Interventional Spine / Physiatry
Pain can be a constant source of anxiety, disruptive and interfering in everyday things you need and want to do. It diminishes quality of life and robs people of their independence. When you live with chronic pain, due to injury or conditions such as arthritis, you are the only one who can know how it truly feels.
The musculoskeletal system is complex and is often prone to injury and pain from degeneration due to disease and wear and tear. The most common type of injury or pain that people suffer from is back pain, commonly lower back pain in the lumbar region of the spine. When it comes to chronic back pain, research states, that 80 percent of people will have back problems at some point in their lives and is noted as being a main cause of disability in adults throughout the United States.
The spine provides structural support for the rest of the body. The spine contains a group of 33 individual interlocking bones called vertebrae, which are the bony building blocks of the spine, making it possible for our spine to function properly. These vertebrae also act as a shock absorber or protective barrier from injury and damage.
The spine specialists at Personalized Orthopedics of the Palm Beaches understand how living with chronic spine pain can chronically impact your daily life. If you experience lower back pain symptoms for over a month that have not responded to more conservative measures (physical therapy, massage or anti-inflammatory medications) and find yourself growing less and less able to participate in rehabilitation efforts, consider a consultation for spine intervention with our specialists. Spine intervention consists of a wide range of treatments for the neck, lower and mid-back conditions. As an outpatient, a non-surgical procedure is performed, focused on diagnosing your condition, and then preventing and treating it. A comprehensive variety of diagnostic and therapeutic injections, when indicated, are a part of your treatment program.
Interventional treatment options are often more efficient and effective than traditional therapy for your spine (back and neck) pain and discomfort. Also, new interventional spine techniques are an exceptional, minimally invasive alternative to conventional surgery.
Common interventional spine procedures administered by Personalized Orthopedics spine specialists, include:
EPIDURAL STEROID INJECTIONS (ESI)
An Epidural Steroid Injection can relieve your neck, back, leg and even arm pain caused by inflamed spinal nerves by way of a minimally-invasive procedure. Medicines get distributed to the spinal nerve by way of the path between the spinal nerves and bony vertebrae. Relief may last for years. The goal is to decrease your pain to enable you to resume normal activities. When incorporated into a comprehensive pain management plan, epidural steroid injections can provide pain relief that allows you to perform the therapeutic stretches and exercises that can lead to long-term, sustainable improvement.
Epidural steroid injections contain a steroid and an anesthetic. When this liquid is injected into the epidural space surrounding your spinal cord and spinal nerves, it reduces swelling and inflammation of the nerves within that space. As your spinal nerves receive less pressure from the surrounding tissues, you’ll experience less back pain and its associated symptoms, including sciatica.
There are two basic types of epidural steroid injections. Lumbar epidural steroid injections are used to address pain problems in or stemming from your lower spine, while thoracic epidural steroid injections are used to treat pain problems rooted in your mid- to upper spine.
NERVE BLOCKS INJECTIONS
Nerve Block Injections are used to treat pain associated with a nerve. Nerve pain in a joint may be caused by arthritis, injury, and degeneration. An injection temporarily prevents the pain and can identify whether the sensory nerves are the true source of your pain. The effects of a Nerve Block are typically temporary.
SPINAL CORD STIMULATION
Spinal cord stimulation is a therapy that uses a small device to interfere with pain signals before they reach the brain. This pacemaker-like device—the spinal cord simulator or SCS—is implanted in the body and sends electrical pulses to the spinal cord. This helps patients better manage their pain and can be especially helpful for people dealing with chronic back, leg or arm pain.
Stimulation does not work for everyone, the amount of pain relief varies and some people may find the sensation unpleasant. Because of this, a trial stimulation must be performed before the SCS is implanted permanently.
TRIGGER POINT INJECTIONS
Trigger Point Injections are used to care for painful muscle knots. Trigger points can aggravate adjacent nerves which causes the pain to spread and even sometimes circulate to other areas. This procedure is also a minimally invasive one and is administered by injecting a dose of corticosteroid directly into the affected area. A trigger point injection is typically successful at relieving the pain.
LUMBAR/CERVICAL RADIOFREQUENCY ABLATION
Radiofrequency ablation is a nonsurgical procedure that uses the electrical currents of radio waves to numb nerves that cause excessive pain. The electrical currents heat your nerves to interrupt pain messages from being sent to your brain. This provides relief from chronic pain you may experience daily. Radiofrequency ablation is often used to relieve long-term pain from arthritis or injury. Many people choose this minimally invasive procedure for the following benefits:
- Decreases their need for pain medication
- Increases their ability to enjoy and complete normal activities
- Reduces the need for surgery
- Relieves pain
Radiofrequency ablation can eliminate the need for surgeries that may lead to a high risk of infection or addictive prescription medications like opioids.
