Interventional pain management can be instrumental in dealing with chronic back pain

United Arab Emirates, Dubai – 12 October, 2015: Chronic back pain is a growing concern these days, with almost 80 per cent of adults suffering from lower back pain at some point in their lives. In fact, back pain is amongst the most common reason cited for absenteeism at work.

The cause for this type of pain could range from our sedentary lifestyles to accidents, strenuous activity and even age. The pain could be acute (short term), chronic (long term), or neuropathic.   Acute pain is defined as pain lasting less than six months, or pain that is caused by injury to the body. It can also indicate a disease. Labour pains, or pain experienced due to a cut or burns are examples. This type of pain tends to subside when the underlying condition causing the pain is treated.

“Chronic pain occurs when there’s a pathway in the nervous system, which continues to send a pain signal despite a lack of tissue damage, or after an injury has healed. Headaches, pain related to cancer, arthritis aches and lower back pain are instances of chronic pain. Around 20 per cent of patients suffering from acute back pain develop chronic pain if it’s not treated in a timely fashion. Neuropathic pain, which can be sharp, burning, or tingling, can be felt traveling along the nerve path from the spine down to the hands and feet. This type of chronic pain usually sets in with tissue injuries and damage to nerve fibres. Pain experienced as a sign of amputation or due to multiple sclerosis, shingles, or diabetes are examples,” said Dr. Ali Zahran, Consultant Anesthetist, Burjeel Hospital for Advanced Surgery (BHAS).

Interventional pain management steps in when chronic pain affects the quality of life. The use of pain management as a medical specialty is relatively new. It is increasingly gaining relevance with chronic pain becoming a primary concern, and not just a symptom of a medical condition.

“Intervention pain management involves the use of minimally invasive procedures that give permanent or long term pain relief.  It fills the gap between the pharmacologic (use of drugs) management of pain and invasive surgical procedures.”

Minimally invasive techniques such as injection therapy, radiofrequency ablation or spinal cord stimulation are used as part of pain management. Interventional pain specialists provide nerve blocks, cervical and lumbar epidural steroid injections, sacroiliac joint steroid injection, radiofrequency ablation, spinal cord stimulation, facet joint injections, lumbar and celiac sympathetic plexus blocks, stellate ganglion block and trigger point injections,” said Dr Zahran.

One of the treatments recommended for patients suffering from lower back pain is a lumbar epidural steroid injections or LESI, which can temporarily relieve low back pain and leg pain (sciatica). A transforaminal epidural steroid injection (TFESI), also called a nerve root block, is an injection that involves placing the needle in the area from which nerves exit the spine. It is especially helpful for patients with leg pain from disc disease, disc herniation, spondylolisthesis, spinal stenosis or patients who have had failed spinal surgeries.

People with chronic neck pain are given a cervical epidural steroid injectionorCESI, which relieves pain in the neck, shoulders and arms caused by a pinched nerve (or nerves) in the cervical spine. Conditions such as herniated discs, spinal stenosis, or radiculopathy can compress nerves, causing inflammation and pain.

The medication injected helps decrease the swelling of nerves. Lumbar epidural steroid injections or LESI can temporarily relieve low back pain and leg pain (sciatica). Radio Frequency rhizotomy is another technique used to reduce or eliminate pain in damaged facet joints. The injection targets the medial branch nerves that pain signals,” added Dr Zahran.

Dr Zahran has used these treatments to help several patients at BHAS. “These treatments are minimally invasive and extremely effective in treating chronic pain of varying degrees. Complemented with the right treatment and physical therapy, interventional pain management can greatly improve the quality of life of patients who are affected by back pain,” he said.

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