13 Jan 2019 Medical Trends – Minimally Invasive
Spine and musculoskeletal pain do not have to have a surgical solution. There are non-surgical alternatives for treatment. Current diagnostic and therapeutic techniques provide many options for pain reduction and optimizing function for a better quality of life.
Many kinds of conditions cause chronic and debilitating pain. Some of the multitudes of conditions requiring pain management include the neck, lower back, hip, elbow, hand, mid back, buttocks, groin, and sacroiliac pain. Additional conditions suitable for non-surgical treatments are ruptured and slipped discs, arthritis, degenerative disc disease, nerve pain, muscle pain, bursitis, and pinched nerves.
There are a variety of treatment options for spine and musculoskeletal pain, including injections, physical therapy, and spinal cord stimulation.
Injections are generally done to relieve pain and inflammation. Epidural steroid injections can relieve nerve inflammation caused by degenerative changes in the spine (including degenerative disc disease). Transforaminal epidural injections can be used to block pain radiating into the arms or legs. Peripheral joint injections can be done for the elbow, knee, or joint pain. Trigger point injections are meant to treat strained muscles in the neck or back by direct injection into the muscles to reduce inflammation or pain.
Physical therapy is an excellent non-surgical procedure that can be used with oral medication for better pain resolution. Therapists are chosen for extensive experience and training in treating spine conditions. While daily exercise programs for the patient are important, learning ways to prevent additional pain causing damage or injuries in daily activities is stressed. The ultimate goals are to increase function while decreasing pain. Exercises the patient can do include stretching muscles, strengthening muscles (includes weight lifting), and low-impact aerobics.
Spinal cord stimulation (SCS) is for patients who still have pain despite physical therapy, injections, medication, and even surgery. Using X-ray guidance, physicians will place a small wire close to nerves responsible for pain in parts of the body. The wire remains in place for about a week and is used to conduct low voltage electrical current from a stimulator to the spinal cord, blocking pain signals before they reach your brain.
A permanent device for treating SCS involves modest and minimally invasive procedures to implant the leads and the stimulator. Incisions are small, and the patient can go home that day with quick recoveries. Risks are those associated with surgery in general (infection, bleeding, allergic reaction). There are also risks specifically associated with SCS. Stimulation may only work sometimes, for example, or it may affect the wrong location, or the stimulation may be too strong.
Treatment of musculoskeletal pain associated with the spinal cord does not always require a surgical solution. Some of the treatments, like exercise, can be done by the patients themselves. And, in cases where the pain cannot be completely alleviated, it can be reduced to where it is manageable, and a normal life can be enjoyed.