How Does RRMG Help To Treat Your Lower Back Pain?
Back pain is considered the major cause of disability in the UK, with lower back pain affecting nearly one-third of adults every year. That’s why you must never ignore your lower back pain, whether it is acute or chronic.
At RRMG, our medical experts offer continuous holistic care starting from the diagnosis to the treatment stage, which includes both conservative therapy and surgery.
Our highly specialised multidisciplinary medical experts are available any time to provide the right care in order to get rid of your symptoms and help you return to your routine life as early as possible.
Before going through the varied treatment options, let us first understand the possible causes of back pain. The timely diagnosis of the cause of back pain helps in choosing the right treatment.
What are the causes of back pain?
The varied causes of back pain include simple mechanical problems arising from spinal structure, facet joints, intervertebral discs, or the surrounding muscles.
There are other serious but rare conditions such as vertebral fracture, disc herniation, spinal stenosis, compression fractures due to osteoporosis, tumour, and infection.
A detailed MRI (Magnetic Resonance Imaging) scan helps to determine the cause of back pain. You can opt for conservative treatment if there is wear and tear change in the spinal structure.
At RRMG, our skilled and experienced medical specialists offer:
- A complete assessment
- Detailed medical history related to back pain
- Thorough neurological and spinal examination
- Quick radiological examinations including X-rays and MRI scans to determine the source of pain
After diagnosing the cause of your condition, our medical experts will recommend the right treatment which should be started as early as possible to prevent permanent damage.
How does RRMG treat your lower back pain?
At RRMG, the treatment for lower back pain is tailored specifically for every patient depending on the cause and severity of the pain.
Our medical team provides:
- A detailed explanation of the cause of your back pain
- The determination of whether the back pain is acute or chronic and the recommendation of an appropriate individualised treatment strategy
- Multidisciplinary care
- Administration of the latest multimodal analgesic medication
- Specialised orthopaedic therapy and physical rehabilitation to improve the spinal function
- Administration of the latest minimally invasive pain management procedures such as facet joint, epidural, and sacroiliac joint injections
- Advanced procedures including facet joint and sacroiliac joint radiofrequency denervation
- Surgical consultation, in case minimally invasive treatments, do not work
The doctors will recommend a follow-up consultation six weeks after undergoing the medical procedure to evaluate the progress. However, our medical team is available at any time for any clinical support or advice.
Furthermore, our consultants might suggest repeating the same procedure or recommend an alternative depending on the severity of the condition during the follow-up visit. Hence, it is mandatory to do follow-up visits as informed.
What are the treatments for lower back pain?
What is a medial branch block and what are facet joints?
Medial branch nerves are very small nerve branches that carry pain messages from facet joints to the brain where they are experienced. The facet joints are small joints in the back of the spine that form connections between each vertebra. If these nerves are blocked or numbed, they will not be able to transfer the painful sensation from the joints to the brain. Therefore, this procedure is completed to see if your back pain is caused by the facet joints.
How is the procedure performed?
The patient lies on his/her stomach. The skin of the back is cleansed with antiseptic solution and a local anaesthetic is injected to numb the area. A small needle is then guided using an X-ray to the targeted medial branch nerve which is then numbed with local anaesthetic like lignocaine. The injection takes about 15 minutes to complete.
Will the injection hurt?
There is some discomfort with needle insertion which we minimize by numbing the skin over the nerves with a local anaesthetic.
How long does the effect last?
The effect will last several hours or more. This is strictly a diagnostic block to test if the facet joint are in fact the source of some of your pain. This is why it is very important for you to fill out your pain log. Once the anesthetic medical wears off the pain will likely return and you may have some increased soreness for a day or two.
What is the next step after the injection?
If you benefit from the procedure, the next step would be consideration of radiofrequency (Cooled RF) treatment of the medial branch nerves. This is a procedure that will provide pain relief for a longer period of time (average of one year). This will be discussed at your next appointment.
What are the risks and side effects?
Serious side effects and complications are rare. The most common problem after the injection is having pain in the area of the injection for a few days. The other complications are infection, bleeding and nerve injury. These complications are minimized by using sterile technique, and fluoroscopy for xray needle guidance.
What is sacroiliac joint dysfunction?
Sacroiliac joint dysfunction is an injury or inflammation of the sacroiliac (SI) joint which causes pain in the lower back region. The SI joint is formed by the connection of the sacrum with ilium.
What is a sacroiliac joint injection and how is it performed?
This injection is used to both diagnose and treat your low back pain caused by inflammation of the joint. To perform the injection, the patient lies on her/his stomach. The skin is cleansed with antiseptic solution and numbed with a local anaesthetic. Using X-ray guidance, a needle is inserted into the SI joint. Once the needle is in the correct location a mixture of numbing medication and steroid is injected. This procedure usually takes 10 minutes to complete.
Will the injection hurt?
There is some discomfort with needle insertion which we minimize by numbing the skin over the join with a local anaesthetic.
How long does the effect last?
The effect might last a few hours to a few weeks or much longer. Pain relief in the first couple of hours after the injection is the most important as this tells us our diagnosis of SI joint mediated pain is correct. If the symptoms do return, we will discuss other options available for extended pain relief.
