Ouch, my back hurts. What are my options?

ST. GEORGE — Spinal and back pain are widespread problems that affect between 60 million and  100 million people in the United States each year. Pain can involve the neck, midback or lower back regions and affects the lives of between 50-80 percent of the population annually. Apart from the suffering it causes, spinal or back pain can negatively affect one’s daily relationships, activities and work responsibilities.  

L-R: Drs. Jon Obray, Rick Obray, Derek Frieden, founding partners of Southwest Spine and Pain Center, Southern Utah | Photos courtesy of Southwest Spine and Pain Center, St. George News

At Southwest Spine and Pain Center, the practitioners focus on both identifying and treating the cause of pain, which in turn improves functionality and quality of life. Patients are able to live life again.

Spinal pain can radiate from multiple structures in and around the spine, including ligaments, muscles, facet joints, spinal nerves, intervertebral discs and vertebral bones. In each of these areas, spinal pain can be acute (sudden) or chronic (long-lasting). Most instances of acute pain resolve with treatment and time, whereas chronic pain is often more complex, involving multiple causes. Such chronic pain can be constant or involve intermittent episodes that last days to years.

Pain from ligaments and muscles can generally be relieved with rest, heat, ice, nonsteroidal anti-inflammatory medications (such as Tylenol), muscle relaxers and physical therapy, including stretching, massage and ultrasound. When muscular pain is chronic, medications that are not habit-forming, such as Lyrica, can be helpful.

The back of the spine is another area where pain may develop, specifically in the facet joints. These joints are responsible for bearing much of the weight of the upper body and allow for bending and rotation of the spine. Due to their movement, the facet joints are prone to injury and, over time, often develop arthritis, just like a knee or hip joint. When inflamed, facet joints cause pain in the neck or low back.

To help diagnose facet joint pain, your doctor may administer a test injection to temporarily numb the tiny sensory nerves that carry pain signals from the facet joints.  If this test injection provides significant relief for a short period of time, a minimally invasive procedure called radiofrequency rhizotomy can then be performed to provide longer-lasting relief, between six and 12 months. During this procedure, X-ray guidance is used to position special needles that destroy the sensory nerves with heat, resulting in pain relief without weakness or numbness.

Pain from degenerative disc disease or disc herniation also can cause pain in the neck or back. If those disc changes compress spinal nerves, the pain can then radiate into the arms or legs. To treat pain from nerve compression, your physician may inject an epidural steroid, which is another minimally invasive, therapeutic procedure that can help relieve the pain caused by inflamed spinal nerves.

Acute back pain also may result from a vertebral compression fracture, which can occur after a fall, or even without a significant injury. In these fractures, the vertebral bone becomes compressed, or flattened, causing pain. These fractures are much more common in patients who have osteoporosis, a condition in which the bone is much thinner than normal, making it more prone to fracture.

Southwest Spine and Pain Center, 652 S. Medical Center Drive, St. George, Utah, date not specified | Photo courtesy of Southwest Spine & Pain, St. George News

Pain from compression fractures can improve with conservative treatments such as bracing, pain medications and physical therapy. If the pain persists, then a procedure called vertebroplasty or kyphoplasty may be indicated. These are both minimally invasive procedures in which a special compound is injected into the fractured vertebrae to treat the existing pain and prevent further collapse of the vertebral bone. This can be performed in-office using special needles through very small incisions; the person is able to go home that same day.

Read more: How kyphoplasty relieves back pain

Spinal cord stimulation is another treatment option that can significantly reduce or relieve chronic pain of the neck, back, arms, and legs. In this minimally invasive procedure, small wires, called leads, are inserted into the spine. These generate a very small electrical current that stimulates areas of the spinal cord to block pain signals before they reach the brain.

Studies have shown it to be incredibly successful in treating chronic pain of the spine and limbs, even in those people who have ongoing pain after previous spine surgery. A temporary trial is performed to determine whether this treatment would be helpful, and if relief is found, the leads and battery are implanted under the skin in a same-day surgery. Southwest Spine & Pain practitioners have found the degree of success and improved quality of life achieved through spinal cord stimulation is often remarkable.

Southwest Spine and Pain Center focuses on both identifying and treating the cause of pain, which, in turn, improves functioning and quality of life. To accomplish this, the center utilizes a multidisciplinary approach that involves injections, minimally invasive procedures, medications and coordinating behavioral health as well as physical therapies. With eight clinics throughout Utah, the center’s board-certified physicians employ a compassionate and proven approach to pain management, with the overall goal of improving patient functioning and quality of life.

If you or someone you know is struggling with spine or back pain, or any other painful condition, contact Southwest Spine and Pain Center at 435-656-2424 to schedule an appointment. Or visit the Southwest Spine and Pain website for more information.

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