Options for spinal pain include traditional medications like over the counter analgesics or opioids, and also in between medications that are different from the traditional on-label medications. One of those medications includes gabapentin, which works well for neuropathic pain. Initially it was designed for epilepsy, but it is often used off-label for pain. Some antidepressants are often used for neuropathic pain issues.
Quite a few conditions represent things that can go wrong with one’s spine. The soft cushions between the vertebral bodies are called spinal disks, and are like jelly-filled donuts. They may get little tears or disk bulges; sometimes these tears result in larger cervical or lumbar disk herniations, and are large enough to press on spinal nerves. This results in burning down one’s legs, called sciatica. If the pain is in the arms, the fancy term is radiculopathy for the pain.
An additonal problem that older patients see is arthritis coming from bony and soft tissue overgrowth. This is called spinal stenosis.
Options for spinal pain include traditional medications including OTC analgesics through to opiates, and also in between medications. One of these, gabapentin is a neuropathic pain medication which was initially meant for epilepsy but now often utilized for pain. Some antidepressants are also used for neuropathic pain conditions.
Another option for back and neck pain that works well is physical therapy. This includes strengthening of the core along with backa and neck muscles, bladder, and diaphragm. Treatment by a chiropractor has lots of research to back it up for neck pain along with acute low back pain. Additional treatments include spine decompression, which is a revolutionary treatment with intermittent traction providing nutrients to the disc. Ice, heat, electrical stimulation, laser, and acupuncture can also give significant relief.
Apart from physical therapy, medications, and alternative treatments, a few injection options are available which can help avoid surgery and can be quite effective for spine pain. There are some studies backing up the use of cortisone shots to these facet joint areas; if it works and then wears off a follow up procedure called radio frequency ablation may be used. This may provide relief for over a year.
Another form of injection involves epidural treatments. In pain patients, these procedures are done with the addition of x-ray fluoroscopy, which helps locate the needle for more accurate placement. The idea is to provide some cortisone along with numbing medicine to irritated nerve roots and help simmer down on the swelling and alleviate sciatic, or radicular pain. It is typically quite effective.
There are 3 ways epidural injections are usually done. One is an intra-laminar approach, which is how the injections were done when epidural injections were first started. Another is a transforaminal approach, or a selective nerve root approach, where the medication is injected into the exiting tunnel in a more precise fashion. A third injection is called the caudal approach, which is above the coccyx in a small tunnel at the base of the sacrum.