Most people get pain in the spine and the lower back and neck the most common areas that develop pain as they are the most mobile part of the spine. Our spine was designed to walk on all four limbs, but once our ancestors started walking on two feet, it puts undue stress on the spine and this leads to painful conditions. Nearly all of us would experience spinal pain sometime in our life and most of them settle down on its own. However, low back pain and neck pain are one of the commonest causes of sickness absenteeism as 1 in 5 people would be experiencing pain for more than three months. It is important that pain is assessed and addressed in a timely manner to prevent undue suffering and disability, but also to rule out sinister conditions.
Sacroiliac pain/ Sacroiliitis
Piriformis syndrome/Deep gluteal syndrome
Spinal canal Stenosis
Failed Back Surgery Syndrome
Degenerative disease of spine
Disc prolapse/ Herniated discs
Sometimes spine pain can occur suddenly or it can occur slowly. Spine pain can also occur immediately after an injury or the onset of symptoms can be delayed.
Symptoms may include; a sharp pain, or a stiff back, pain radiating down into the buttock or leg and even into the foot. There might be tingling, numbness, pins and needles and weakness.
Sometimes people can be very unwell if there is a more serious cause like an infection or fracture of the spine.
The back is mechanical in nature and spine pain occurs when there is a disruption in the way the parts of the back fit together and work. These include the spine bones (vertebrae), intervertebral discs between the bones, spinal cord, many complex nerves and surrounding muscles, tendons and ligaments.
The parts of the back all work seamlessly together like components of a complex piece of machinery but if one part is faulty, the whole system can be affected and malfunction.
When back experts make an assessment, a few things need to be considered because pain in the back could be caused by a number of problems in or around the back. A few spine pain causes are:
Most of the spinal pain people experience are in the lower back and neck. These are discussed in detail in our pages for low back pain & sciatica and neck pain. Pain in the middle of the spine is not that common, but persistent pain there should be investigated. The diagnosis of spinal pain is mainly on history and clinical examination and if required, it would be confirmed with appropriate investigations. These include X-rays, MRI/CT scans, Bone scan/DEXA scan and blood tests.
ACUTE SPINE PAIN TREATMENT
If pain is long lasting (chronic pain), debilitating and has not been responding to treatments an assessment should be made by a pain management specialist, who can assess and treat most types of chronic pain.
CHRONIC SPINE PAIN TREATMENT
Through years of experience, we’ve figured out that good and long-lasting chronic spine pain relief doesn’t work unless all bases are covered.
The best spine pain management combines pain-reducing treatments with selected therapies like physical and psychological rehabilitation treatment.
TYPES OF TREATMENT
Most types of chronic pain treatment should be managed alongside some form of specialist rehabilitation. This is when the best results occur.
Each injection can have different side-effects. Please refer to appropriate injections information leaflet in the section of treatments.
In situations where the pain is disabling severe and not allowing you to do the day-to-day chores, medications have proven inadequate to reduce the pain; injections are targeted to be given either under x-ray guidance or ultrasound guidance at the presumed sources of pain. Injections mainly consist of local anaesthetic with or without steroid. This works as anti-inflammatory at the source of pain.
Injections are not a permanent cure. Injections help by reducing the intensity of pain. The aim is to reduce pain and break the cycle of pain, allow you to carry out rigourous physiotherapy and help and healing. We may have to repeat injections in order to achieve the goals.
There are other injections available when nerves can be ablated (burnt) or we can apply what is called a radio-frequency lesioning at lower temperatures. These treatments have intermediate to long-term benefits and also work to reduce inflammation. These can be offered if the initial injection does not last long enough to follow on with strengthening Physiotherapy. These injections are not operations or permanent treatments. They are used to improve your condition of pain in order for you to carry out rehabilitative strengthening physiotherapy and come out of the vicious cycle of pain.
We can offer you Non-injection interventions such as acupuncture. We can introduce you to other means of self management of pain such as using a TENS machine . We have a modalities to offer at our clinic for example Medical yoga therapy, deep electrical muscle stimulation, TENS treatment. If the pain is unbearable, not responding to medications, or you do not want to try the non-invasive modalities ; we could offer you injection therapies.
You will have a detailed consultation, examination and then be given information and advice about your condition. We may also organise investigations. We may be able to prescribe you medication and give you details about how to manage pain and other interventional options can be discussed.
You will be reviewed only by MACS clinic senior Pain Consultants for your condition.
If your pain is very severe, not responding to over-the-counter painkillers you should contact your GP and get an appointment for review. If you are in severe disabling pain, unable to carry out any routine tasks, you could book an emergency appointment with your GP or go to the local A&E for a review.
These are not very common, but it is important to rule them out if there is suspicion of a serious underlying condition. These include some instances, pain can indicate more serious back problems. These problems might include cancer, fractures, infection, severe nerve compression (pinched nerve) and ankylosis spondylitis.
Seek urgent and specialist medical advice if you have:
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