Interventional Pain Management for Lower Back Pain

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lower back pain

By: Melissa Brady

Lower back pain, or lumbar pain, is one of the most common pain conditions that people experience. Because of it being, “invisible,” lower back pain is sometimes difficult to diagnose and treat.

In this day and age where opioids are so readily prescribed, often times physicians are encouraged to prescribe medications to treat the symptoms rather than getting to the root of the problem. Whether you are suffering from chronic or acute lumbar pain, finding treatment can be frustrating.

To avoid the tedious medication “trial and error period,” a more beneficial course of treatment may be found by using interventional pain management.

What is Interventional Pain Management?

Interventional pain management is provided by a healthcare specialist with the goal of reducing or relieving a person’s pain. This allows that person to manage his or her condition, resulting in an improved quality of life.

Interventional pain management relies upon minimally invasive procedures, which help treat and/or diagnose painful conditions so individuals can return to acts of daily living (ADLs) without having to rely upon heavy duty narcotic medications or surgical intervention.

With this type of treatment, there’s less downtime than surgery, and the benefits often far outweigh the risks when considering a less-invasive, outpatient procedure versus a more invasive, inpatient surgery.

Lumbar Conditions and Interventional Pain Management

Lumbar pain is one of the most popular complaints that physicians or physiatrists hear from patients. Once you have been properly diagnosed by means of diagnostic imaging and a physical exam, your physician can then recommend the best course of action for treatment.

Usually combined with NSAIDs, heat/ice and physical therapy, interventional procedures can help with the management of acute or chronic pain. Types of lumbar conditions that can be treated with interventional pain management include:

  • Muscle Spasms- most commonly caused by a sprain or strain to the surrounding tissues and muscles, thus resulting in painful “spasms.”
  • Sacroiliitis- the sacroiliac joint is the joint connecting your hip to your spine. When this joint becomes inflamed from either arthritis or trauma, it produces pain.
  • Facet Arthropathy- the facet joints are the joints connected to the spine that provide stability and movement. When they start to age (degeneration) or become arthritic (arthropathy), the joints become painful.
  • Facet Hypertrophy- a condition in which the facet joint becomes enlarged, causing the lining to become inflamed, swollen and painful.
  • Ankylosing Spondylitis- a form of arthritis affecting the spine and joints, most commonly the facet joints and sacroiliac joints. This form of arthritis causes inflammation, stiffness and pain at the affected area. In severe cases, it can cause the bones to naturally fuse together, making the affected area immobile.
  • Lumbar DDD- “DDD” is the abbreviation for degenerative disc disease. This is the degenerative process in which the cushioning discs between the vertebrae lose hydration, resulting in stiffness and pain.
  • Lumbar Herniated Disc(s)- There are discs in between each vertebrae of the spine that provide cushioning. Within these discs is a gel-like substance. When the disc becomes injured or ruptured, that substance can leak from a tear into the disc annulus (disc wall). Once this happens, the internal disc fluid causes spinal nerve irritation and inflammation, resulting in pain.
  • Lumbar Stenosis- stenosis is the narrowing of the spinal canal, either from trauma or degeneration. This narrowing can cause back pain, stiffness, lower extremity pain, including paresthesias (numbness and tingling) and weakness.
  • Lumbar Spondylosis- spondylosis is a fancy word for degeneration or osteoarthritis. This condition can affect the spine, vertebral joints or discs in the back, causing discomfort. In some cases of degenerative change, bone spurs (a bone outgrowth which forms along the edge of a bone or joint) can form, resulting in pain and a decreased range of motion.
  • Lumbar spondylolisthesis- is a condition in which the vertebrae slips forward or backward from the vertebrae below it. This “slipping” causes a narrowing of the spinal canal and in some cases, causes narrowing around the exiting nerve roots. Spondylolisthesis can cause low back pain and stiffness, and also lower extremity pain, paresthesias and weakness.

Types of Interventional Treatment for Lumbar Pain

Once you have been properly diagnosed, your medical care provider will discuss different treatment options for which you are eligible. One option is injections. Most (but not all) injections are cortisone based.

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