For back pain sufferers, interventional pain management techniques can be particularly useful. In addition to a thorough medical history and physical examination, interventional pain management physicians have a wide array of treatments that can be used including the following:
Epidural injections (in all areas of the spine):
The use of anesthetic and anti-inflammatory medications injected into the epidural space to relieve pain or diagnose a specific condition.
Nerve, root, and median branch blocks:
Injections done to determine if a specific spinal nerve root is the source of pain. Blocks also can be used to reduce inflammation and pain.
Facet joint injections:
An injection used to determine if the facet joints are the source of pain. These injections can also provide pain relief.
Discography:
An "inside" look into the discs to determine if they are the source of a patient's pain. This procedure involves the use of a dye that is injected into a disc and then examined using x-ray or CT Scan.
Pulsed Radiofrequency Neurotomy (PRFN):
A minimally invasive procedure that disables spinal nerves and prevents them from transmitting pain signals to the brain.
Rhizotomy:
A procedure in which pain signals are "turned off" through the use of heated electrodes that are applied to specific nerves that carry pain signals to the brain.
Spinal cord stimulation:
The use of electrical impulses that are used to block pain from being perceived in the brain.
Intrathecal pumps:
A surgically implanted pump that delivers pain medications to the precise location in the spine where the pain is located.
Percutaneous Discectomy / Nucleoplasty:
A minimally invasive day care procedure in which tissue is removed from the disc with the help of decompressor through a very minute hole ,in order to decompress and relieve pressure on the spinal nerves.
Ozoneucleolysis or Ozone discectomy:
Has emerged as an affordable, least invasive approach and costs 2/3 of the price of conventional surgery. Ozone injected inside the affected intervertebral disc under c- arm guidance, causes shrinkage of disc and thus reducing the volume and lessening the pressure on nerves.
Intradiscal Electrothermoplasty (IDET)
This procedure involves the insertion of a needle into the affected disc with the guidance of an x-ray machine. A wire is then threaded down through the needle and into the disc until it lies along the inner wall of the annulus. The wire is then heated which destroys the small nerve fibers that have grown into the cracks and have invaded the degenerating disc.
These techniques are exciting. They offer the possibility of treating low back pain and sciatica with much less trauma and risk than surgery.
Dr Pankaj Surange
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