Lower back pain, a.k.a lumbar pain, is one of the most common pain conditions that you may experience. Because it’s invisible, lower back pain may be difficult to diagnose and treat. Whether you’re suffering from chronic or acute lumbar pain, finding treatment can be frustrating. If you’re looking for a treatment option that doesn’t rely on medication, then interventional pain management may be right for you.
What is Interventional Pain Management?
Interventional pain management is a type of treatment method that relies upon minimally invasive procedures to reduce or relieve your pain. Consequently, these less invasive techniques treat pain without relying on heavy-duty narcotic medications or surgical intervention.
For example, interventional pain management techniques may include:
- injections (in particular epidural steroid injections, facet joint injections, sacroiliac injections, trigger point injections, spinal injections)
- radiation
- nerve blocks
- epidural infusion
- spinal cord stimulation
- deep brain stimulation
- radiofrequency ablation
- and much more
The benefits of interventional pain management often far outweigh the risks, especially when compared to surgery.
Lumbar Conditions and Interventional Pain Management
In fact, great strides have been made with interventional pain management techniques and lumbar conditions. Once you’ve received a proper diagnosis for your pain, usually by diagnostic imaging or a physical exam, your physician can recommend the best course of action for treatment. Oftentimes, interventional procedures, especially when combined with NSAIDs, heat/ice and physical therapy, can help with the management of acute or chronic pain.
Lumbar conditions that use interventional pain management techniques include:
- Muscle Spasms: commonly caused by sprains or strains to surrounding tissues and muscles, resulting in painful “spasms.”
- Sacroiliitis: the sacroiliac joint connects your pelvis to your spine. When this joint becomes inflamed, it can produce pain.
- Facet Arthropathy- the facet joints connect to the spine, providing stability and movement. When they start to degenerate or become arthritic, the joints may 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, causing inflammation, stiffness and pain. In severe cases, it can cause bones to naturally fuse together, making the affected area immobile.
- Lumbar Degenerative Disc Disease (DDD)– this degenerative process causes the cushioning discs between vertebrae to lose hydration, resulting in stiffness and pain.
- Lumbar Herniated Disc(s)– discs between each vertebra of the spine provide cushioning. Within these discs is a gel-like substance. When the disc becomes injured, the substance can leak from a tear into disc wall. When this happens, the internal disc fluid can cause 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 and neck pain, stiffness, numbness, and tingling.
- Lumbar Spondylosis- spondylosis, often used as a synonym for osteoarthritis can affect the spine. In some cases, bone spurs (a bone outgrowth which forms along the edge of a bone or joint) can form, resulting in pain and decreased range of motion.
- Lumbar spondylolisthesis- a condition in which a vertebrae slips forward or backward from the vertebrae below it. This slipping causes a narrowing of the spinal canal or exiting nerve roots. Spondylolisthesis can cause low back or lower extremity pain, stiffness, paresthesias, and weakness.
Types of Interventional Treatment for Lumbar Pain
Many pain management specialists suggest interventional treatments for lumbar pain. But what types of interventional pain management techniques can be implemented into your treatment plan?
They include:
- Cortisone injections– cortisone, a synthetic-based injectable medication, has anti-inflammatory properties. When cortisone is injected into the affected area, it can decrease inflammation.
- Trigger point injections- intramuscular injections that decrease inflammation in the tissue and affected muscles.
- SIJ injections/lumbar facet injections: injecting cortisone directly into the sacroiliac joint or multi-level facet joints.
- Lumbar medial branch blocks: a diagnostic procedure in which Lidocaine or cortisone is injected around the affected facet joints nerve ending’s. Oftentimes, it allows the physician to determine if a patient should use radiofrequency ablation.
- Radiofrequency Ablation (RFA): a therapeutic procedure in which the affected nerves are cauterized for longer-lasting relief.
- Lumbar Epidural Steroid Injection: therapeutic injections in which cortisone is injected around the affected disc and nerve endings.
- Stem Cell Injections: stem cells, formed at birth, have the unique ability to change into other types of cells found throughout the body. Once stem cells have been harvested from the body, they can regenerate, producing tendons, ligaments, bones, and joints. They can also enhance the natural repair of the affected area.
- Intrathecal Pain Pump: an implanted device that provides targeted drug delivery. Cerebrospinal fluids flow through the intrathecal space (the area surrounding the spinal cord), providing protection for the spine. The pump uses an implanted catheter to deliver small amounts of opioid medication muscle relaxers directly into the spinal fluid.
- Spinal Cord Stimulator: a small device implanted underneath the skin. Electrical leads thread through the epidural space, providing stimulation to block pain signals traveling to the brain. Additionally, a small handheld device allows you to turn the stimulator on/off, and adjust the setting of the internal device.
Where to Get Help for Lower Back Pain
In order to achieve long-term pain relief with interventional pain management techniques, consult with a pain management physician or primary care physician to discuss treatment options for lower back pain. By using a combination of interventional pain treatments, physical therapy and medications, they can improve your quality of life, while also preventing the need for surgical intervention.
Although lumbar pain can affect the old and young alike, you can take steps to prevent it. For example, as they age, many people get stairlifts installed”. Your doctor can help by offering suggestions for the treatment of pain and for the increase in your quality of life. For more information, ask your doctor about the benefits of interventional pain management and how it can help with your condition.
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