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DMG Spine Pain
Transcript of DMG Spine Pain
Discogenic Pain 26%
Sacroiliac Pain 2%
L. Manchikanti, M.D., etal:
Pain Physician, 2001, pp.308-16 Mechanical Low Back Pain Phospholipase A2 (PLA2), a very inflammatory substance, is found in herniated discs
Steroids have potent anti-inflammatory properties
Allows application of steroids directly to the affected areas
Usually performed in a series of 3 injections 1-2 weeks apart for maximal benefit Lumbar Epidural Steroid Injection Non intervention
Antidepressants and anticonvulsants
Therapeutic Injections Pain Management Herniated L3-4 Disc Herniated Disc Non Interventional Pain Treatment
Normal Spine Anatomy
Interventional Pain Techniques Dorsal Column Stimulation Non-radicular pain
Worse with sitting or standing
Disc loses elasticity with age and ruptures
Pain fibers grow into diseased disc Discogenic Pain Sacroiliac Joint Facet Nerve Block
Diagnostic and Therapeutic Facet Joint Pain Herniated Disc Herniated Disc Spondylolisthesis Narrowing of spinal canal
Results in nerve compression and may cause sciatica
Caused by herniated discs, facet hypertrophy, spurs, etc
Symptoms: back pain, pain in thighs and buttocks, sciatica Spinal Stenosis Sacroiliac Joint Patellar Reflex = L4 Achilles Reflex = S1 Reflexes S1 L5 L4 Dermatomes Cervical Thoracic Sacral Lumbar Vertebra slips
forward May result in nerve root compression National Bike to Work Day
Friday, May 17, 2013 http://www.spinecenterofdupage.com