Cleveland’s Pain Management for
Back, Neck & Spine
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The common causes of low back pain include trauma, ageing, degeneration, and fractures. The specific anatomic sources of low back pain include muscles, tendons, ligaments, joints (including the facet and sacroiliac joints), intervertebral discs, nerve roots, bursa, and the coccyx. The spine can also become affected by disc herniations, protrusions, bulges, or extrusions.
There have been many studies which have recently helped us to better understand the common causes of low back pain. Many of these causes can be pinpointed by specifically blocking the nerves that travel to the joints, muscles, tendons, ligaments, and discs, and in doing so, enable us to accurately diagnose low back pain. Until recently, many people have suffered with low back pain without a clear diagnosis … doctors have simply diagnosed their pain as “low back pain”. And while this is a description, it does not offer a diagnosis or specific cause. There can also be other anatomic structures that are confused with low back pain, such as pain that originates in the hip joint, so they must be ruled out as well during the diagnosis process.
“The personal, economic, social and functional impact of persistent low back pain can be substantial.”
Low back pain is a common health issue which can cause debilitating pain as well as functional impairment. Accurate diagnosis is the key to effective treatment and conservative therapy should be utilized before considering surgery.
Chronic Neck Pain
The prevalence of patients reporting a Grade 2-to-4 pain level, which is defined as “high pain and dense intensity with disability”, has increased. In other words, more people are experiencing a long-lasting pain that impairs their daily function and is associated with significant health, social, and economic impacts as well.
Causes of neck pain can include traumatic events, degeneration, fractures or dislocations, tumors, and infections. Some of the structures that can cause pain in the neck include the discs, nerve roots, bones, muscles, tendons, bursa and ligaments. Facet joints have been implicated as the source of pain for nearly half of all patients who suffer from chronic neck pain, and the reason is simple … they have a significant and abundant nerve supply which can cause pain to be referred to the back of the head, neck, shoulders, and upper arms. But despite the recent explosion in popularity of imaging studies such as x-rays, MRIs, and CT scans, facet joint pain doesn’t always show up. In fact, most of these studies are not reliable for an accurate diagnosis of facet-related pain, so other measures must be taken.
“Long lasting pain relief can be obtained by radio frequency ablation, which is commonly known as burning of the nerves. This gives anywhere from 9 to 18 months of continuous pain relief.”
Treatments for neck pain include non-steroidal anti-inflammatory medications (NSAIDs), anti-depressant medications (Elavil, trazodone), anti-convulsants (Lyrica, Neurontin), opiate pain medications, physical therapy, chiropractic care, neck braces, gravity inversion therapy, stretching, manipulation therapy, injection therapy, radiofrequency ablation, and spine surgery.
Spinal surgery should be a last resort and should be embarked on only after conservative therapy has not alleviated the pain. An accurate diagnosis is the key to successful outcome for patients suffering from chronic neck pain.
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