lower back pain

Injectable Corticosteroids

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Corticosteroid injections are powerful drugs used to decrease inflammation in the body’s tissues.  Corticosteroid injections can treat a range of muscular, skeletal, and spinal conditions.  This article from KRAMES STAYWELL shows us the most common uses of corticosteroid injections:

  • Lower back pain – Lower back pain from strains, spinal stenosis, ruptured disks, and other common conditions may be treated with injectable corticosteroids to provide some reprieve from pain. Lumbar radiculopathy is pain in the buttocks, hips, or legs that stems from a pinched nerve in the lower back.  This kind of pain can usually be treated with corticosteroid injections near the pinched nerve.  If a patient is having excruciating pain, the injection may target the spinal cord area through a catheter.  Sometimes other drugs such as local anesthetics or narcotics are given in conjunction with the corticosteroid.
  • Osteoarthritis – Osteoarthritis suffers often develop inflammation and pain in their joints. An injection of corticosteroids into the affected joint can provide temporary pain relief for several weeks or even months.  After the treatment, you will need to rest the joint for at least 24 hours for the best results.
  • Carpal tunnel syndrome – Carpal tunnel syndrome may occur when a nerve in the wrist becomes compressed or pinched, causing pain and weakness in the hand. Infecting a corticosteroid in the wrist can provide immediate relief.
  • Cervical radiculopathy – This is neck pain that radiates to the shoulder and arm. It occurs when the vertebrae in the spine moves closer together, pinching a nerve in the neck.  Injecting corticosteroids near the pinched nerve may reduce pain and swelling allowing for time to heal .

Blue Ridge Orthopaedic & Spine Center has two convenient office locations in Warrenton (540) 347.9220 & Gainesville (703) 743.2814 to serve all of your Orthopaedic needs. Call us today to schedule an appointment. Same day/next day appointments are available. For more information on all comprehensive orthopaedic services we offer visit www.broava.com.

Is Minimally Invasive Spine Surgery ever an Option?

Is Minimally Invasive Spine Surgery ever an Option?

Article written by: Allison Walsh – spine-health.com

After months of conservative therapy, some spine patients may opt for spine surgery if their pain is uncontrolled or if they are unable to do their daily tasks, and if a surgeon can identify a spine lesion that is responsible for the pain.

Conservative vs Surgical Care for Lower Back Pain

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Some surgical candidates worry that they will need a spine fusion, which is an invasive surgery requiring months of recuperation.

The good news is that some spine conditions can be treated with a minimally invasive surgery, like a discectomy.

Reasons you may need a spinal fusion

First, let’s take a look at the types of conditions that may need to be treated with a fusion.

A fusion surgery is designed to stop joint motions in the spine that are generating pain. This may happen as a result of:

 

For many patients, spinal fusion helps them get back on the road to leading a normal, pain-free life. But as stated above, the surgery is considered invasive and the recovery time can be up to a year long.

Spine Fusion Risks and Complications

Many patients who need spine surgery will find relief from less invasive surgical procedures known as microdiscectomy or a microdecompression.

 

Reasons you may need a microdiscectomy or microdecompression surgery

Sometimes nerves in the spine are compressed by a narrowing of the spinal canal, causing referred pain to radiate down the arms or legs. This pain is called radiculopathy. The narrowing of the spinal canal may be caused by a bone spur or by a herniated disc.

 

See herniated discs and bone spurs

 

A microdiscectomy or microdecompression spine surgery, considered a minimally invasive surgery, removes the small portion of the offending bone or disc, allowing the nerve to heal.

See also Microdiscectomy (Microdecompression) Spine Surgery

The majority of patients with only radiculopathy pain (in the absence of one of the conditions mentioned above as a reason for spine fusion) improve without fusion surgery.

Microdiscectomy is often done on an outpatient basis. Typically, the patient will have no restrictions on their activity immediately following the surgery, and the success rate is 90-95%.

Most back patients will never need surgery. If you do need spine surgery, it doesn’t necessarily mean you will need a spine fusion.

 

BRO-Logo-colorBlue Ridge Orthopaedic & Spine Center has on-site state-of-the-art technology to diagnosis and treat orthopaedic conditions. Both of our offices are equipped with in-office
radiology departments. Not only does this facilitate rapid diagnosis but it is also convenient for patients who may be experiencing pain or disability at the time of their visit. To schedule an appointment with one of our board-certified and fellowship trained physicians, call our Warrenton office at 540-347-9220 or our Gainesville office at 703-743-2814.

Have you Considered Anesthetic or Corticosteroid Injections for your Lower Back Pain?

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Examples

  • Trigger point injections – Sometimes, putting pressure on a certain spot in the back (called a trigger point) can cause pain at that spot or extending to another area of the body, such as the hip or leg.  To try to relieve pain, a local anesthetic, either alone or combined with a corticosteroid, is injected into the area of the back that triggers pain (trigger point injection).
  • Facet joint injections –A local anesthetic or corticosteroid is injected into a facet joint, which is one of the points where one vertebra connects to another.
  • Epidural injections –A corticosteroid is injected into the spinal canal where it bathes the sheath that surrounds the spinal cord and nerve roots.

How It Works

Local anesthesia is believed to break the cycle of pain that can cause you to become less physically active.  Muscles that are not being exercised are more easily injured, so the irritated and injured muscles can cause more pain and spasm disrupting sleep.  This pain, spasm, and fatigue, in turn, can lead to less and less activity.

