Chronic pain affects millions of Americans each year. Back pain is not only uncomfortable, but it can be debilitating and cause damage to other parts of the body. Living with back pain interferes with the quality of life on a regular basis and can be incredibly limiting.
Back pain can be acute or chronic and there are many factors that determine the kind of pain you experience. Because the back is such a complex structure, conditions vary from short-term wear-and-tear that is relieved using over-the-counter medications to degenerative conditions that are treated by invasive surgeries.
In many cases, back pain is treated through the use of minimally invasive procedures and joint injections. Many physicians use fluoroscopic guidance to perform these types of treatments. This allows them to see the affected area on a display screen and place the needle with extreme precision. Fluoroscopy guidance helps prevent surgery, since is allows minimally invasive techniques to be performed with the greatest accuracy.
Your individual symptoms, the source of pain, and need will determine the best treatment method. There are many minimally invasive procedures and joint injections that work to reduce pain.
This injection is used to reduce inflammation in the spinal column that causes pain and nerve irritation. An anti-inflammatory medication is injected into the epidural space in the spine. These injections are a good option for patients with spinal stenosis, herniated discs, and degenerative disc disease. Patients typically find their relief starts within a week of receiving the treatment and it lasts anywhere from a few days to a few months.
Facet joints are the small joints that allow your back to bend, twist, and move. When they become inflamed or injured, they can cause immense pain. In this procedure, a steroid and anesthetic medication is injected into the joint. It can be very effective for patients who have suffered cartilage damage or back injuries from twisting. Pain relief may last weeks or months. (See image below*)
Trigger points are hyper-irritable nodules within the body of a muscle that are extremely tender. Trigger points refer pain to other areas of the body. These injections administer a numbing agent to the trigger point which allows it to relax and reduce pain. If you experience back pain when pressure is applied in a specific area, trigger point injections may be helpful.
The SI joint connects the lower back of the spine to the pelvis. When the joints become inflamed and painful, movement can be affected and tasks such as sitting and walking. This injection consists of both an anti-inflammatory steroid and numbing agent. It is injected directly into the sacroiliac joint to relieve pain as effectively as possible.
A medial branch nerve is a small nerve that stems from facet joints in the spine. They transmit pain signals from the joints to the brain. This medial branch nerve block procedure is one in which an anesthetic is injected near the medial nerves connected to a specific facet joint.
Lumbar medial branch radio frequency ablation is a procedure that uses radio waves to prevent the lumbar medial branch nerve from carrying pain signals from the injured facet joint to the brain. It is injected into the nerve using X-ray guidance for precision.
*Lumbar Epidural Steroid Injection
Joint injections are an outpatient procedure, and many times, they can be performed in your pain specialists’ office. Patients normally resume walking after the procedure, but need to have someone drive them home after receiving treatments. This is because doctors will administer a low-dose local anesthetic to numb the affected area before treatments.
Is is common for pain to continue a few days after the treatments, especially as the numbing agent wears off before the medication takes effect.
Pain relief generally starts two to seven days after the injection and can be reduced for several months. Many times, your physician will refer you to a physical therapist during this time so you can exercise and strengthen your joints during this time of reduced or eliminated pain.
If injections prove to be helpful, the procedure can be repeated approximately 3 times a year. When joint injections do not reduce your pain, other treatment options are available. Keep track of your pain levels and be sure to communicate clearly with your doctor in order to create the best-suited treatment plan for your individual back pain.