Lumbar Spine Pain
Low Back pain is a significant public health problem worldwide.
Chronic low back pain (LBP) is one of the most common pain syndromes and represents an enormous burden and cost generator for society.
Most Common Syndromes
Lumbar facet joints (FJs) constitute a common source of pain and remain a misunderstood, misdiagnosed and improperly treated pathology. Facet osteoarthritis is the most frequent form of facet pathology.
Radicular pain is a term applied to describe pain that results from the stimulation of, or a disorder of, a nerve root. Irritation of the nerves in the spine can cause a variety of symptoms, which differ from person to person. Common symptoms include: pain and increased sensitivity; pins and needles, and numbness; muscle weakness; altered sensations such as trickling water. Nerve pain is usually described as burning in nature, and normally spreads below the knee or elbow in the affected limb. Often nerve pain and back pain are present at the same time.
Facet Joint Syndrome
Chronic low back pain (LBP) is one of the most common pain syndromes and represents an enormous burden and cost generator for society. Lumbar facet joints (FJs) constitute a common source of pain and remain a misunderstood, misdiagnosed and improperly treated pathology. Facet osteoarthritis is the most frequent form of facet pathology.
FJ pain may be referred distally into the lower limb, thereby mimicking sciatica. “Pseudo-radicular” lumbar pain typically radiates uni- or bilaterally to the buttock and the trochanteric region, the groin and the thighs, ending above the knee, without neurological deficits. However, radiating pain may reach the foot, mimicking sciatic pain, especially in cases of osteophytes or synovial cysts. Claudication is possible. Pain is usually worse in the morning, during periods of inactivity, and following stress exercise, lumbar spine extension or rotary trunk motions, is provoked by standing or sitting positions, and may be elicited on FJ palpation.
Sacroiliac joint pain
Patients experiencing Sacroiliac Joint (SIJ) pain may present with a wide variety of complaints. Gluteal pain near or surrounding the posterior superior iliac spine is the most common region. Other symptoms include groin pain, pain radiating into the lower extremity, numbness, and clicking or popping in the posterior pelvis. Pain, clicking, or both with transitional activities such as getting up from a chair or in and out of a car may also be noted. Activities requiring asymmetric loading through the lower extremity or pelvis may provoke pain and should be revealed during the history.
Lumbar spinal stenosis
The term lumbar spinal stenosis (LSS) refers to the anatomical narrowing of the spinal canal and is associated with a plethora of clinical symptoms. The clinical features of the condition are heterogeneous, and often, but not always, include neurological symptoms. Typically, patient symptoms comprise unilateral or bilateral (exertional) back and leg pain, which slowly develops and persists over several months, or even years. The back pain is localized to the lumbar spine and can radiate towards the gluteal region, groin and legs, frequently displaying a pseudo radicular pattern. In cases of lateral recess stenosis or foraminal stenosis, isolated radiculopathy can occur. neurogenic claudication is the most specific symptom of LSS, although it is nearly always accompanied by further symptoms.
Diagnostic medial branch block followed by radiofrequency ablative denervation have been used for decades now showing pain relief and improvement in the functional repercussion of pain range higher than 50%. There are several reports about the use of this treatment applied to chronic radicular pain, both cervical and lumbar, with little response to other treatment modalities.
Discogenic pain shares clinical signs with lumbosacral radicular pain. There are no specific characteristics in the patient’s history that confirm or disprove the diagnosis of discogenic low back pain. More typical features include persistent, nociceptive low back, groin and/or leg pain that worsens with axial loading and improves with recumbence. Patients may have experienced a prior episode of acute, intense pain caused by an acute tear in the innermost part of the annulus fibrosus (although no scientific proof of this exists). Discogenic low back pain is often localized medially in the back.
We have a team expert in diagnosis and management of the cervical and lumbar pain.
Pharmacological management pain is commonly part of the treatment and a wide range of drugs can be used to manage pain.
Radiofrequency ablation is a minimally invasive procedure guided for ultrasound or fluoroscopy.
Corticosteroids medications are used to reduce pain and inflammation and can be taken oral or through an injection.
Cryoablation uses cold temperatures and is a minimally invasive procedure guided for ultrasound or fluoroscopy.
Nucleoplasty is an advanced injection procedure guided for fluoroscopy for treating the disc herniation.
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