If you struggle from chronic pain from adult scoliosis, don’t despair. Here are five treatments that can combat the wear and tear to your back and spine, while delivering pain relief that can last for weeks — or months — at a time.
Sacroiliac joint injections
Up to one-third of people suffering from chronic low back pain can trace it to the sacroiliac joint (SIJ). One way to alleviate SIJ pain is through injection therapy: the administration of a local anesthetic and anti-inflammatory medication (called a “corticosteroid”) directly into the joint and into the surrounding nerves. This pain relief can be immediate and can last up to several months at a time.
One double-blinded study at the National Institute of Health analyzed the effectiveness of SIJ injection and found that one month following a SIJ injection, patients described up to 70 percent pain relief in 83 percent of the joints injected with a corticosteroid.
However, there are instances where an SIJ injection may not bring lasting relief. Your doctor may recommend a follow-up treatment called radiofrequency ablation of the sacroiliac joint.
Epidural steroid injection
An epidural steroid injection can relieve pain from scoliosis when medication is delivered to the spinal nerve roots through the epidural space (the area between the protective coverings of the spinal cord and the vertebrae). The injection should be performed under live X-ray (fluoroscopy) and may involve the use of a dye to visualize the proper placement or spread of the medication.
In an ESI, the steroid medication is an extremely potent anti-inflammatory, which breaks the pain cycle at the level of the spinal cord or nerve roots. In severe degenerative back pain, the length of pain relief tends to be a bit shorter but still delivers relief. Note: if you are diabetic, have an allergy to contrast dyes or have other serious medical conditions, you should discuss these with your pain doctor prior to the injection.
A facet injection actually can be used for two purposes. One, the injection can be used as a test to diagnose if pain is coming from the facet joints (as opposed to disc pain, which can be similar). Second, a facet injection can be used to relieve back pain. It can be an attractive option for managing back pain as a minimally invasive procedure. The doctor injects a long-lasting corticosteroid and local anesthetic directly into the joint capsule, or into the tissue surrounding the joint capsule. However, this type of injection tends to be more temporary than the others listed, but may reduce pain enough for a patient to be able to do physical therapy for their back pain.
Radiofrequency ablation should be a follow-up treatment from the Facet Injections or Sacroiliac Joint Injections. If the facet injections or sacroiliac joint injections provide temporary relief of hours, then the source of the pain has been identified and should lead to a radiofrequency ablation being performed to provide a much longer lasting relief. During this treatment, the nerves that supply sensory pain signals from the facet joint or SIJ are treated with radiofrequency heat energy. The doctor first begins by injecting numbing medication into your skin, then using a special kind of X-ray machine called a fluoroscope to position the radiofrequency needles precisely over the targeted nerve tissue. Radiofrequency ablation is an outpatient procedure that takes about 30 minutes to complete.
This treatment is used to disrupt the communication of pain signals, which can result in six to 12 months of freedom from back pain.
Trigger point injection
Trigger point injections are helpful in treating myofascial pain syndrome, which is a chronic form of muscle pain. According to the Mayo Clinic, when sensitive areas of tight muscle fibers form in your muscles after injuries, they become “trigger points” that can cause pain to radiate outward in your back.
Trigger point injections help reduce inflammation and break the pain cycle of the myofascial tissue. A small amount of an anti-inflammatory drug, mixed with local anesthetic, is injected into the trigger point.
Living with chronic back pain can be discouraging, but relief is on the horizon. At Novocur, its doctors specialize in pain management to help you break the pain cycle and regain control of your life.
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