The Spine And Pain Institute: Non-Surgical Interventions For Back Pain Management

Epidural Steroid Injection

A steroid is a powerful type of anti-inflammatory medication that treats pain by reducing swelling of muscle tissue and soft tissue. When tissue is swollen it can put pressure on nerves and cause pain. Although inflammation occurs normally when the body’s immune system is triggered, some conditions like arthritis and auto-immune diseases trigger an inflammatory response even when there is no need. Doctors can treat inflammation that is causing back pain by injecting a steroid directly into the spinal cord.

Facet Joint Injections

A common cause of back pain is osteoarthritis, also known as facet joint syndrome.  The facet joints are the joints within the spine that allow the back to bend and curve. Pressure on the joints, often caused by the degeneration of disks, can cause the cartilage to wear away, and this leads to painful bone-on-bone friction and irritation of muscle tissue and nerves. To treat facet joint syndrome, doctors often prescribe an injection of an anesthetic directly into the affected joint or joints. The injection is guided by a fluoroscope, a tiny camera that helps doctors target a very precise area.

Medial Branch Block

When pain originates in the facet joints between the vertebrae, a medial branch block can be used to deaden the nerves that transmit pain signals from the joints to the brain. This procedure involves injecting a long-lasting local anesthetic near the nerves that branch from a facet joint, and the treatment may include injections at multiple sites. This treatment can provide temporary relief and also serve as a diagnostic tool to determine which joints are affected.

Radiofrequency Ablation

Once doctors have determined exactly which nerves are involved in a patient’s back pain, they may recommend a more long-term pain solution known as radiofrequency ablation. To perform this procedure, the doctor inserts a micro-electrode through needle-like tube. A radiofrequency current is transmitted through the electrode to the surrounding tissue. The heat generated by the current disrupts the nerve’s capacity to transmit pain signals. Though not a permanent solution, this method can bring pain relief for up to two years.

Vertebroplasty And Kyphoplasty

A compression fracture of the spine occurs when a vertebra compresses and cracks due to pressure or weakness of the bone. The pain of a compression fracture can be especially severe. Our doctors treat this condition with vertebroplasty, a procedure which involves injecting a cement-like substance into the broken bone. When the cement hardens, it can stabilize and support the spine, which in turn relieves pain and increases mobility for the patient. An alternative method of vertebroplasty is known as kyphoplasty, a procedure that involves inserting balloons to create space in a compressed bone and then filling the balloon with bone cement.

 

Lumbar Sympathetic Nerve Block

The lumbar sympathetic nerves are located on either side of the spine in the lower back. Although these nerves normally control functions like blood flow and digestion, they are also sometimes associated with pain in the lower back, legs and feet. To treat pain originating in the lower back, the doctor may recommend a lumbar sympathetic nerve block. This procedure involves injecting a local anesthetic, sometimes along with a steroid and other medications to extend the pain relief benefits.