Why do you feel back or neck pain?
Tamer Elbaz, MD, FIPP
Second only to the common cold, back and neck pain are the leading reasons Americans visit a doctor’s office each year. Why are you feeling back or neck pain? Is it a slipped disc, muscle sprain or a pinched nerve? There are many structures in your spine that can cause pain. Often times you will find out that you have a herniated or slipped disc from an MRI or CT scan. Simply having a herniated or slipped disc doesn’t necessarily mean that it is the source of your pain. Having this piece of information is just one piece of the puzzle. This information has to be put into perspective. What I mean is that MRI (or CT scan) findings have to be combined with information gathered from your history and a physical exam to accurately determine the source of the pain.
Using innovative diagnostic tools, Interventional Pain Physicians are able to pinpoint the source of pain. Finding the source of pain is the most important step in your treatment. Often times the pain is caused by more than one pathology, but only one is the major culprit.
Treatment of pain starts with the diagnosis followed by formulating a treatment plan. The plan can be as simple as rest or as involved as surgery. Pain physicians recommend the least invasive modality first. If the pain is not responsive, more invasive modalities are recommended.
Keep in mind that you have to seek urgent medical advice in certain circumstances. If the back pain is associated with weakness, numbness, tingling or loss of control over the bowel or bladder functions, you need to see a doctor immediately. These are warning signs of impending injury to one or more nerve roots. They can also be signs of permanent damage and disability and should be checked out urgently.
A significant amount of back and neck pain is derived from muscle strains, which often occur as a result of overuse of the spinal muscles or overexertion. If the spine is not in proper position during strenuous activities, a large amount of force can be exerted on the muscles and result in pain and inflammation. In most instances, acute back and neck pain will subside within 2-6 weeks with over the counter pain medications, a prescription strength medication or simply with rest, stretching and massaging your muscles. If these modalities do not alleviate the pain, it may be time to consider other forms of therapy.
For pain that persists, physical therapy is an effective option. When treating back pain, a physical therapist focuses on strengthening the muscles of the back as well as the “core.” The core muscles are the muscle groups of the pelvis, abdomen and back that help the spine remain upright and in the proper position throughout the day. Using both “passive” and “active” exercises, physical therapy often helps to relieve pain as well as prevent future injuries.
In some instances, a spinal procedure may be needed to alleviate the pain. In years past, many chose to forego spine procedures because of the perceived invasiveness and long recovery period associated with spine procedures. Most spine procedures performed today for pain are simple injections that take only a few minutes. The recovery for most procedures is minimal to none.
Sometimes, surgery is recommended. Minimally invasive spinal procedures have become the standard of many progressive physicians and offer a much less traumatic alternative to traditional spine surgery.
Traditionally, a large incision was made along the spine to give the surgeon access to the spine. Conversely, minimally invasive spine procedures require a ½ -1 inch incision to access the affected disc or vertebrae.
New percutaneous spinal procedures require no incision at all. They are needle-based approaches to the affected part of the spine. This approach ensures a much shorter recovery period, and these procedures are performed on an outpatient basis with the patient returning home the same day.
One of the more innovative procedures is the Percutaneous Disc Decompression, which is a procedure used to treat pain caused by herniated disc in either the cervical or lumbar spine. Disc decompression is performed using a small needle. Under fluoroscopic guidance, the needle is placed into the protruding disc. Once the disc has been accessed, the excess disc material causing pressure on the spinal nerves is evacuated. After this material has been removed, the offending spinal disc will decrease in size and withdraw from the spinal canal. This reduction and withdrawal of the disc will eliminate the neck and back pain you have been suffering from as well as any radiating pain in the extremities.
Dr. Tamer Elbaz is Board Certified in Pain Medicine. He completed his Pain Medicine training at St. Luke’s-Roosevelt Hospital. Dr. Elbaz has extensive knowledge and experience performing Interventional Pain procedures for chronic and acute pain. He served as the Director of the Pain Medicine Fellowship Training Program at Roosevelt Hospital for 6 years, educating physicians who wanted to specialize in Pain Medicine. He lectured extensively in regional, national and international conferences teaching new techniques for treating pain.