Interventional Procedures for Chronic Low Back Pain

Many patients with chronic low back pain do not respond to conservative treatments, such as medications and physical therapy. For many people, chronic low back pain is best managed using interventional procedures. These procedures are interventional because they involve invasive methods for treatment of pain.

How common is chronic back pain?

According to a recent Internet-based survey in the U.S., 30% of people report some type of chronic pain. Of those surveyed, 8% reported chronic low back pain. More than half of the respondents said they had daily pain, and rated the pain as severe.pain-procedure2

Who performs interventional procedures?

Because interventional treatment procedures are precise, they must be performed by licensed, trained professionals who have the appropriate credentials. Neurologists, anesthesiologists, radiologists, and physiatrists all perform interventional procedures.

What types of injections are considered interventional procedures?

To temporarily interrupt the cycle of pain, the doctor may recommend an injection. These include:

  • Epidural steroid injection (ESI) – This involves injecting a corticosteroid, along with a local anesthetic, into the epidural space, which is near the spinal cord. This procedure relieves inflammation, decreases swelling, and alleviates pain.
  • Selective nerve root block (SNRB) – A local anesthetic or neurolytic agent can be injected onto or near the affected nerve. This works to alleviate pain by blocking pain signal transmission from the nerve to the brain.
  • Facet joint injection (FJI) – The facet joints are tiny spaces along the posterior region of the spinal column. These spaces can be injected with an anesthetic and/or steroid agent.
  • Trigger point injection (TPI) – Trigger points are painful regions along the body that cause pain. The doctor can inject these areas with an anesthetic to deactivate them.

What is spinal cord stimulation (SCS)?

Spinal cord stimulation (SCS) is a method of providing pain relief using a special stimulator device. This unit is implanted into the body (lower abdomen or buttocks) and has wires that connect to electrodes surgically placed along the spinal cord. Mild, pleasant electrical impulses are sent to the spinal cord to interrupt the transmission of pain signals to the brain. SCS is used when other treatment measures have failed.

What is an intrathecal pain pump?

An intrathecal pain pump is a device that infuses opioid and other medication directly into the cerebral spinal fluid (CSF), which surrounds the spinal cord. This is used for patients who have tried many forms of therapy and radiofrequency ablationprocedures without positive results. Severe, intractable pain and cancer pain are treated with intrathecal pain pumps.

Can the Chicago pain management doctor destroy the nerves responsible for the pain?

Using radiofrequency nerve ablation (RNA), the pain management specialist can temporarily disable nerves responsible for back pain. This procedure involves heating the inserted needle to interrupt the nerve’s ability to transfer pain signals. The nerves are only sensory, so it’s perfectly ok to disable them for relief.

What if the back pain is related to a vertebral compression fracture?

When a patient suffers a fracture of one of the vertebra (vertebral compression fracture or VCF), the doctor may choose to perform a kyphoplasty procedure. This involves inserting a special needle and balloon through an incision and into the damaged bone. Once the balloon is inflated, and bone height is restored, cement is injected into the area to hold the bone in position.

The Chicago pain specialists at PPS are tops in their field and provide top treatment at eight locations in the metro area. Most insurance is accepted, with appointments for back pain relief being readily available. Call today!

Resources

Cameron, T. (2004). Safety and efficacy of spinal cord stimulation for the treatment of chronic pain: A 20-year literature review. Journal of Neurosurgery, 100, (3, Suppl Spine): 254–267.

Johannes, C.B., Le, T.K., Zhou, X. et al. (2010). The prevalence of chronic pain in United States adults: results of an Internet-based survey. Journal of Pain, 11(11), 1230-1239.

National Institute of Arthritis and Musculoskeletal and Skin Diseases (2005). Handout on health: back pain. Retrieved June 19, 2008. http://www.niams.nih.gov

Raphael, J.H., Southall, J.L., Gnanadurai, T.V., Trehane, G.J., & Kitas, G.D. (2002). Long-term experience with implanted intrathecal drug administration systems for failed back syndrome and chronic mechanical low back pain. BMC Musculoskeletal Disorders, (3)17.

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