Pain Management Education

EPIDURAL STEROIDS

An epidural steroid injection (ESI) is an injection of a small dose of anti-inflammatory medication (called a glucocorticoid) into the lower back to relieve pain in your legs or lower back. The medication is injected into an area of fatty tissue surrounding the spinal nerves called the epidural space. By reducing inflammation, an ESI can help reduce your pain. An ESI can be both a treatment and a way to diagnose a specific nerve root problem when there is a question.

SPINAL CORD STIMULATOR

A Spinal Cord Stimulator is a type of implantable neuromodulation device that is used to send electrical signals to select areas of the spinal cord for the treatment of certain pain conditions which is called Spinal Cord Stimulation. In spinal cord stimulation (SCS), mild electric currents applied to the spinal cord through small medical devices modulate pain signals and in some settings, replace the pain sensation with a mild tingling known as paraesthesia. Spinal cord stimulation involves placing a series of electrical contacts in the epidural space in the spine near the region that supplies nerves to the painful area. The procedure is a minimally invasive ambulatory surgical technique.

FACET JOINT BLOCK

A facet joint block is an injection of local anesthetic (numbing medicine) into one or more of the small joints located along the side of each vertebra on both sides of the spine in the lower part of the back. Multiple injections may be performed, depending upon how many joints are involved. Facet joint blocks are typically requested for patients who have pain primarily in their back as a result of arthritic changes in the facet joints or for patients who have mechanical low back pain. A facet joint block may be diagnostic (a test to see if your pain is coming from this area) and/or therapeutic (to relieve your pain).

NERVE ABLATION

Nerve ablation or Radiofrequency ablation (RFA) is a minimally invasive procedure that is performed at a doctor’s office or a hospital. Patients usually return home the same day. RFA uses heat to destroy tissue. To manage the pain, radio waves are sent through a precisely placed needle to heat an area of the nerve. This prevents pain signals from being sent back to your brain. RFA is considered for long-term pain conditions, especially in the neck, lower back, or arthritic joints that haven’t been successfully treated with other methods.

RADICULAR PAIN

Radicular pain is generally a severe lancinating pain, often burning in nature, which is felt in the distribution of the dermatome associated with the nerve root. Radicular pain occurs when pain radiates from an inflamed or compressed nerve root. As an example, an inflamed nerve root in the neck may radiate pain into the arm or hand. Radiculopathy occurs when a compressed or inflamed nerve root results in neurological deficits, such as problems with reflexes, numbness, and/or weakness.

SCIATICA

Pain that results from irritation of the sciatic nerve and typically radiates from the buttock to the back of the thigh. Although sciatica can result from a herniated disc pressing directly on the nerve, any cause of irritation or inflammation of this nerve can reproduce the painful symptoms of sciatica. Diagnosis is made via observation of symptoms, physical examination, nerve tests, and sometimes X-ray or magnetic resonance imaging (MRI), if a herniated disk is suspected. Treatment options include avoiding movements that further irritate the condition, use of medication, physical therapy, and sometimes surgery.

HERNIATED DISC

Rupturing of the tissue that separates the vertebral bones of the spinal column. The center of the disc, which is called the nucleus, is soft, springy, and receives the shock of standing, walking, running, etc. The outer ring of the disc, which is called the annulus (Latin for ring), provides structure and strength to the disc. The annulus consists of a complex series of interwoven layers of fibrous tissue that hold the nucleus in place.

LOW BACK PAIN

Pain in the lower back area that can relate to problems with the lumbar spine, the discs between the vertebrae, the ligaments around the spine and discs, the spinal cord and nerves, muscles of the low back, internal organs of the pelvis and abdomen, or the skin covering the lumbar area. Low back pain can start in a person’s early twenties and continue on throughout adulthood. Studies have shown that up to 80% of the general population are affected by low back pain (LBP) at some time during their lives. Learn to prevent lower back pain by knowing what activities could be putting you at risk.

PHYSICAL THERAPY FOR BACK PAIN