Back Pain Management


The spinal cord is the main thoroughfare of our nervous system. It is connected to, and surrounded by, a large number of bones, ligaments, tendons, nerves and muscles. This means that a problem in just one area can affect all of the others.

One of the most difficult things to handle during rehabilitation is pain. During treatment and recovery from spine surgery, injury or disorder, pain is still felt even if the patient is already getting better.

Pain can cause depression and limitations in mobility. It can also disrupt your basic needs, making you unable to eat or sleep. Pain management is a big part of non-surgical rehabilitation for the spine.

Managing pain makes sure that the treatment continues properly. It helps you stay active, and able to do any other physical therapies your doctor recommends. Even if the pain is just minimal, it is important to treat it so that it does not worsen. Talk to your therapist or physician so that they can handle it immediately. Most back pain disappears after two to 12 weeks, but do not disregard or ignore it. A dull ache or sharp piercing sensation can mean something else to a medical doctor.

An injury or disorders like arthritis can lead to acute back pain that may last up to six months. This pain can be described as a shooting or stabbing pain or even a muscle ache. It may prevent you from standing up straight, restrict your ability to move as well as prevent you from doing your daily activities.

If the pain is the same kind that you felt at the initial onset of your spinal problem, that means the pain is recurring. If the pain lasts longer than six months, that means it is chronic. It typically gets worse over time and it may be hard to pinpoint the source of this pain. It is important to contact your doctor if the pain continues even after your spinal disorder has healed. If the pain prevents you from sleeping or doing your daily activities you should also tell your physician.

Pain management overlaps with other kinds of non-surgical pain management therapies such as acupuncture, conservative medical care, braces, drug therapies, electrotherapy, behavioral medicine, chiropractic medicine, physiatry, physical therapy, stress management and surgical intervention. However, the newest trend is interventional pain management.

Instead of oral pain medication, interventional pain medication uses injections. Aside from delivering the medication directly to the affected area, this also helps in the diagnosis. An x-ray or MRI scan often shows two or more problem spots. In cases like these, doctors can inject separate areas of the spine with anesthetic solution to determine which is causing the most pain.
There are different kinds of procedures that can be done in interventional pain management. One is the epidural steroid injection. This injection contains a cortisone solution that has anti-inflammatory properties. This is injected directly into the spine. It lessens the swelling and irritation of a section of the spinal cord. The effects of the therapy are known to last for weeks or months, removing or lessening the pain in patients. Additional injections can be made in case the symptoms flare up again.

A selective nerve root injection can also be done. An x-ray or fluoroscopy is done to find the problematic nerve root. Instead of injecting the entire spine, the medication is delivered directly to this specific nerve.

Facet joints connect the vertebral bones of our spine, with one pair connecting each level. Arthritis in these joints is one of the common causes of spine pain. Again using the fluoroscopy or x-ray, drugs are delivered straight to the facet joint. This helps relieve pain and confirm that these joints are the ones that are causing the problem.

The last kind of interventional pain management therapy is a sacroiliac joint injection. The sacrum, also called your tailbone, is found at the base of your spine. A joint, called the sacroiliac joint, connects it to your pelvis. If there is a problem with this joint, it can result in lower back or leg pain. Like the other treatments, the aim is to inject medication directly to the sacroiliac joint.