Why Radiofrequency Ablation Is Great for Neck Pain

One of the most technological modern advancements in pain management these days is the advent of radiofrequency ablation. What exactly is radiofrequency ablation? The procedure is one that is performed as an outpatient by pain management physicians.

When a patient has neck pain itself and not pain that radiates into the arms, surgery is routinely not indicated. Why? The answer is that they've done studies over the past two decades looking at surgical intervention for neck pain in and of itself, and the results have been routinely poor.

If the patient has a herniated disc in his neck, and has surgery to fix that, the results are very good. In fact, the results are typically well over 90% good to excellent. The same cannot be said for neck arthritis conditions, or slight pain in the neck due to post traumatic arthritis. It's also not a good idea to operate on patients with facet arthritis.

Along with physical therapy and chiropractic adjustments, injections in or around the facet joints can be extremely beneficial. If those injections are done and then wear off, they may need to be repeated or the pain doctor can perform a radiofrequency ablation. This is a procedure that heats up and deadens the small little nerve endings that supply sensation to the small facet joints in the neck. This can relieve pain for one to two years.

The injection performed prior to radiofrequency ablation is called a medial branch block. This involves injecting numbing medication along with potentially a steroid material around the arthritic joints of the neck in the areas of the nerves that are bringing sensation to the joint. A medial branch block can be used as a diagnostic procedure, where insurance companies typically look for the injection to provide at least 50% pain relief and sometimes upwards of 80% relief in order to approve the patient for a radiofrequency ablation.

The medial branch block can also be used as a therapeutic procedure, and the patient may receive a few months of pain relief. If it works then wears off the patient would then be a candidate for a radiofrequency ablation. The results of radiofrequency ablation have been extremely good. The pain doctor will use a needle that heats up at the end of it to burn the small little nerve endings called the medial branches. As mentioned, this may provide an early for well over a year.

Eventually the small medial branches will regenerate and the pain may return. If this happens the radiofrequency ablation may simply be repeated with hopefully the same result. An RF procedure should definitely be attempted prior to a patient undergoing surgery in the neck for pain that is centered in the neck and not due to a herniated disc.

Causes of Back Pain - Spasmodic Torticollis, Sciatica, and Spinal Stenosis

Although many people will suffer from back or neck pain at some point in their lives, it can be quite difficult to diagnose these acute, short-term problems. Often, a muscle strain may be the culprit, which can heal in a manner of days or weeks. But for chronic pain in the neck and back, doctors have named a variety of disorders that people commonly experience. From sciatica to spinal stenosis, being aware of a few of these common painful conditions may help people suffering from back injuries understand why they are in pain and what treatment paths to take when they are recovering.

If a person has shortening of muscle fibers or periodic spasms in the neck, spasmodic torticollis may be the problem. The neck muscles may contract so much that the neck is forced to turn from a neutral position to a deranged one. Unfortunately, though, doctors do not know what actually causes this condition. A reaction to drugs or medication is the most common reason people suffer from spasmodic torticollis, but the actual reason that some people develop it is uncertain. Treatments for the condition involve such modalities as physical therapy, injections of botulinum toxin into the neck muscles, drugs to control the pain, or even surgery in some cases.

Sciatica is a condition in which the nerve roots are compressed. The most common cause is a vertebral disc begins to protrude out of the spinal column and additional pressure is put on the spinal cord. Osteoarthritis, bony irregularities, tumors, and abscesses may also cause sciatica. People who have this condition often describe the pain as burning or stabbing, and pain or numbness may be felt all the way from the lower back to the feet, with discomfort in the hips or knees also present. Rest, rehabilitative exercises, spinal flossing, medication, and surgery have all be used to treat sciatica, with varying degrees of success in different patients.

Another disorder that can cause harmful pressure on the spinal cord and sciatic nerve roots is called lumbar spinal stenosis. This results from a narrowing of the spinal canal in the lower back or upper back regions. In fact, it may even be one of the causes of sciatica. Degenerative diseases such as osteoarthritis or disc degeneration may lead to spinal stenosis. Pain is most commonly experienced in the hips, thighs, and even down to the calves, and may be felt when standing, walking, and running. The treatments for spinal stenosis are similar to treatments for sciatica and aim to reduce spinal compression causing pain.

Though there are a number of other conditions that can cause pain in the back and neck, these ones detailed here are some of the most common but most debilitating for those suffering from them. Pain in the lower back and neck can be very uncomfortable, even when it lasts only for a day or a week at the most. But chronic conditions such as sciatica or disc disease can cause pain for a great portion of person's life. This makes it even more important to find ways to deal with the problem by reducing the pain and then relearning how to move without severe back or neck pain.

