Back pain can be a complex condition with multiple treatments. At Nevada Pain, we offer many different options for our patients, working with their particular condition and history to find the safest, least invasive treatment for them. The first step of any treatment is gathering a detailed health history including type of injury (if any), current level of pain and its location, and any other pertinent information.
Your condition may warrant further examination in the form of an MRI or X-rays to rule out any more serious conditions, or Nevada Pain may be able to offer a diagnosis based on physical palpation and examination of the painful area. In some cases, neurological examinations are necessary if there is an indication that nerve damage may be causing the pain. From there, we offer an array of treatments, looking for the most effective, least invasive options first.
For acute back pain that is a result of an injury, strain, or sprain, Nevada Pain staff may recommend something as simple as brief rest, light exercise, and over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs). These types of strain and injuries are typically the result of incorrect use or misuse (e.g., overdoing it at the pick-up basketball game after a long period of inactivity).
Topical treatments such as capsaicin patches are another excellent treatment for acute pain that is neuropathic. On the initial application, the skin may feel like it is burning, itching, or tingling, but with repeated use the pain receptors become desensitized. Capsaicin patches are not necessarily indicated for back pain that is skeletal in nature.
Massage therapy is another non-invasive technique that we recommend for all types of back pain. Massage of affected muscles can help loosen and relax them to relieve pain and soreness. When there is spinal cord involvement, such as spinal stenosis, this would not be an effective treatment.
For back pain that involves the spine, chiropractic adjustments at Nevada Pain can offer immediate pain relief. The doctor uses controlled manual manipulation of the spine to adjust and realign vertebrae. These actions can release trapped air bubbles in the joints, resulting in a harmless popping sound. Some types of spinal manipulation therapy can help create space between the vertebrae, an excellent treatment option for those with herniated or bulging discs.
Minimally-invasive treatments at Nevada Pain for back pain related to the bony structures of the spine include:
- Facet joint injections: These injections of pain-blocking medicine are made directly into the joint that is causing back pain. In addition to pain relief, joint injections can be used as a diagnostic tool.
- Lumbar facet nerve blocks: Lumbar facet nerve blocks target the vertebrae in the lumbar region of the spine and are indicated as a treatment for chronic low back pain.
- Sacroiliac joint injections: This type of injection is administered directly into the sacroiliac joint at the base of the spine. Back pain that radiates down the legs may be relieved with this type of injection.
- Vertebroplasty: Vertebroplasty can be used when a patient has suffered a spinal fracture. Medical-grade cement injected into the fractured vertebrae offers support and structure to the vertebrae that can help with pain.
- TENS: Transcutaneous electrical nerve stimulation is a non-invasive treatment for low back pain that has anecdotal support but still needs more research to better examine the benefits. An electrical pulse administered through pads placed on the skin interrupts pain signals.
- Lysis of adhesions: This procedure is recommended for patients who are experiencing back pain as a result of back surgery. Doctors inject a chemical compound into built-up scar tissue to help dissolve the tissue that may be causing the pain.
- Spinal cord stimulation: Spinal cord stimulation (SCS) uses a device (charger shown above) implanted at the base of the spine to send an electrical, pain-blocking pulse up the spine. SCS is effective for patients who continue to experience low back pain after back surgery.
- Intrathecal pump implants: Unlike other treatments that use numbing agents or electrical pulses to block pain signals, intrathecal implants directly deliver pain-relieving medication to the spinal cord. This treatment is effective for back pain that has not responded well to other treatments.
Prescription medications may be indicated for use in cases where acute injuries become chronic. Rather than utilize opioid medications for chronic pain, more research has shown tricyclic antidepressants to be a good pain management tool. Although their function is not yet well understood, researchers believe that they effectively block pain receptors in the brain and increase the production of serotonin, both of which can offer relief from pain.
In addition to these traditional types of pain relief, Nevada Pain pain specialists also utilize complementary techniques such as biofeedback to help patients learn to cope with their pain and, eventually, minimize the impact it has on their bodies. Doctors measure a patient’s response to pain using the following types of instruments:
- Electromyogram (EMG): Measures muscle tension
- Electroencephalography (EEG): Measures brain wave activity
- Electrocardiogram (ECG): Measures heart rate and heart rate variability
- Galvanic skin response (GSR): Measures the amount of moisture on the surface of the skin
- Thermal feedback: Measures skin temperature
Patients are then taught ways to manage their stress response to pain. Biofeedback is completely non-invasive and has very few, if any, side effects. Offering patients this type of control over their pain management can produce results that go beyond more invasive treatments.
Nevada Pain is committed to offering our patients many different treatment options to manage their pain. Contact us to schedule your appointment today!
Image by JD Hancock via Flickr