Interventional Treatment Options for Back Pain

The human spine consists of 24 separate vertebrae interspaced with cartilage, plus the two bones of the sacrum and coccyx. Supporting these bones are 23 discs, more than 30 muscles and tendons that provide spinal balance, stability and mobility, and three major ligaments that prevent excessive movement of the vertebrae.

With all those moving parts, what could go wrong?

Why Does My Back Ache?

When it functions properly, the human spine is a wonder of engineering. The bones, muscles, tendons and ligaments operate like a finely tuned machine to keep us erect, support us while we sit and allow us to bend, twist and turn with ease.

But like all machines, if one part fails, it can interrupt the entire smooth operation. So it is with the back.

There are plenty of reasons why people suffer from  back pain, but among the most common are:

• Injuries such as ligament sprains, tendon strains or muscle spasms that are often the result of playing sports or traumatic auto accidents or falls.
• Degenerative conditions such as osteoarthritis, osteoporosis and spondylosis that are caused by normal wear and tear of the joints, discs and bones of the spine as we age.
• Herniated or ruptured discs that press on spinal nerves.
•  Spinal stenosis which occurs when the spinal column narrows, often putting pressure on the sciatic nerve (sciatica).
• Sacroiliitis is the inflammation of one or both of the sacroiliac joints where the lower spine and pelvis connect.
• Failed back surgery (laminectomy).
• Congenital conditions that affect the natural curvature of the spine such as scoliosis.
• Pain from other sources that radiate to the back, such as kidney stones, endometriosis, fibromyalgia and tumors.

What if Conservative Therapies Fail to Bring Relief?

When treating patients with back pain, responsible physicians will always prescribe the most conservative therapies first. These include the tried-and-true recommendations of:

• Acetaminophen, aspirin or non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen
•  Heat and/or ice to relieve the pain, reduce inflammation and improve mobility
• Gentle stretching exercises that strengthen core or abdominal muscles

But if the pain persists, an experienced pain medicine specialist can offer a number of interventional treatments based on the exact source of the pain.

Putting Pain in its Place

Advancements in science and technology are enabling skilled pain medicine specialists to accurately diagnose and treat chronic back pain without the risks of major surgery. These treatments are performed on an out-patient basis without the need for lengthy hospitalization or rehab. In fact, patients are often able to resume their normal activity level within days.

• Facet Joint Injections: Corticosteroid medication is delivered directly to worn or inflamed cartilage inside the joints of the lower spine (facets) that control our ability to bend and twist.
• LinQ™ is a new minimally invasive therapy that uses a small bone graft to fuse and stabilize the sacroiliac (SI) joints for patients with SI joint disruption or inflammation.
• Lumbar Steroid Injections: Corticosteroid medication to reduce inflammation is injected into the area surrounding the spinal nerve root that is irritated and causing pain. 
• Spinal Cord Stimulation (and peripheral nerve stimulation): A small device implanted under the skin delivers precise electrical pulses that interrupt pain signals before they reach the brain. 
• Vertiflex: A small h-shaped spacer is fed through a tube and placed between the vertebrae to expand the space and relieve the pressure on affected nerves caused by spinal stenosis. 

Given the complexity of the spinal anatomy, patients with back pain should seek the expertise of a qualified pain medicine specialist. They have the skills to accurately locate and diagnose the source of the pain so that they can then provide the best treatment options for long-term relief.

Dr. Ioannis Skaribas is fellowship-trained and double board certified in Pain Medicine and Anesthesiology. He has been performing minimally invasive treatments to address chronic pain for more than 25 years and is nationally recognized for his expertise in employing the latest advanced treatments such as LinQ™ to help his patients with complex chronic pain.

Sources: 

https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Low-Back-Pain-Fact-Sheet

https://www.innerbody.com/image_skelbov/ligm23_new_bov.html