All patients have different tolerance levels for pain. In general, back pain can be some of the most intense pain to treat. Treatment can range from over the counter drugs, prescription drugs, exercise or physical therapy, interventional pain management and of course surgery to correct a problem back.
Interventional Pain Management is treating pain by use of injections into the spine or joint for immediate pain relief and usually longer lasting pain relief. It may be used alone as a treatment or together with a surgical procedure. Xray guidance is used to let the physician clearly see the area to be treated.
Your surgeon will decide if this treatment might be right for your case. A referral will be made and you will be injected in a surgery center location or at the hospital. The procedure will be performed by a physician with advanced training in Anesthesia. You will likely meet the physician on the day to the procedure.
Epidural Steroid Injection
This is a conservative procedure to attempt to control pain due to swollen and irritated nerve roots in the back. These nerve roots can become irritated from bulging discs, spinal stenos is or arthritis. The epidural space is the area outside the sack that contains the spinal cord. Placing steroid in the space reduces the swelling and irritation. Relief varies for each patient. In some cases a series of injections may be necessary.
Facet Joint/Medial Branch Block
This is a steroid injection placed near the two medial nerves that come off one facet joint that separate any two vertebrae in your back. The block is performed to determine if this is the right location of the pain. While you may get some pain relief, this is mostly done as a diagnostic procedure. Ultimately if the correct facet joint is able to be identified you can move to the next level of pain treatment.
Facet Rhizotomy/Radiofrequency Ablation
If the correct medial branch nerve has been identified, you may be a candidate for an ablation, or intentional destruction, of the nerves to stop this pain. It is a nonsurgical procedure using heat. Pain relief can last 6-24 months and will not impact feeling and movement in you arms and legs. Your physician will determine if you are a good candidate for this treatment.
Sacroiliac Joint Injection
The sacroiliac joints are the long joints between your lower spine and hip joint. This injection can be both diagnostic and therapeutic. If anesthetic placed in the joint relieves pain, then the source of pain might be identified. Steroid can then be placed into the joint for relief.