Epidural Steroid Injections
Chronic Back Pain
Back pain is a common complaint. Most people in the United States will experience low back pain at least once during their lives. Back pain is one of the most common reasons people go to the doctor or miss work. Back pain is the second most common symptomatic reason for medical office visits in the US. Risk factors include age, general health, occupation, lifestyle, psychosocial, and cultural factors
On the bright side, you can take measures to prevent or lessen most back pain episodes. If prevention fails, simple home treatment and proper body mechanics will often heal your back within a few weeks and keep it functional for the long haul. Surgery is rarely needed to treat back pain.
Pain in cancer may arise from a tumor compressing or infiltrating nearby body parts; from treatments and diagnostic procedures; or from skin, nerve and other changes caused by a hormone imbalance or immune response. Most chronic (long-lasting) pain is caused by the illness and most acute (short-term) pain is caused by treatment or diagnostic procedures. However, radiotherapy and chemotherapy may produce painful conditions that persist long after treatment has ended.
The presence of pain depends mainly on the location of the cancer and the stage of the disease. At any given time, about half of all patients with malignant cancer are experiencing pain, and two thirds of those with advanced cancer experience pain of such intensity that it adversely affects their sleep, mood, social relations and activities of daily living.
With competent management, cancer pain can be eliminated or well controlled in 80 to 90 percent of cases, but nearly one in two patients in the developed world receives less than optimal care. Worldwide, nearly 80 percent of people with cancer receive little or no pain medication.
Complex Regional Pain Syndrome
Complex regional pain syndrome (CRPS) is a chronic pain condition most often affecting one of the limbs (arms, legs, hands, or feet), usually after an injury or trauma to that limb. CRPS is believed to be caused by damage to, or malfunction of, the peripheral and central nervous systems. The central nervous system is composed of the brain and spinal cord, and the peripheral nervous system involves nerve signaling from the brain and spinal cord to the rest of the body. CRPS is characterized by prolonged or excessive pain and mild or dramatic changes in skin color, temperature, and/or swelling in the affected area.
There are two similar forms, called CRPS-I and CRPS-II, with the same symptoms and treatments. CRPS-II (previously called causalgia) is the term used for patients with confirmed nerve injuries. Individuals without confirmed nerve injury are classified as having CRPS-I (previously called reflex sympathetic dystrophy syndrome). Some research has identified evidence of nerve injury in CRPS-I, so the validity of the two different forms is being investigated.
CRPS symptoms vary in severity and duration. Studies of the incidence and prevalence of the disease show that most cases are mild and individuals recover gradually with time. In more severe cases, individuals may not recover and may have long-term disability.
Diabetic neuropathy is a type of nerve damage that can occur if you have diabetes. High blood sugar can injure nerve fibers throughout your body, but diabetic neuropathy most often damages nerves in your legs and feet.
Depending on the affected nerves, symptoms of diabetic neuropathy can range from pain and numbness in your extremities to problems with your digestive system, urinary tract, blood vessels and heart. For some people, these symptoms are mild; for others, diabetic neuropathy can be painful, disabling and even fatal.
Diabetic neuropathy is a common serious complication of diabetes. Yet you can often prevent diabetic neuropathy or slow its progress with tight blood sugar control and a healthy lifestyle.
The facet joints connect the vertebral bodies to one another, and like the hip and the knee, they can also become arthritic and painful, and can be a source of back pain. The facet joints are located at the back of the spine and counterbalance the intervertebral discs. They help keep the normal alignment of the spinal vertebrae and limit motion. The pain and discomfort that is caused by degeneration and arthritis of this part of the spine is called facet arthropathy, which simply means a disease or abnormality of the facet joints.
The goal of a facet rhizotomy, either a cervical facet rhizotomy or lumbar facet rhizotomy, is to provide pain relief by "shutting off" the pain signals that the joints send to the brain. The pain relief experienced by most patients who have this procedure lasts months or even years.