Do You Sit All Day Long? - Protect Your Back

Sitting down for the majority of the day isn't always a bad thing, sometimes people have to for their jobs, attending school and other stuff as well. Something most people don't understand about sitting down is that it is almost always the leading cause of back lower back pain. Did you know that lower back pain can easily be avoided with the proper chair, cushion or pillow?

Something most workers don't understand about sitting down all day is that if they buy a chair, cushion or pillow they can deduct that on their taxes because it is a work related expense. If you sit down most of the day then you really need to protect your back by using a lumbar support cushion or pillow. In more severe cases using a lumbar support cushion or pillow just isn't enough, they will tear and wear down really quick. In this case you should use a lumbar support chair since it will last much longer and be more durable.

Tips for protecting your back when you have to sit all day long

Take breaks - The first way you can protect your back if you have to sit all day long is to take short breaks throughout the day. Most people will work until they are allowed a break but this just isn't enough, you need to at least stand up so your back will stretch and your muscles can move.

Use lumbar support - Using lumbar support is a great way to protect your back from back pain. The problem most people have is that they don't like the way a decent lumbar support feels but it is worth the discomfort until you get used to it. Just make sure you are using something if your sitting form is proper.

Sitting stretches - Stretching while you are sitting down is a great way to protect your back. All you need to do is do side bends to the left and the right and extend your back ever once and a while. The great thing about doing sitting stretches is you don't have to get up, you can stretch while you work, and most importantly it is easy to do so you won't have any excuse not to do it.

Proper form - The last thing you need to understand is that proper form is very important to protecting your back. The best way to sit is having your shoulders directly over your shoulders with a straight spine. If you aren't sitting this way then you are hurting your back which will cause back pain for years to come.

If you need extra help then I highly recommend getting a decent lumbar support cushion because they help more than you will ever know.

Reasonable Goals Of Pain Management

A reasonable goal of pain management in most cases is to reduce pain by 50% or more without reducing function and typically, increasing function.

There are 3 goals to pain management:

1. Pain relief - partial or total


2. Maintain and hopefully improve function


3. Tolerable side effects

One of the main fundamentals of narcotic treatment is to control the pain with the least amount of side effects. Unfortunately, there's not a spreadsheet telling providers exactly how much to prescribe to make that happen. A lot of pain is subjective.

The two important effects of opioids are pain relief and pleasure. Once the opioid hits its receptors in the brain and spinal cord, pain relief occurs along with stress reduction and euphoria. The brain is encouraged to release dopamine, which causes a brief rush followed by a relaxed state.

Side effects reported by those who take opioids include blurred vision, difficulty concentrating, nausea, vomiting, constipation, itching, sleepiness, low energy, fatigue, anxiety, and depression. One consideration when starting narcotics should be an exit strategy for those where the opioids are not working or when the side effects exceed the benefits.

The problem a lot of patients find is that despite being on pain medication, their pain level is still high and function is decreased. They aren't playing with their kids, socializing, or performing well at work or school. Many people find themselves prisoners of their pain medications.

Many people who take narcotics for more than a month or two develop physical dependence. The longer someone takes opioids and the higher the dose, the worse the withdrawal will be upon stopping. Physical dependence is a state of adaptation manifested by a specific withdrawal syndrome that can be started from abruptly stopping, rapidly reducing the dose, or administering an antagonist of the drug(s).

Doing the Correct Stretching Exercises For Sciatica

Sciatica is a problem that affects millions of people and only a small percentage of the people get permanent relief from it. This is not because there are no treatments or cures for it, but because people don`t take action and simple have no idea what to do. Stretching is very important and it can be very helpful, but in order to make it work, you need to know which stretches you need to be working on. Doing the right stretching exercises for sciatica is essential.

Stretching exercises for sciatica

If you have sciatic nerve pain, then you need to be focusing on targeted stretching. This means doing stretching exercises that target a specific muscle group or muscle to increase the flexibility and range of motion of that area and bring joints and bones back to their correct positions.

The reason why so many stretches, that are used in Yoga and Pilates are not working, is because they don`t target the areas that cause the sciatica. The most common cause of sciatica is muscle imbalancement. When different muscle groups are out of balance, then this in turn pulls the joints, bones and pelvis out of their correct positions. If the exercises you are doing, do not help to restore the muscle balancement, then they are useless.

