvature. One treatment that can help significantly is physical therapy. This can strengthen up the muscles around the spine along with a person’s core muscles including abdominals. Similar to physical therapy for extremity arthritis, this can help decrease pain and take some pressure off of the arthritic spinal joints. chiropractic treatment can also help relieve some pain in the back and also from the spinal stenosis. It can help improve blood flow and bring more oxygen in to help with pain control.

Pain medication can be very helpful for degenerative scoliosis pain. Typically from mild to moderate pain over-the-counter medications such as ibuprofen and Tylenol are sufficient. For acute flare-ups, short-term narcotic medication may be very helpful as well. Chronic narcotic medication is not the best idea for the treatment of degenerative scoliosis pain, however, if the person is in severe pain and not a surgical candidate then it may be necessary.

Pain management procedures for the pain from degenerative scoliosis are the best treatment going. Due to the fact that multiple levels are afflicted with arthritis and in pain, injections in or around the arthritic facet joints can significantly reduce the pain level a person is experiencing.

adult scoliosis treatment

Radiofrequency Ablation for Degenerative Scoliosis

Medial branch blocks around the arthritic facet joints can provide pain relief for months, and if the pain returns a radiofrequency ablation at multiple painful levels can diminish the pain for over a year.

Surgery for degenerative scoliosis is a very big decision, as any procedure entails significant risks. It’s a very different procedure then a fusion for adolescent scoliosis, as the individual is not as able to withstand a lot of the  fluid shifts and blood loss involved with the procedure. Most adult scoliosis procedures are either staged or last a very long time, and if surgery can be avoided with effective pain management that is best.

If you’re suffering from painful scoliosis, let Arizona Pain Specialists help you. The practice has multiple locations with Award-winning, Board-certified Arizona pain management doctors and chiropractors who are experts in the management of painful scoliosis.

Call 602-507-6550 for more information and scheduling with the best pain management doctors in Arizona.

Three Reasons Spinal Arthritis is Harder to Treat Than Hip or Knee

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Facet InjectionsWhen one looks at arthritis in joints such as the knee, hip or ankle, it is very different than spinal arthritis. Treatment of spinal arthritis that is causing low back pain, mid back pain or neck pain is significantly tougher to treat than either hip or knee arthritis.

Here are the three main reasons why Arizona pain doctors struggle with it a bit more than extremities:

1. Spinal joints are smaller and there are a lot of them. Typically when a person has arthritis of spinal joints, they have the problem with several spinal joints. These spinal joints are called facet joints and are subjected to arthritis and loss of cartilage just like the hip and knee.

They are only about the size of a thumbnail, yet they have the potential to cause just as much pain on a scale from 1 to 10 as a painful arthritic knee. At every level of the spinal column, a facet joint exists on both sides of the spine. Considering there are over 20 levels in the spinal column, that means there over 40 chances of having an arthritic facet joint. the human body only has 2 knee joints and two hip joints, and two ankle joints. So when you do the math, the facet joints are much more probable to lead to a painful condition.

2. Spinal surgery for arthritis is not as successful as hip or knee replacements. Quality-of-life surveys after hip or knee replacement have shown those procedures to be in the top five worldwide for successful outcomes. Spinal surgery for arthritis is nowhere near the top pain management phoenix azfive outcome procedures. At times it is a roll of the dice, and in others success rates hover around 75%. the success for an artificial disc replacement is equivalent to a spinal fusion procedure, and the success of a spinal fusion for degenerative scoliosis is usually between 75 and 85%.

There is no joint replacement that has been FDA approved for spinal facet joints. The only real surgical procedure available is a fusion for an arthritic facet joint, and that will then take away any movement at that level. The pressures and forces normally seen at that level will then go up or down, and the person may be subjected to adjacent level arthritis with the need for subsequent surgeries in the future.

3. The joints are smaller and difficult to get into for injections. Arizona pain management doctors perform spinal injections for arthritis all the time. Some of these injections involve putting steroid medication directly into the facet joint, and this may be very difficult since the joint is tiny and often overgrown with bone from arthritis.

The good news though is that often times procedures can be performed to alleviate the pain from spinal arthritis without actually having to put a needle into the joint. A medial branch block involves placing medication outside the joint to stop the transmission of pain from the surrounding nerve endings. A radiofrequency ablation is a procedure that can relieve pain from the same tiny nerve endings and can be effective for over a year.

These are the three main reasons why spinal arthritis is more difficult to treat than extremity arthritis. However, nonoperative treatment can be very successful if done with experienced and competent pain management doctors in Arizona.

The Arizona pain doctors at Arizona Pain Specialists are award-winning and Board-Certified. They are experts in the nonsurgical treatment of spinal arthritis, and utilize comprehensive treatment options such as medication management, injections, radiofrequency ablation, along with Scottsdale chiropractor treatment, spinal decompression therapy and physical rehabilitation.

The success rate at Arizona Pain Specialists for the nonoperative treatment of spinal arthritis is over 90%. Call today at 602-507-6550 for more information and scheduling.