Top 3 Back Pain Treatment Approaches

An estimated 80 percent of American adults will miss work at some point in their careers because of back pain. For the majority, the pain is neither permanent nor serious – approximately 95 percent of backaches go away within six weeks without a specific treatment.

Unless you are totally immobilized from a back injury — your doctor will test your range of motion and nerve function and touch your body to locate the area of discomfort.

Importantly if you suffer from pain that doesn’t subside – or becomes worse – there are three levels of back pain treatment you should explore.

Conservative Treatments

The most common, and least invasive, treatments for back pain include physical therapy, bracing, medication, oral steroids, massage therapy, acupuncture, and chiropractic support.

Steroid Injections

Using imaging (x-ray) guidance for needle placements, these injections are performed by specialized physicians. Your doctor may recommend one of several types of steroid injections, depending on the location and level of pain you experience.

Epidural Steroid Injections (ESIs) – ESIs are a minimally invasive outpatient procedure performed by injecting a mixture of a steroid and long-acting anesthetic into the epidural space (a space containing nerves and nerve roots). ESIs are typically performed for central (axial) back or neck pain. Some indications for ESIs include back pain from degenerative, bulging, or herniated discs, spinal stenosis, and spinal nerve root inflammation (such as shingles). If successful at relieving pain, an ESI can be performed three times in a 6-month period.

Selective Nerve Root Block (SNRB) – SNRBs are a minimally invasive outpatient procedure performed by injecting a mixture of a steroid and long-acting anesthetic into a specific nerve root sleeve. The main indication for a SNRB is a patient with peripheral (arm or leg) pain, which is felt to be secondary to compression or inflammation of a specific nerve root (s).

Medial Branch (Facet Joint) Blocks – The facet joints in our back and neck have cartilage that allows our back and neck to bend, twist, and flex. As we age, these joints can become degenerative or arthritic. The cartilage loses fluid and height, which can lead to a bone-on-bone condition often resulting in bone spur formation and chronic neck or lower back pain. Facet joint arthritis is one of the most common causes of chronic neck or lower back pain. Medial branch (facet) blocks are performed by injecting a mixture of a steroid and long-anesthetic into the medial branch nerves going to the facet joints.

Medial Branch (Facet Joint ) Denervations – If a medial branch (facet) block results in pain relief for the patient but the pain recurs, the patient may then be a candidate for a medial branch (facet) denervation. Using a radiofrequency (RF) device is recommended to perform the denervation. A RF denervation is a minimally invasive, outpatient procedure performed by placing a needle electrode adjacent to medial branch nerve (s) and then ablating (burning) the nerves with RF heat energy. If successful, the RF denervation procedure can result in longer-lasting pain relief, from 6 months to 2 years.

Sacro-iliac (SI) Joint Injections – Degenerative arthritis and inflammation of the SI joints is a common cause of chronic low back and buttock pain. Patients often complain of chronic low back pain, groin pain, and sitting intolerance without associated leg pain. SI joint injections are minimally invasive, outpatient procedures performed by injecting a mixture of a steroid and long-acting anesthetic into the SI joint.

Kyphoplasty – This procedure is for patients with acute painful compression fractures of the spine. These fractures typically cause severe pain and may lead to the patients being wheelchair bound or bedridden, with severely limited daily activities. The most common reason for these fractures is the presence of osteoporosis; other less common causes are trauma and cancer. Kyphoplasty is a minimally invasive, non-surgical, outpatient treatment performed through one or two needle holes for each spine fracture. The needles are inserted using the latest in high resolution imaging technology. Balloons are inserted through the needles to re-expand the bone; the resultant cavity is filled with a bone cement to internally cast the broken bone. Kyphoplasty procedures typically result in greater than 90 percent of patients experiencing near-complete or complete pain relief. Patients with spinal compression fractures have a higher risk for additional fractures; these fractures can also be treated with kyphoplasty.


When patients with intolerable pain have exhausted all conservative therapies and injection treatments, the remaining option is surgery.

10 Tips to Prevent Varicose Veins

Varicose veins are enlarged, dark purple or blue blood vessels that bulge out from the skin, most frequently on your legs. In addition to being unsightly, varicose veins can cause aching pain, throbbing, and discomfort. They may also be an indicator of serious health issues, including poor circulation. Fortunately, you can take steps to help prevent varicose veins and maintain healthy circulation in your legs. Here are 10 tips for prevention:

Weight Loss – Carrying extra weight causes added strain on your legs. Reducing your weight will not only help your overall health, but minimize the likelihood of developing varicose veins.

Find a Chair – Standing for long periods of time adds to your risk of developing varicose veins. Look for opportunities to reduce the stress on your legs by sitting when possible.

Improve Circulation – Compression stockings help your legs by supporting your weight, which improves circulation. If you have a job that requires you to stand often, compression stockings are a valuable option. Another method for those who stand a lot is to flex your calf muscles. You can also try squeezing your feet in your shoes to improve blood flow.

Exercise – Staying active is great for your health, in general, but it also improves the circulation in your legs. Activities like biking, swimming, and walking are highly recommended. You must still use caution, however, when exercising. Abdominal pressure, for example, can block blood flow to your heart. If you lift weights, make sure you blow out to limit the pressure.

Stop Smoking – Smoking is obviously bad for your health, but many people don’t realize the effects it has on your circulation. By quitting, you improve blood flow throughout your body and minimize your risk for high blood pressure – both associated with varicose veins.

High-Estrogen Birth Control – Birth control pills and hormonal supplements that are high in estrogen can alter your circulation. As noted already, poor circulation can lead to varicose veins. Note that pregnancy also causes an elevation of many hormones. Approximately 70 percent of women who become pregnant and have inherited a family gene for varicose veins will see them develop. The good news is that many of these veins will disappear 4 to 6 weeks after you finish breast-feeding.

Crossed Legs – Many people automatically cross their legs when they sit down. Unfortunately, doing so hampers circulation. You can help prevent varicose veins by avoiding this habit.

Wear Comfortable Clothing – You want to avoid constricting your legs and waist to ensure circulation remains fluid. When possible, try to wear low-heeled or flat shoes and clothes that don’t restrict. Girdles or knee-high nylons or socks can block blood flow. High-heeled shoes – 1.5 inches high or more – don’t allow proper circulation.

Elevate – Take time each day to kick up your feet and relax! Elevating your feet above your heart for a short while helps circulation, lessening the chances of varicose veins developing.

Seek Treatment – In some cases the steps above just aren’t enough to prevent varicose veins. If you’re struggling with them, consider speaking with a specialist about medications and other treatments to alleviate the discomfort.