Steroids reduce inflammation.  A corticosteroid injected into the spinal canal can help relieve pressure on nerves and nerve roots.

Why It Is Used

Injections may be tried if you have symptoms of nerve root compression or facet inflammation and you do not respond to nonsurgical therapy after 6 weeks.

How Well It Works

Research has not shown that local injections are effective in controlling acute or chronic low back pain that does not spread down the leg.

The physicians at Blue Ridge Orthopaedic and Spine Center are board certified and fellow-ship trained.  This means you will be seen and treated by a physician with the most advanced training and certifications.  Our mission at Blue Ridge Orthopaedic and Spine Center is to deliver the highest quality of service and medical care to our patients.  We offer inpatient and outpatient, surgical and non-surgical, as well as minimally invasive cutting edge solutions for patients with acute or chronic pain.

For more information on the comprehensive services offered by Blue Ridge Orthopaedic & Spine Center or to schedule an appointment with one of our specialists, please call 540.347.9220 (Warrenton office) or 703.743.2814 (Gainesville office).

Our Goal – Get YOU back to GOOD health!

Herniated Disc

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A herniated disc in most cases is the culprit that causes lower back pain and is often referred to as a slipped or ruptured disc.

According to the American Academy of Orthopaedic Surgeons sixty to eighty percent of people will have back pain at some point in their life and a high percentage of lower back/leg pain is caused by a herniated disc.

Causes

  • Aging/Wear and tear
  • Sedentary Lifestyle – Consistent exercise is critical as it helps to prevent several medical conditions from developing.
  • Gender – Men between 30 and 50 are more susceptible to herniated discs.
  • Repetitive actions – Constant lifting, pulling, bending, or twisting can cause a herniated disc.  It’s important to use safe lifting and movement techniques to protect your back.
  • Weight – When a body is overweight it causes extra stress on the discs in the lower back.
  • Smoking – Smoking is believed to lessen oxygen supply to the disc and causes more rapid degeneration.

Symptoms

  • Back Pain
  • Deep Muscle Pain
  • Spasms
  • Tingling or numbness in the leg or foot
  • Weakness in the legs and loss of bladder or bowel control (extremely rare) might indicate a more serious problem known as cauda equine syndrome, which develops when spinal nerve roots are being compressed.  Immediate medical attention is required.

Treatment

There are several non-surgical solutions available to improve symptoms of a herniated disc.

  • Rest – If you are experiencing severe back pain, 1-2 days of rest will calm the pain.  Don’t stay off your feet any longer than your initial rest period.  Take several breaks throughout the day and avoid sitting for long periods of time.  Use controlled and slow movements and change your daily activities to avoid further pain.
  • Anti-inflammatory medications – Ibuprofen or naproxen may temporarily relieve back pain.
  • Physical Therapy – Trained specialists with experience in specific exercises can strengthen your muscles.
  • Epidural steroid injection – Steroids are injected into your back to minimize inflammation.

Whether you suffer from wear-and-tear or a spinal injury, Blue Ridge Orthopaedic & Spine Center offers the best care available for a wide variety of spine/neck related ailments.   Blue Ridge Orthopaedic & Spine Center’s physicians have extensive experience treating nearly every kind of condition, including spinal trauma of the neck and back, tumors and infections, spinal stenosis, degenerative disc disease, herniated discs, and adult degenerative conditions of the next and back.

To schedule an appointment with our spine specialists please call 540.347.9220 (Warrenton office) or 703.743.2814 (Gainesville office) and don’t forget to visit us @ www.broava.com for all comprehensive services offered by Blue Ridge Orthopaedic & Spine Center.

Can Surgery Help your Lower Back Pain?

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Surgery to treat lower back pain can be extensive. Usually, patients are given six to 12 months of more conservative treatment, such as physical therapy, before surgery is recommended for lower back pain.

Recovery is also extensive, taking anywhere from three to 12 months to return to routine daily activity. As with any surgery, success rates vary—in the case of lower back pain, a success rate of between 70 percent and 90 percent is expected, with the main variable being the specific condition being treated.

Osteoarthritis and more

Lower back pain is caused by several factors. In patients 55 and older, it is often caused by degenerative arthritis (osteoarthritis) that might result in a narrowing of the canal (spinal stenosis) and/or instability of one vertebral segment, as this Spine-Health article explains. The article continues:

Generally, the low back pain and/or leg pain created by these back conditions will get worse with walking and will improve with sitting. Often, the symptoms will have been present for years, and may get worse at a very slow rate. Once a patient gets to the point that he or she can no longer adequately function because of the low back pain, lumbar decompression with or without spine fusion may be recommended to help increase the individual’s activity tolerance and quality of life.

Spine surgery is usually elective and follows many months of alternative treatment. However there are two scenarios that may require emergency back surgery. As Spine-Health explains:

  • Sudden bowel and/or bladder incontinence (either the inability to retain or hold waste) or progressive weakness in the legs. Either of these symptoms could indicate nerve damage or cauda equina syndrome.
  • Severe, continuous abdominal and back pain, which could indicate an abdominal aortic aneurysm.

Our Spine Center experts handle all types of back pain, and provide a range of appropriate treatments, from physical therapy through surgery. If you’re suffering from back pain that is getting worse or won’t go away, contact us @ 540.347.9220 (Warrenton location) or 703.743.2814 (Gainesville location) and let’s talk.  Visit www.broava.com to learn more about the comprehensive services offered at Blue Ridge Orthopaedic and Spine Center.