Failed Back Surgery Syndrome (FBSS)
Failed back syndrome (FBS), also called "failed back surgery syndrome" (FBSS), refers to chronic back and/or leg pain that occurs after back (spinal) surgery, usually after laminectomy.[unreliable medical source?] It is characterized as a chronic pain syndrome. Multiple factors can contribute to the onset or development of FBS. Contributing factors include but are not limited to residual or recurrent disc herniation, persistent post-operative pressure on a spinal nerve, altered joint mobility, joint hypermobility with instability, scar tissue (fibrosis), depression, anxiety, sleeplessness and spinal muscular deconditioning. An individual may be predisposed to the development of FBS due to systemic disorders such as diabetes, autoimmune disease and peripheral blood vessels (vascular) disease.
Common symptoms associated with FBS include diffuse, dull and aching pain involving the back and/or legs. Abnormal sensibility may include sharp, pricking, and stabbing pain in the extremities. The term "post-laminectomy syndrome" is used by some doctors to indicate the same condition as failed back syndrome.
Joint pain is discomfort that arises from any joint — the point where two or more bones meet. Joint pain is sometimes called arthritis or arthralgia. Joint pain can be mild, causing some soreness each time you move your joint. Or joint pain can be severe, making it impossible to use your joint. Joint pain is rarely an emergency. Most cases of mild joint pain can be successfully managed at home
Neck Pain, Arm Pain, Leg Pain
Pain located in the neck is a common medical condition. Neck pain can come from a number of disorders and diseases and can involve any of the tissues in the neck. Examples of common conditions causing neck pain are degenerative disc disease, neck strain, neck injury such as in whiplash, a herniated disc, or a pinched nerve. Neck pain can come from common infections, such as virus infection of the throat, leading to lymph node (gland) swelling and neck pain. Neck pain can also come from rare infections, such as tuberculosis of the neck, infection of the spine bones in the neck (osteomyelitis and septic discitis), and meningitis (often accompanied by neck stiffness). Neck pain can also come from conditions directly affecting the muscles of the neck, such as fibromyalgia and polymyalgia rheumatica. Neck pain is also referred to as cervical pain.
Neuropathic pain is a localized sensation of unpleasant discomfort caused by damage or disease that affects the somatosensory system. The IASP's widely used definition of pain states: "Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage."
Neuropathic pain may be associated with abnormal sensations called dysesthesia, and pain from normally non-painful stimuli (allodynia). It may have continuous and/or episodic (paroxysmal) components. The latter resemble stabbings or electric shocks. Common qualities include burning or coldness, "pins and needles" sensations, numbness and itching. Nociceptive pain, by contrast, is more commonly described as aching.
Peripheral neuropathy, a result of damage to your peripheral nerves, often causes weakness, numbness and pain, usually in your hands and feet. It can also affect other areas of your body.
Your peripheral nervous system sends information from your brain and spinal cord (central nervous system) to the rest of your body. Peripheral neuropathy can result from traumatic injuries, infections, metabolic problems, inherited causes and exposure to toxins. One of the most common causes is diabetes mellitus.
People with peripheral neuropathy generally describe the pain as stabbing or burning. Often, there's tingling. In many cases, symptoms improve, especially if caused by a treatable underlying condition. Medications can reduce the pain of peripheral neuropathy.
Postherpetic neuralgia (post-her-PET-ic noo-RAL-jah) is a complication of shingles, which is caused by the chickenpox (herpes zoster) virus. Most cases of shingles clear up within a few weeks. But if the pain lasts long after the shingles rash and blisters have disappeared, it's called postherpetic neuralgia.
Postherpetic neuralgia affects your nerve fibers and skin, and the burning pain associated with postherpetic neuralgia can be severe enough to interfere with sleep and appetite. The risk of postherpetic neuralgia increases with age, primarily affecting people older than 60. The area affected also makes a difference. When shingles occurs on the face, for example, the likelihood of postherpetic neuralgia is significantly higher than for other parts of the body.
Currently, there's no cure for postherpetic neuralgia, but there are treatment options to ease symptoms. For most people, postherpetic neuralgia improves over time.
