Back pain and low back pain can often be alleviated and even prevented with a few simple exercises to strengthen the muscles of the back, stomach, hips and thighs. Activities such as running, walking, swimming and bicycling are excellent ways to keep these muscles strong and flexible. There are also numerous stretching and strengthening exercises that condition these muscle groups, including wall slides, leg raises and sit-ups. Talk withyour doctor about which activities are best for you. Whatever fitness regimen you choose, it is important to start out slowly if you have not been active in a long time, and to stretch thoroughly before and after exercising to prevent injury.
Epidural Steroid Injections
Epidural steroid injections, or ESIs, have been used for decades to temporarily relieve low back and leg pain (sciatica). They have been shown to be effective for pain in the neck (cervical) and mid-spine (thoracic) regions as well. They are most often recommended for patients with:
Facet Joint Blocks
Like SNRBs, facet joint blocks can be diagnostic or analgesic. They are performed when pain arises from the cushioning cartilage or lubricating capsule of a facet joint. Facet joint pain usually results from twisting injuries or age-related cartilage degeneration. During a facet joint block, the physician injects the solution of a steroid and a local anesthetic and/or saline solution into the joint under fluoroscopic (real-time X-ray) guidance. If the injection relieves pain, the doctor knows that that particular joint is the source of the problem.
Radiofrequency ablation uses radio wave-generated heat to destroy the nerves that serve the facet joint alongside the rear of the spine. This prevents the joint from transmitting pain to the rest of the body. The procedure may be recommended after a series of nerve blocks has determined that the facet joint is the source of the patient's back pain.
During RF ablation, the physician inserts a needle via fluoroscopic guidance beside one of the two nerves of the facet joint. A local anesthetic numbs the area, and then the nerve receives RF energy for about a minute and a half. The needle is repositioned, and then the other nerve is treated. Pain should be relieved after the procedure. However, the nerves may regrow after about six months. To reduce or prevent a recurrence of pain, patients are often encouraged to adopt a physical therapy or exercise program to strengthen the muscles around the facet joint. If pain returns, RF ablation can be repeated.
Discography, or a discogram, is an injection that helps doctors locate a painful disc before performing lumbar fusion surgery in patients whose pain has not responded to conservative treatments. A discogram may be ordered when other diagnostic injections have failed to pinpoint the source of the pain, which may affect the back, legs, groin or hips.
Plasma Disc Decompression (Nucleoplasty)
Disc decompression procedures have long been used for patients suffering back and leg pain from a herniated or "slipped" disc. The goal of the procedure is to remove part of the intervertebral disc and thus reduce pressure on the nearby nerve roots that cause the pain. Plasma decompression, or DISC Nucleoplasty, is the most advanced technique for disc decompression yet developed. A slim tool called a SpineWand is inserted into the center (nucleus) of the herniated disc via a small needle. Then, unique Coblation® plasma technology decompresses the disc without the use of heat, leaving surrounding tissue undamaged. Taking only 30 minutes to perform, DISC Nucleoplasty offers patients a less traumatic procedure and faster recovery than other traditional and even minimally invasive decompression techniques.
For more information about our Spine Services, or to schedule an appointment, please call 978-454-0706.