Pain Awareness Month
Lower Back Pain
Established in 2001 by the American Chronic Pain Association, September marks National Pain Month in the U.S. One of the most common sources of pain is the lower back, and according to the National Institutes of health, about 80 percent of us experience low back pain at some point in our lives. Low back pain is also the most common cause of job-related disability and a leading contributor to missed workdays.
Two major causes of low back pain are radiculopathy (better known as sciatica) and spinal stenosis. A visit to your health care professional is the first step in dealing with low back pain and getting a proper diagnosis.
Low back pain can sometimes be treated with exercise, physical therapy and, in some cases, medication. For difficult low back pain problems – including sciatica, spinal stenosis, and pain in nearby joints – epidural (near the spinal cord) injection of steroidal painkillers may be used. These pain injections fall into an area of medical practice called interventional radiology.
Interventional radiologists use their expertise in reading X-rays, ultrasound and other images to guide small tubes such as catheters through blood vessels, tissue or other pathways to treat everything from varicose veins to tumors, including procedures that target pain with special injections. These non-surgical, minimally invasive procedures can be used to treat back and joint pain on an outpatient basis with faster recovery times and much less cost than traditional surgery.
For spinal procedures, radiologists use a procedure called CT fluoroscopy to help accurately guide a specialized needle into the epidural space to deliver pain medication. This image guidance ensures accurate delivery of the pain and anti-inflammation medication used to treat the patient’s pain. CT fluoroscopy is also used for spine facet joint injections, which treat the facet joints that allow your back to twist and bend.
Although non-guided injections (no imaging to guide the needle) were once common, the injection of pain medication near the spinal cord using image guidance is now standard practice, and it is the best option for patients who are good candidates for back pain injections. These image-guided procedures give radiologists and technologists the safest, most accurate delivery of painkillers possible.
Patients should always check with their health care provider first to diagnose low back pain, and if pain injections are recommended as an option, check with your physician, hospital or imaging facility about image-guided procedures before your scheduled appointment.
Kenneth V Salce, M.D.
Board certified radiologist practicing diagnostic and interventional radiology in Flagstaff, Arizona. Dr. Salce attended the University of Southern California, School of Medicine and completed his training at UCLA/Harbor General Hospital and Los Angeles County/USC Medical Center.
Dr. Salce has developed an active interventional radiology practice including the treatment of arterial and venous vascular disease. He is an active member of the Society of Interventional Radiology and acts as a medical consultant for W.L. Gore & Associates.