Question

Interventional Pain Management For Low Back Pain!

Dr.Ruchi Gupta · Accepted Answer

Chronic pain in the lower back is intolerable. Treating it with interventional pain medicine ensures you can have a pain-free life. The best part happens to be the multiple alternatives offered by this system and it does not recommend surgery. Chronic lower back pain disables more people than cancer or cardiovascular diseases. This not only affects the quality of life but can also lead to depression. Affected people cannot concentrate on career, and not all nature of jobs is apt for them.

Interventional pain medicine creates a program and routine for various treatments.

Facet injections: Diagnosis and pain relief are offered by facet injections. It diagnoses if the pain emanates from the facet joints of the spine. To identify this, a numbing medicine is injected in the facet joints of the spine. If these joints are where the pain originates, then you will be satisfied for the relief is instant. If the problem is severe, the relief is temporary and if the degeneration is mild, then the relief is long-lasting. The steroid cortisone with the numbing agent is injected, which helps in offering the pain-relieving effect. When only the numbing agent is injected, the pain relief is temporary. Using the steroids helps in bringing down the inflammation. This improves the quality of treatment. Facet blocks, as these facet injections are called, got this name because they block the facet pain. If you are not responding to the facet injections, radiofrequency rhizotomy is recommended.

Radiofrequency Rhizotomy: This advanced treatment helps in alleviating pain caused by progressive degeneration of the facet joints. The pain-sensing nerves in the facet joints are targeted in this treatment. A radiofrequency-generated heat is used to alleviate the pain. The key factor is that your doctor should be aware of the place of origin of your pain. To identify the right nerves, an MRI scan, discography, or facet injection might be used by your doctor. Lumbar discography comes into picture when patients do not respond to the other conventional treatment methods. You need to be awake and guide the radiologist when radiofrequency rhizotomy is performed. An electrode needle is used close to the facet joint that suffers degeneration. After the nerve is numbed with an anesthetic, this thin needle is used to apply heat. The connection between the brain and the nerve is cut down. During this treatment, the nerves above and below the affected nerves are targeted, in addition to the affected nerves. This ensures that no pain is caused even by the less damaged nerves in the future.

Lumbar epidural steroid injection: When the aforementioned treatments fail, Lumbar Epidural Steroid Injection, LESI in short, helps in pain relief by using steroids. The skin is numbed with an anesthetic and the steroids are injected. The targets are the dura and sac that contain the nerve roots. The injections are effective in offering results for a few months. Over a period of one year, three LESI injections can be given. The pain relief is excellent and you can do exercises and stretches after getting one injection. This is an excellent treatment for chronic back pain and sciatica.

Sacroiliac joint block: These are a type of injections that used for diagnosing as well as treating low back pain pertaining to sacroiliac joint dysfunction. It is the joint that is located right next to the spine which is connected from the bottom of the spine to the hip. Here in a needle is inserted in the sacroiliac joint to inject a numbing agent and an anti-inflammatory medicatiton. This injection is repeated thrice a year. Also, for best results the injection must be followed by a physical therapy.

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