Radiofrequency neurotomy is a procedure to reduce back and neck pain. Heat generated by radio waves is used to target specific nerves and temporarily interfere with their ability to transmit pain signals.
The radio waves are delivered to the targeted nerves via needles inserted through the skin above your spine. Imaging scans are used during radiofrequency neurotomy to help the doctor position the needles precisely.
Radiofrequency neurotomy works better in some people than in others. Tests may be needed to determine if the nerves commonly targeted by radiofrequency neurotomy are the same nerves responsible for your pain.
Reflex Sympathetic Dystrophy
Reflex sympathetic dystrophy (RSD) is a clinical syndrome of variable course and unknown cause characterized by pain, swelling, and vasomotor dysfunction of an extremity. This condition is often the result of trauma or surgery. Limb immobility may lead to RSD; RSD in a hemiplegic upper limb after stroke is often termed shoulder-hand syndrome. RSD may also develop in the absence of an identifiable precipitating event.
Newer taxonomy categorizes RSD as type 1 complex regional pain syndrome (CRPS), which occurs in the absence of definable nerve injury. Type 2 CRPS, causalgia, develops after nerve injury; the term causalgia was coined by Mitchell in 1864 and derives from the Greek for burning pain. In patients with either type 1 or type 2 CRPS, sympathetic mediation of the pain (ie, improvement with sympathetic blockade) may or may not be evident.
RSD is largely a clinical diagnosis (see Presentation and Diagnostic Considerations). Two major approaches to the treatment of early RSD are sympathetic blockade and anti-inflammatory therapy. Surgical sympathectomy may be considered in patients with refractory RSD that had initially responded to sympathetic blockade. Spinal cord stimulation is another surgical option. (See Treatment and Medication.)
The sacroiliac joint or SI joint (SIJ) is the joint in the bony pelvis between the sacrum and the ilium of the pelvis, which are joined by strong ligaments. In humans, the sacrum supports the spine and is supported in turn by an ilium on each side. The joint is a strong, weight bearing synovial plane joint with irregular elevations and depressions that produce interlocking of the two bones. The human body has two sacroiliac joints, one on the left and one on the right that often match each other but are highly variable from person to person.
Sciatica is a set of symptoms including pain caused by general compression or irritation of one of five spinal nerve roots of each sciatic nerve—or by compression or irritation of the left or right or both sciatic nerves. Symptoms include lower back pain, buttock pain, and numbness, pain or weakness in various parts of the leg and foot. Other symptoms include a "pins and needles" sensation, or tingling and difficulty moving or controlling the leg. Typically, symptoms only manifest on one side of the body. The pain may radiate above the knee, but does not always.
Sciatica is a relatively common form of lower back and leg pain, but the true meaning of the term is often misunderstood. Sciatica is a set of symptoms rather than a diagnosis for what is irritating the root of the nerve to cause the pain. Treatment for sciatica or sciatic symptoms often differs, depending on underlying causes and pain levels. Causes include compression of the sciatic nerve roots by a herniated (torn) or protruding disc in the lower back
Spinal stenosis is an abnormal narrowing (stenosis) of the spinal canal that may occur in any of the regions of the spine. This narrowing causes a restriction to the spinal canal, resulting in a neurological deficit. Symptoms include pain, numbness, paraesthesia, and loss of motor control. The location of the stenosis determines which area of the body is affected. With spinal stenosis, the spinal canal is narrowed at the vertebral canal, which is a foramen between the vertebrae where the spinal cord (in the cervical or thoracic spine) or nerve roots (in the lumbar spine) pass through. There are several types of spinal stenosis, with lumbar stenosis and cervical stenosis being the most frequent. While lumbar spinal stenosis is more common, cervical spinal stenosis is more dangerous because it involves compression of the spinal cord whereas the lumbar spinal stenosis involves compression of the cauda equina.
A workplace injury is an injury or illness that occurs in relation to an employee's job. Most states narrow the definition of a workplace injury to one that “arises out of and in the course of employment” to prevent employees from pursuing compensation for injuries not directly caused by the job.