Low back and neck pain are among the most common complaints of everyday life.
Study: 31% of Americans have a Neck or Back Condition
According to a 2011 study by Gallup-Healthways, an average of 31% of Americans reported having a neck or back condition. The percentage of Americans reporting they have a neck or back condition climbs steadily between the ages of 18 and 59, rising from 16% among 18- to 23-year-olds to 37% among 54- to 59-year-olds and then plateaus at about 36% among people ages 60 and older. The Well-Being Index was based on a survey of more than 353,000 U.S. adults, aged 18 and older.
Billions Spent Treating Back and Neck Pain
Whether due to injury, illness, arthritis or congenital factors, the chance of developing low back or neck pain in one’s lifetime is significant. A 2008 study reported in the Journal of the American Medical Association indicated that billions of dollars are spent annually in the US treating low back and neck pain. Which naturally raises the question of medical treatment options available to combat this pain.
Treatment: From Rest to Invasive Surgery
Treatment modalities for back and neck pain generally range on a scale from conservative to more invasive: rest, medication, physical therapy, injections, and lastly, surgery. Of course these options are not mutually exclusive, and it is rare, for instance, that a doctor would begin treatment by recommending surgery except for the most serious and threatening conditions.
Injections a Mid-Line Treatment Option
This article will focus on “mid-line” treatment- injections, of which there are several different types. Injections are the insertion of medication directly into the painful area through use of a hypodermic needle, typically recommended after the more conservative modalities - rest, medication and therapy, have failed to alleviate the pain.
Understanding Trigger Point Injections
An understanding of trigger point injections and epidural steroid injections can be gleaned from the deposition of a doctor treating one of our firm’s clients. Here is a partial transcript of that deposition:
Lipkin & Apter: Trigger points are what?
Medical Doctor: Trigger points are spots that you feel over the muscles of the neck and where they extend down to the shoulders, that when pressure is applied to them that they trigger the pain that the patient is complaining about, potentially even radiating pain into the extremity and a feeling of pseudoparethesias into a hand or a forearm or other area.
Lipkin & Apter: Tell us for the record what a trigger point injection is?
Medical Doctor: Well, those trigger points I was talking about before that radiate the pain down the leg and give the pain locally in that area that could be associated with myofascial pain syndrome, can respond in some people fairly nicely to a superficial injection down to the fascia over the muscle with the ligamentous coating on the muscle utilizing a local, and sometimes incorporating a small amount of long-lasting cortisone with it.
Lipkin & Apter: And the epidural steroid injection goes where and the purpose is what?
Medical Doctor: Well, that is more specifically for deep inflammation within the spinal canal itself where the nerves are simply irritated or inflamed, and so the needle has to be inserted under x-ray control between those arches of bone that we talked about before, and so that the medication itself can flow right over the nerves or in the lumbar spine, actually place off to the side at the edge, the outer edge of that nerve tunnel where the nerve comes out.
Two additional types of common injections are nerve blocks and radiofrequency neurotomy. A nerve block involves the injection of an anesthetic like lidocaine, around the nerve. Numbness, and marked pain relief usually occurs. The positive effect however, typically lasts only a few hours, and more definitive treatment is required. Radiofrequency neurotomy or ablation, is used to treat facet joint pain by injecting medication adjacent to the effected area of the bony vertebral column. Facets are part of the spinal structure that connect successive vertebrae to each other.
The hope with any type of injection is to shrink swollen tissue and nerves, relieve pain, and improve function.
More Information and Videos
If you are considering an injection of low back or neck pain, or want more information about injections, please go to one of the short videos we’ve included on this page.
Should you wish to discuss your potential accident case with an experienced attorney, feel free to call and speak with one of the personal injury attorneys at Lipkin & Apter. The consultation is free of charge.
Learn about this outpatient procedure designed to relieve the pain associated with Trigger Points.
A radiofreqency neurotemy is a type of procedure used to treat facet joint pain.
An epidural spinal injection may be used to reduce the inflammation around the spinal nerves.
Cervical Selective Nerve Root Block is an injection used to identify the source of nerve pain in the neck and sometimes to provide longer term pain relief.