Hi, im daniel yadegar,im an interventional pain management specialist with the Orlin and Cohen Orthopedic Group. More often than not people ask me what exactly is interventional pain management? Interventional pain management is a discipline of medicine devoted to the diagnosis and treatment of pain related disorders. Our goal is to relieve, reduce, or manage pain and improve a patient’s overall quality of life. This is accomplished by utilizing a multidisciplinary approach,in which a.
Team of health care professionals worktogetherto provide a full range of treatment optionsand services for patients suffering from chronic and/or acute pain. Common musculoskeletal pain disorders include: Back, Hip, and Leg Pain Neck, Shoulder and Arm Pain Whiplash Injuries Work Related Injuries Sports Injuries Failed Back Surgery and Other Post Surgical Pain Syndromes.
Myofascial pain facet syndrome Sacroiliac Joint Pain Today I will be briefly talking about back pain with sciatica (or pain radiating down the leg). This is a common complaint that we encounter on a daily basis. Sciatic pain results when injury or pressure have compressed the spinal roots or nerves that branch off the spinal cord in the lower region of the spine.
Sciatic paincan be described as sharp, dull, burning, tingly, numb, continuous, or intermittent and usually affects only one side of the body. There may be associatedweakness in the affected limb as well. Sciatic pain is most often the result of aherniated disc,spinal stenosis, ornarrowing of the spinal canal associated with arthritis or bony overgrowth, or in extremely rare cases, infection or tumor. An initial work up including a detailed and comprehensive history and physical examis.
The first step in diagnosis. further work up may be needed such as imaging studies (which include xrays, MRIs CT scans) and/ or nerve study testing. Once the diagnosis of the cause of sciatica has been determined, a treatment plan is then established. Most cases of back pain resolve with nonsurgical treatment. Some of the most common nonsurgical treatment options that we utilize are physical therapy and exercise, medication management and spinal injections. As an interventional pain physician, I am.
Trained through the use of xray guidance or flouroscopy to deliver potent medications targeted specifically to the affected site of inflammation in the spine. The use of flouroscopy allows the medication to be placed safely and precisely. These procedures are done as an outpatient in our accredited flouroscopy suite, which is fully staffed with certified personnel and licensed anesthesiologists. Other common procedures that we are trained to administer for appropriate musculoskeletal problems include:.
Cervical, thoracic, and caudal epidural steroid injections Facet Joint Injections Medial Branch or Nerve Blocks Radiofrequency Ablation SacroiIiac Joint injections Hip Injections Trigger Point Injections Bursa Injections Lumbar Discography Spinal Cord Stimulation Percutaneous Disc Decompression.
Lumbar Spine Degenerative Disc Disease Herniated Discs Isolated Disc Resorption Spine Expert
We’re going to talk now about degenerative disc disease it’s not really a disease process that’s its name but it really is a disorder just like arthritis is a disorder well remember that the disc again is the jelly filled donut you have the jelly or the nucleus on the inside which is under high pressure.
And you have the annulus or the outer plies of the tire there’s about sixty of them that hold the jelly in over time you can get tears within the disc these tears look like this they’re called annular tears.
Because the rings of collagen are making up the annulus these tears by themselves can be quite painful many times when somebody says my back went out they have just torn a very small portion of the annulus and they can be incapacitated for four five days even a couple weeks other people that get tears in the disc don’t necessarily even.
Notice them the answer to why some people are incapacitated and others aren’t is a nobel prize winning answer so these tears cause back pain and if you notice that the jelly itself actually seeps into these tears the other very interesting thing about the nucleus or the jelly.
Is that it is toxic to nerves why God or mother nature designed this system is anybody’s guess but when you have tears in the back of the disc and this jelly will seep next to the pain nerves it aggrevates them and sets them off that’s typically what starts the degenerative cascade or what causes.
These discs to start to go bad the discs can fail in a number of different ways you can tear through and through the disc and if you do that you can have a disc.
Herniation and that’s what this looks like you can see the tear through and through the disc where the jelly squirting out in back the reason why this is a problem is because what sitting in back here is the nerve route.
And you start to compress the nerve root and that causes leg pain and so a herniated disc not always but very many times will cause leg pain the disc can also degenerate other ways the disc back wall can become very very loose.