02-22-2023 Primetime Living - Flipbook - Page 19
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even certain anti-depressants. Physicians
often determine the specific medications
to prescribe to help ensure that any given
medication is both safe (after accounting
other conditions and medications used)
and effective (with clearly defined doses
and durations).
Some patients are candidates for various injections, which allow for targeted
delivery of a medication to the painful
area, unlike oral medications that spread
throughout the body and cause various
side effects. For example, if a severe disc
bulge is pinching a nerve and causing
extreme pain that goes down the leg, an
epidural injection of a steroid medication near the disc bulge can sometimes
be effective. Dr. Karri explains that “in
certain cases these injections can be
preferable when oral medications are
ineffective or limited by risk factors or
intolerable side effects.”
In some instances, physicians may
suggest physical therapy where patients
work with a licensed physical therapist
several times a week for a finite period of
time. The therapist addresses the illness
or injury with various physical modalities
including manual therapy, manipulation,
mechanical devices, and specific exercises to promote healing and restore
movement and functionality. “The best
successes with physical therapy are
achieved with motivated patients who
are also compliant with the prescribed
home exercise program,” Dr. Karri states.
Some physicians may also suggest
acupuncture, which is a form of alternative medicine that involves the placement
of small needles at key acupuncture
points to promote the body’s natural
healing response by balancing the flow
of electromagnetic energy and channeling it through pathways in the body. It
can be a safe and effective complementary strategy in treating pain, especially
if medication use for treatment is limited
for a patient.
Advances in treatment
In certain cases, back pain may be
unresponsive to many conservative strategies (outlined above) and patients may
require advanced treatments for their
symptoms, such as a minimally invasive
procedure performed by an interventional pain specialist, to surgeries that require
a spine surgeon.
Advanced treatment options include:
*Radiofrequency ablation involves
the delivery of radiofrequency waves to
nerves that supply painful facet joints to
interrupt pain signals. This procedure can
be performed anywhere from the neck
to the low back to the SI joint. “It’s not
a permanent fix, unfortunately, because
these nerves do grow back,” Dr. Karri
says. “But this is a simple procedure that
we can repeat as frequently as every four
to six months.”
*Spinal cord stimulation involves
the placement of wires along the spinal
cord to emit a mild electric current and
interrupt painful nerve impulses from
traveling to the brain. “Essentially, the
roadway that goes from your legs to the
lower back and all the way up to the brain
consists of various nerve bundles including some circuits that transmit pain,”
says Dr. Karri. “Along this roadway, spinal
cord stimulation acts as a roadblock to
stops these pain signals from reaching
the brain, so the patient no longer feels
the pain.” Spinal cord stimulation is most
effective for nerve pain that travels from
the neck to the arm or from the low back
to the leg or even pain that’s localized
to the feet (as with diabetic neuropathy),
but recent evidence suggests that it may
also be helpful in certain patients with
localized low back pain. As spinal cord
stimulation may not work for everyone,
a one-week trial is typically performed
with an external battery connected to
wires that are injected into the spine. For
patients with successful trials, a perma-
Back on track,
continued on page 26
A life without
joint pain.
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LOCATIONS: Camden Yards,
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A better state of care.
umortho.org
19
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Medical
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Affiliated with the University of
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