Issue 27.16
Do you wake up stiff in the morning? Feel like you have to roll out of bed like a log and slowly inch yourself up? Does it take a good 20 minutes or more before you feel like you can finally move like a normal human being? Do long car rides or sitting for long periods of time become almost unbearable?
If you can answer yes to any of these questions, you are likely suffering from arthritis in your low back. You may notice your pain is at its worst in the morning. Once you get moving, your pain begins to subside. The pain often remains in the low back and may occasionally radiate into the buttocks. Infrequently, it will radiate further down the leg. You may experience tightness in your low back. Your mother would tell you to stand up straight but you are unable to due to the pain.
Long car rides become miserable and even the best talk at church does not make the pew any more comfortable for your back.
Your doctor may order an X-ray, CT scan or MRI to evaluate your low back pain. You may hear words like: facet arthropathy, lumbar spondylosis and facet hypertrophy. These terms all essentially refer to small joints in our spine called facet joints or zygopophyseal joints (if you are looking for a new word of the day). These joints prevent excessive twisting and bending of the spine. The joints are larger as you move down the spine and allow less movement to improve stabilization. There is a small fluid-filled sac that surrounds each joint allowing the joints to glide on each other during our daily movements. When these sacs become irritated, the small nerve fibers within send our brain a signal of pain. Our back muscles then try to protect these joints and tense up and go into spasm. This may happen only once or twice a year. Some experience this type of pain daily.
So what can you do? Medications can be prescribed to alleviate the muscle spasms and reduce the pain. Proper posture, as our mother always taught us, will help reduce recurrence.
Commonly, the aid of a local physical therapist is best to help demonstrate proper exercises to strengthen our core muscle groups and improve our posture. Interventional spine specialists or pain management doctors can inject steroid into these joints. If the steroid injections work well but only last a short while, lumbar medial branch radiofrequency ablation can be performed.
First, numbing medication (lidocaine) is placed into the joints and a pain diary is kept to rate
your pain relief over the next few hours. If you have significant reduction of your pain for the first two hours following the procedure, you are a great candidate for radiofrequency ablation.
Radiofrequency ablation, or essentially burning of the nerve, can provide pain relief for 1-2 years before the nerve regenerates. This procedure can be repeated as necessary every year.
If you feel like you may be suffering from any of these symptoms please feel free to contact our office, Desert Pain Specialists, at 435-216-7000.