What is the next step after the injection?
You will be given a follow up appointment to discuss how effective the treatment was. If it was not successful other treatment options will be discussed.
What are the risks and side effects?
Serious side effects and complications are rare. The most common problem after the injection is having pain in the area of the injection for a few days. The other complications are infection, bleeding and nerve injury. These complications are minimized by, using sterile technique, and fluoroscopy for xray needle guidance.
What are facet joints?
The facet joints are small joints in the back of the spine that form connections between each vertebra. If these joints are blocked or numbed, they will not be able to transfer the painful sensation to the brain. Therefore, this procedure is completed to see if your back pain is caused by the facet joints.
How is the procedure performed?
The patient lies on his/her stomach. The skin of the back is cleansed with antiseptic solution and a local anaesthetic in injected to numb the area. A small needle is then guided using an X-ray to the targeted facet joints which are then numbed. An anaesthetic and steroid is then injected into the joint. The injection takes about 15 minutes to complete.
Will the injection hurt?
There is some discomfort with needle insertion which we minimize by numbing the skin over the joint with a local anaesthetic.
How long does the effect last?
The effect might last for a few months or much longer. If the symptoms do return, we will discuss other options available for extended pain relief, such a radiofrequency neurotomy (Cooled RF).
What is the next step after the injection?
You will be given a follow up appointment to discuss how effective the treatment was. If it was not successful other treatment options will be discussed.
What are the risks and side effects?
Serious side effects and complications are rare. The most common problem after the injection is having pain in the area of the injection for a few days. The other complications are infection, bleeding and nerve injury. These complications are minimized by using sterile technique, and fluoroscopy for xray needle guidance.
What is an epidural steroid injection?
An epidural injection is an injection of steroid into the epidural space. The epidural space is a space located in the spine between the vertebrae and the dural sac, which surrounds the spinal cord. Theoretically, the steroid reduces the inflammation of the nerve roots as they exit the spine, which can help alleviate pain in the back.
How is the injection performed?
The patient lies on his/her stomach and the skin on the back or neck is cleansed with an antiseptic solution. The skin and deeper tissues are numbed with an anaesthetic using a small needle and once the skin is numb, an X-ray machine helps guide the needle into the epidural space. Once the epidural space is entered, X-ray contract is injected to ensure correct positioning of the needle, then medication consisting of a numbing medicine and a steroid (dexamethasone) will be injected. The procedure takes approximately 15 minutes.
Will the injection hurt?
There is some discomfort with needle insertion which we minimize by numbing the skin over the joint with a local anaesthetic.
How long does the effect last?
The effect might last a few months or much longer. Pain relief in the first couple of hours after the injection is the most important as this tells us our diagnosis is likely correct. If the symptoms do return, we will discuss options available for continued pain relief, which may include repeating the injection for additive benefit.
What is the next step after the injection?
You will be given a follow up appointment to discuss how effective the treatment was. If it was not successful other treatment options will be discussed.
What are the risks and side effects?
Serious side effects and complications are rare. The most common problem after the injection is having pain in the area of the injection for a few days. The other complications are infection, bleeding and nerve injury. These complications are minimized by using sterile technique, and fluoroscopy for xray needle guidance.
What is radiofrequency Neurotomy and why is it performed?
Radiofrequency Neurotomy is an injection that uses a specialized machine that generates radiofrequency current. The current is then passed through a special needle placed next to the nerve (medial branch) which carries pain from the facet joints to the spinal cord. The current generates heat which interrupts transmission of pain. radiofrequency neurotomy is preformed after the patient has benefitted from a diagnostic medial branch nerve blocks.
How is the procedure performed?
The procedure is performed under x-ray with the patient lying on his/her stomach. The skin is cleansed with an antiseptic solution and then anesthetized with a numbing medication. After the skin is numb, needles are places near the target nerve under x-ray guidance. The nerve will then be numbed prior to starting the radiofrequency neurotomy. It is typical for 3 nerves to be targeted, so there are usually 3 injections performed during this procedure.
Will the injection hurt?
There is some discomfort with needle insertion which we minimize by numbing the skin over the joint with a local anaesthetic.
How long does the effect last?
The effect will hopefully last for an extended period of time (one year on average). You will likely experience some increase in your back pain over the next several days and then your pain should improve.
What is the next step after the injection?
You will be given a follow up appointment to discuss how effective the treatment was. If it was not successful other treatment options will be discussed.
What are the risks and side effects?
Serious side effects and complications are rare. The most common problem after the injection is having pain in the area of the injection for a few days. The other complications are infection, bleeding and nerve injury. These complications are minimized by using sterile technique, and fluoroscopy for xray needle guidance
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Rogers Regenerative Medical Group (RRMG) provides world-class Regenerative Orthopaedics and Sports Medicine specializing in the comprehensive treatment of the musculoskeletal system and the use of specific treatment types best suited for sports injuries and a variety of other health issues. The treatments range from non-operative, minimally invasive, regenerative therapies or a combination.
Other services include metabolic medicine, exercise physiological testing, weight management, biomechanical analysis, ergonomic assessments, gait and postural analysis to identify and measure abnormal movement patterns and muscle imbalances, running medicine, nutritional guidance and weight management.
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