There is one really effective stretching exercise, that you can try right now. Firstly, lie on your back on the floor. Then hold your left knee and pull it towards your right shoulder. You really need to pull the knee and foot across your body, then hold this position for around half a minute and repeat with the other leg. This is simple but effective. Of course you need to be doing a lot more exercises and stretches to have get any permanent relief but it is a start.

Treating Chronic Pain With Spinal Decompression

Spinal Decompression therapy is a highly effective way to treat chronic back pain without surgery or drug intervention. It is a noninvasive technique that does not allow for any major side effects. When pressure builds up between the vertebrae in the spine, discs get stressed. When this occurs, bulges and herniations many ensue causing the patient to experience a numbness or tingling sensation down one or more of their limbs. In severe cases the pressure exerted on the discs may cause weakness and or atrophy of the involved limb correlating to the spinal disc level being affected.

How It Works:

Depending on the area being affected within the spine, the computerized spinal decompression table isolates the disc level allowing pressure to be released off of the disc as well as the nerve root involved. This occurs because the table itself creates a negative vacuum like movement at the disc level affected allowing the major inside "jelly" like substance within the center of the disc to be drawn back to its original state. Decompression therapy also allows for nutrients to get in and out of the discs.

Treatments on the table last around 30 minutes and patients feel a difference around their fourth to sixth treatment. As with any form of physical therapy, decompression will take a series of treatments to stabilize the disc being affected. A schedule of 16-20 treatments is recommended within a two month span to assist in correcting the problem.

Patients suffering from herniations, bulges, arthritis and congenital abnormalities such as facet syndrome are prime conditions for utilizing spinal decompression therapy.

Spinal Degeneration Not Only An Aging Process!

"Joints don't break down with age alone, but rather with disuse, misuse, or no use. It just so happens as we get older we have more and more opportunity to do less and less". Murray Allen, M.D.

Despite medicine's best efforts, degenerative joint disease, also known as osteoarthritis, continues to be one of our society's most common - and tragic - degenerative diseases. By age 30, about one third of the population will show osteoarthritic changes on spinal x-ray, and by 70 years of age degenerative joint disease is almost universal.

The prevalence of osteoarthritis has lead to two widespread misconceptions. Many people attribute back or neck pain to the presence of spinal degeneration. Similarly, many believe spinal degeneration is a normal and inevitable aging process. Both these traditional beliefs are now starting to be questioned as more, and better, research is expanding our knowledge of this condition.

Although recent medical research has identified a possible genetic component to certain forms of osteoarthritis in certain individuals, spinal degeneration is still considered largely a "wear and tear" condition. In the simplest terms, the spine is comprised of vertebra separated from one another by discs (analogous to cushions or sponges). As we age, these discs undergo subtle biochemical changes resulting in a loss of thickness and cushioning ability. Evidence now suggests these biochemical alterations in the disc may be a product of chronic undernourishment due to faulty spinal mechanics, rather than an inevitable part of the aging phenomenon. Faulty spinal mechanics is primarily the result of accidents, microtrauma and postural distortions. Trauma and abnormal posture produces malalignment of the spine, further contributing to spinal wear and tear.

The major significance of spinal osteoarthritis, however, lies in its effect on the nervous system. Studies show even minor changes in spinal configuration - the beginning stages of the degeneration process - result in compromise of the spinal cord and associated nerve function. As the arthritic changes progress in severity so does nervous system compromise. The potential implications of this are enormous, as science confirms the nervous system controls every tissue, organ and system in the body. For example, evidence shows there is a direct connection between the nervous and immune systems.

The process of spinal degeneration may not be an inevitable part of aging. This is evident from the fact many older people have healthy, well-preserved discs and no sign of disc or joint degeneration. Yet severe degenerative change can be seen in young adults if there has been trauma or prolonged, abnormal spinal stress, such as the result of postural distortion and malalignment.

Chiropractic care can significantly benefit osteoarthritis sufferers by gradually improving movement in dysfunctional joints and through restoring normal spinal curves and alignment. In addition to relieving pain, chiropractic may also assist in preventing further degeneration from occurring. The most important contribution chiropractic care can have to spinal health, however, may lie in prevention. Through maintaining optimum joint movement and spinal alignment, regular chiropractic care can help prevent spinal degeneration from starting in the first place.

An ounce of prevention...

For a consultation or more information you can reach Dr. Browner & Dr. Behar at Windmill Health Center, Weston 954-217-4881. We also have two additional locations to serve you in Pembroke Pines and Plantation, contact our Weston location for more information.