Spinal Cord Stimulator Trial

Spinal cord stimulation for chronic back pain uses electrical pulses to stimulate nerves in the spinal cord, with the goal of interfering with the path of pain signals as they travel to the brain.

 

The first step in the process is a trial period of spinal cord stimulation.

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Radiofrequency Ablation

This minimally invasive procedure, also known as a Radio Frequency (RF), reduces or eliminates the pain of damaged facet joints by disrupting the medial branch nerves that carry the pain signals.

RFA  to treat neck pain is performed on medial branch nerves that carry pain signals from the facet joints. RFA to treat low back pain or posterior pelvic pain from the sacroiliac joint is performed on the lateral branch nerves.

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Laminectomy

A lumbar laminectomy is typically performed to alleviate pain from lumbar spinal stenosis. Spinal stenosis is caused by degenerative changes that lead to enlargement of the facet joints in the back of the vertebrae. The enlarged joints and related degenerative changes place pressure on the nerve roots as they exit the spine.

Each vertebra has two portions of vertebral bone over the nerve roots in the back of the spine. These small flat bones are called the lamina.

Removing all or part of the lamina through a lumbar laminectomy can give the affected nerve root more space and a better healing environment.

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Sciatica

Sciatica is a term that describes symptoms of pain, numbness, and/or weakness that radiate along the sciatic nerve from the lower back to the buttocks and leg. The medical term for sciatica is lumbar radiculopathy.

The vast majority of sciatica symptoms result from lower back disorders between the L4 and S1 levels that put pressure on or cause irritation to a lumbar nerve root.

Most commonly, sciatica is caused by a disc problem, such as a herniated disc that is pressing against a nerve root.

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Sacroiliac Joint 

Sacroiliac joint dysfunction is improper movement of the joints at the bottom of the spine that connects the sacrum to the pelvis. It can result in pain in the low back and legs, or inflammation of the joints known as sacroiliitis.

The sacrum is a triangular bone at the bottom of the spine, below the lumbar region of the spine and above the tailbone. It consists of five fused vertebral segments. The sacrum is connected to the pelvic bone, also known as the iliac crest, on the right and left sides at the sacroiliac joints. These joints act as shock-absorbing structures and typically only move a small amount.

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Osteoarthritis

Knee osteoarthritis is a condition where the cartilage in the knee degenerates, or breaks down, which can lead to inflammation, pain, and swelling in the knee joint.

The knee is the largest joint in the body. It is the point where the femur, or thigh bone, meets the tibia, or shin bone, as well as the fibula, which is a smaller bone that runs beside the tibia.

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Migraine

A headache can be caused by a problem in the neck. What we call that is cervicogenic headache. Most of the headaches do not come from the neck, most of the headaches have a different source, but there is a very specific type of a headache that is called cervicogenic headache stemming from the cervical spine - or in other words, the neck.

Cervicogenic headache usually starts in what we call the suboccipital area, which is that muscular area that is just under the occiput of the head. That pain starts there - it can be on one or both sides - and it tends to radiate up into the head and around the head. The easiest way to visualize it is to actually take the palm of your hand and place it on the back of the head and that really is where the pain spreads. More rarely, the pain can travel to the front of the head and behind the eye. Once again, that's not common and it is even less common for it to just appear in the front of the head or behind the eye, but it does happen.

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Botox

Botox is only FDA-approved for chronic migraines, which means headache on 15 or more days a month.  “The more frequent the headaches, the better the patient does with Botox,” says Dr. Andrew Blumenfeld, Director, The Headache Center of Southern California. Botox is not recommended for patients who experience fewer than 15 headache days a month.

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