SI JOINT INJECTIONS
SI joint problems can be difficult to diagnose for a variety of reasons. Because of its location, the joint itself is not easily palpated or manipulated. SI joint dysfunction also shares many of its most typical symptoms with other common problems, including spinal disc herniation and sciatica.
Even when there is a verifiable problem within the SI joint, standard imagining tests like X-rays, MRIs, and CAT scans often appear normal.
If you’re experiencing symptoms that could be related to SI joint dysfunction, our physicians can offer a definitive diagnosis after going over your medical history, checking your SI joint for tenderness, and performing a diagnostic SI joint injection.
A diagnostic SI joint injection involves the injection of a numbing medication directly into your SI joint, using X-ray guidance to ensure accuracy. If the injection offers significant pain relief, it’s likely that your SI joint is the source of your pain problem.
Once you’ve been diagnosed with SI joint dysfunction, our team develops a well-rounded treatment plan that addresses the underlying cause of your pain while providing immediate relief, usually in the form of a therapeutic SI joint injection.
A therapeutic SI joint injection is done in much the same way as a diagnostic SI joint injection, but instead of bathing the area with a temporary anesthetic, it uses a powerful anti-inflammatory medication, or corticosteroid, to reduce inflammation within the joint for immediate and long-lasting pain relief.
Balloon kyphoplasty is a spine surgery that relieves back pain caused by a vertebral compression fracture. Osteoporosis (bone disease) is the primary cause of vertebral compression fractures. Other causes include trauma such as a fall or motor vehicle accident, and some types of cancers affecting the spinal vertebrae. The aim of balloon kyphoplasty is to relieve pain, stabilize the fracture and restore the vertebral body height.
Your doctor recommends balloon kyphoplasty if you have severe pain and deformity that is not relieved by non-surgical treatment modes including rest, pain medications, and braces.
The surgery is performed under general anesthesia. During the procedure, you will lie face down on the operating table. A small incision is made in the back through which a narrow tube is inserted into the compressed vertebra under the guidance of live X-ray. Then a special balloon is inserted through this tube and carefully inflated. This elevates the fracture and restores the vertebra to its original height. The balloon is then deflated and removed leaving behind an open cavity. The cavity is filled with bone cement with the help of miniature surgical instruments. The cement hardens within a few minutes and stabilizes the bone.
You may experience significant pain relief following surgery and will be allowed to get up and walk. Your doctor will prescribe pain medication if necessary and recommend a rehabilitation program to strengthen your spinal muscles. You should avoid strenuous activities for at least 6 weeks.
As with any surgery, balloon kyphoplasty may be associated with certain complications which include infection, nerve or spinal cord injury and cement particles entering the blood or spinal fluid.
OCCIPITAL NERVE BLOCK
An occipital nerve block is a pain-relief treatment that involves an injection of steroid medication into the occipital nerves at the back of your head. This procedure can be an excellent treatment option for many types of chronic headaches, including:
- Cluster headaches
- Tension headaches
- Occipital neuralgia
In some cases, an occipital nerve block can also help treat a neck or spinal injury that’s causing chronic pain. Occipital nerve blocks are usually not a first-line treatment, but they can provide relief for patients who have not responded well to other treatments.
KNEE/HIP JOINT INJECTIONS
Illnesses or injuries can damage the connective tissue in your joints. Damaged joints may feel achy, stiff, swollen, or hot and you may struggle to perform your daily activities. You might even rely on a constant supply of painkillers to manage your discomfort.
Joint pain can be a symptom of many different health conditions. People with the following conditions often suffer from pain in their hips or knees:
- Repetitive stress injuries
- Sports injuries
- Autoimmune disorders
These conditions are often treated with medications or physical therapy. But in some cases, you may struggle with ongoing pain even after receiving other treatments. Joint injections can be a valuable part of your treatment strategy.
We also use nonsurgical methods combined with rehabilitation techniques, that may provide pain relief and improved mobility. To determine which interventional spine treatment method is best for you, call Personalized Orthopedics of the Palm Beaches at (561) 733-5888, Ext. 1 to request an appointment.