Back Pain Conditions, Procedures, and Care
Effective Treatments for Severe Back Pain
Back pain is a common complaint, affecting 4 out of 5 people at some point in their lives. There are many causes of back pain, and, fortunately, the majority of causes can be treated conservatively and non-surgically. Under the direction of Dr. David Lloyd, our fellowship-trained neuroradiologist specializing in neuroimaging and percutaneous (passage through the skin) spine procedures, VISP physicians offer many pain-relieving spinal therapies. Our doctors use their expertise to pinpoint the likely cause of each patient’s back pain and select the most appropriate therapeutic procedure for that patient.
How Our Interventional Radiologists Diagnose Back Pain
Sometimes determining the source of back pain can be difficult. Discography is used to determine whether a damaged disc between the vertebrae is the source of back pain. During discography, our interventional radiologists inject contrast, or x-ray dye, into the discs, and the patient’s response to the injection is noted. Pain during the procedure that is similar to the patient’s existing back pain suggests that the injected disc might be the source of the pain. This allows the patient’s doctor to more accurately tailor an appropriate treatment plan. VISP physicians offer many pain-relieving spinal therapies. Our doctors use their expertise to pinpoint the likely cause of each patient’s back pain and select the most appropriate therapeutic procedure for that patient.
Procedures to Help Relieve Back Pain
Selective Nerve Root Blocks (SNRB)
The selective nerve root block procedure is used if back pain is caused by inflamed foramina, which are the openings that the nerves to the trunk, arms, and legs exit the spine through, due to arthritis or a ruptured disc. This may cause the nerves to become compressed and inflamed, producing pain, weakness and/or uncomfortable sensations in the back, severe or chronic back pain, and discomfort in the arms and legs. An MRI and physical examination can confirm which nerve is affected. During the nerve block procedure our doctors use a small needle to administer spinal injections containing anti-inflammatory medication into the space where the nerve exits the spine.
A facet injection is used to target the joints between the vertebrae in the back that are causing pain. Arthritis, mechanical stress or back injury may make the joints inflamed and painful. Similar to a cortisone injection but more improved, facet injections bathe the joint in an anti-inflammatory medication as well as a numbing agent to lessen the pain.
Paraspinous Joint Injections
Another type of spinal injection to relieve back pain is the paraspinous joint injection. Back pain can sometimes be caused by arthritis of different joints near the spine. These joints include costovertebral and costotransverse (rib-to-vertebra) and sacroiliac joints (sacrum-to-pelvis). Affected joints are injected with anti-inflammatory medicine, similar to a cortisone injection to relieve pain as well as a numbing agent for faster relief. The discography will help to determine the source of the pain in the upper back, the lower back, the neck, and other pain as related to the spine. The specialist will be able to locate the disc that is causing the problem.
Lumbar Epidural Steroid Injections
The lumbar epidural steroid injection is an injection for sciatica and to treat severe or chronic back pain. The epidural steroid injection (ESI) is a common yet effective procedure for these common ailments. Sciatica is pain, tingling, numbness or weakness that originates in the lower back and travels down one or both legs. If the sciatica is very specific in location, a selective nerve root block is sometimes the better procedure option. Otherwise, an ESI can be helpful to improve the pain. In an ESI, anti-inflammatory medicine is injected into a small space surrounding the spinal canal, reducing inflammation of the nerves originating from the spinal cord. Our doctors use image guidance, which ensures accurate and safe placement of the needle. A full assessment will be completed prior to this spinal injection as well as any epidural injection side effects you may experience will be discussed.
If other methods of treatment are not effective, or there is further need to assess the source of chronic back pain or severe back pain, which has not had successful alleviation, a spine biopsy may be considered. The patient will see our interventional radiologist for the spine to diagnose a bone tumor or infection, which will give better direction for proper treatment. Using image guidance, VISP physicians perform the biopsy by inserting a needle directly into the bone. A small piece of the bone will be removed for further examination. A local anesthetic will be used to decrease the pain during this procedure. Our Vascular and Interventional Specialists are highly qualified and trained to take the best care of their patients, especially concerning any type of back pain. Back pain can be hard to diagnose as well as to distinguish the cause, though our specialists have the tools and equipment for proper evaluation and treatment to get you on the road to feeling better.
Treatments for Back Pain
Vertebral Cement Augmentation (VCA)
A patient with back pain due to vertebral compression fractures, caused by osteoporosis or tumor, may undergo a vertebral cement augmentation (VCA). After a patient fails to respond to a 4-6 week course of conservative medical management, including interventional pain management with pain medications, bed rest, or back bracing, a VCA would be the next option. A VCA is a minimally invasive procedure using a needle to inject medical-grade bone cement into the fractured vertebra. Our VISP physicians are trained in two effective methods to complete this procedure; vertebroplasty and kyphoplasty.
- Vertebroplasty: alleviates the pain by injecting the bone with cement, it also prevents further loss of body height
- Kyphoplasty: uses an inflatable balloon inserted into the bone to create a cavity for the cement to relieve the pain, restore height and reduce spine curvature
When properly selected, most patients experience significant to total pain relief within hours to a couple of days.
Providing the Ultimate Back Pain Care for Prescott’s Community
We are pleased to be able to say that our Dr. Lloyd is the only subspecialty board certified neuroradiologist in the Prescott area. With excellent training and expertise in this medical area, you are in good hands at Vascular and Interventional Specialists of Prescott. Trust our specialists with assessing and addressing your back pain needs to get back on your feet.