Besides the common cold, back pain is the No. 1 reason people visit the doctor. Shockingly, about 80 percent of people will experience back pain in their lifetimes. Worldwide, it is the leading cause of disability.
For most, the pain will subside within a few days, but if it doesn’t, it’s a good idea to seek the guidance of a professional.
Not all back pain is created equal
Your spine consists of 24 bones (vertebrae) connected by surrounding ligaments and muscles to form your spinal column. Your spinal column protects the spinal cord that is made of up nerves that send out signals to different parts of your body. You can imagine, then, with that much complexity, how important a custom treatment plan is to determine the proper care for your specific injury.
There are a number of options to consider when creating your treatment plan, ranging in scope from injections to surgery. Here is what you should know about each treatment option:
There are different injections available depending on your ailments.
- Facet injection: This is best for pain that stems from your movable facet joints (a fancy way of saying the joints that allow your spine to have full range of movement). This will help reduce pain quickly and can also serve to help diagnose where the pain stems.
- Radiofrequency ablation: This is best if the small nerves in the spine are carrying the pain and can provide longer-lasting pain relief than the facet injection.
- SIJ injection: It is best to help quickly diminish pain caused by inflammation. When this injection is used as the treatment, it’s likely physical therapy is the next best move toward healing.
- Epidural injection: As it turns out, an epidural isn’t just beneficial during labor, but it can quickly help pain caused by nerve roots and disks (don’t worry, there are multiple ways to administer).
Often times, no injection is needed and NSAIDs, muscle relaxers, neuropathic pain medications or opioid pain medications can be enough to help.
If you’ve already had surgery and it didn’t work, neuromodulation therapy may be a great next step. Using a generator to implant small electrodes into the affected areas of the spine, it tricks your nervous system into feeling pleasure instead of pain.
If back surgery is the best option…
Some surgeries will require longer healing time than others. For instance, lower back pain may need a more extensive surgery than a pinched nerve resulting in pain in other areas of your body.
While there are exceptions, these are the most common surgical procedures and what to expect.
- Spinal fusion: This does exactly what it says — it fuses the vertebrae to limit how far your nerves can stretch. The good news is that, more often than not, this doesn’t inhibit your post-surgery activity too much.
- Laminectomy: In this procedure, pain is reduced by taking out part of your bones, bone spurs or ligaments, and that can relieve pressure on your nerves and reduce pain. This can also be done in tandem with a spinal fusion.
- Diskectomy: It’s possible that a disk in your spine has slipped, causing pain. If this is the case, the surgeon will remove all or part of the disk. A disk replacement is also common, where an artificial disk is put in place of the one that was taken out so you can continue to have wider range of motion in your spine.
- Interlaminar implant: A U-shaped implant is put between vertebrae to let pressure off of your spinal nerves. With this procedure, there is enough stability with the implant that afterward, besides not being able to backbend as easily, you can move around like normal.
If you are working with an experienced pain professional, your doctor will do everything they can to save surgery as a last option, but it’s important to note for yourself that one of the biggest risks of back surgery is it may not help with the pain. Being under the care of someone you trust is one of the most important things you can do for your long-term health.
Dr. Alex Bigham is the owner and CEO of Novocur Pain Management Clinics and has over 18 years of healthcare experience in private practice and Ambulatory Surgical Center settings. Novocur offers advanced treatment options in a concierge type practice without the concierge price tag. Dr. Bigham appears frequently on local TV and radio programs to discuss the latest in Pain Management or related health topics.