State of pain

typy-bolesti

Cervical spine

Pain coming from facet joints
Facet joints are small joints connecting vertebrae. They allow our spine to tilt and bend. The symptoms coming from facet joints in the cervical area include pain in the neck area, headache, pain in the shoulders, the area above and in the shoulder-blade and also pain in the upper limbs. The movement of the neck is constricted, the pain worsens in a backward bend and improves slightly in a forward bend.

To confirm that the facet joints are the real source of pain, it is necessary to perform the so-called diagnostic medial branch block, which innervates the facet joints. During this procedure, an anesthetic is administered to the proximity of these nerves. In case of significant alleviation of pain following this procedure, we can proceed with a treatment with a more long-term effect – the radio-frequency ablation of these nerves. This procedure applies heat to the respective nerves, thus interrupting their ability to carry pain signals to the brain.

Diagnostic procedures:

Medial branch blocks

Therapeutic procedures:

Thermal radio-frequency ablation

 

Pain coming from the disc
The intervertebral fibrocartilages or discs are flexible pads, which are located between individual vertebrae. They allow the spine to bend and rotate. If the disc is damaged, its inner part presses outward and may irritate spinal nerves. Pain coming from the discs is typically linked to activities that increase the pressure on its interior, like prolonged seated posture, especially in a prolonged forward bend. Frequent changes in posture may result in partial relief.

To confirm the diagnosis, a test called provocation discography is used. During this procedure, a contrast dye is administered to the affected disc, which shows the structure of the disc and also allows us to provoke pain in the patient’s body. It may be followed by intradiscal electrothermal therapy, i. e. application of heat to the tissue of the damaged disc using a special needle.

Diagnostic procedures:

Provocation discography

Therapeutic procedures:

Thermal radio-frequency ablation

 

Pain caused by nerve-root irritation
Pain that manifests itself in the arm area comes from cervical nerves. The pain sensation may radiate over the shoulders towards the fingers. Even combinations of pain in the neck and arms are not unusual. The treatment options include an injection into the epidural range in the area of the damaged nerves or a targeted injection into canal to the actual damaged nerve. Another treatment option is the pulsed radio-frequency therapy – application of moderate heat and intermittent electric current.

Diagnostic procedures:

Nerve-root block

Therapeutic procedures:

Pulsed radio-frequency

Thoracic spine

Pain coming from facet joints
The pain is localized in the upper and central part of the back with possible radiation towards the chest or ribs. It is blunt, deep, hard to describe. A forward bend, like when tying your shoelaces, worsens it. Morning stiffness is quite common and so is pain along the sides of the back, which may be accompanied by muscle spasms.

To confirm that the facet joints are the real source of pain, it is necessary to perform the so-called diagnostic medial branch block. During this procedure, an anesthetic is administered to the proximity of these nerves. In case of significant alleviation of pain following this procedure, we can proceed with a treatment with a more long-term effect – the radio-frequency ablation of these nerves. This procedure applies heat to respective nerves, thus interrupting their ability to carry pain signals to the brain.

Diagnostic procedures:

Medial branch blocks

Therapeutic procedures:

Thermal radio-frequency ablation

 

Pain coming from the disc
The intervertebral fibrocartilage or discs are flexible pads, which are located between individual vertebrae. They allow the spine to bend and rotate. If the disc is damaged, its inner part presses outward and may irritate spinal nerves. The pain coming from the disc is usually linked to activities which increase the pressure on its interior, like sitting, bending forward, coughing or sneezing. Discogenic pain may be accompanied by leg pain, caused by the irritation of surrounding nerves, especially when sitting, getting up or walking. Back pain is generally permanent, day-to-day, as opposed to root pain, which changes its character.

To confirm the diagnosis, a test called provocation discography is used. During this procedure, a contrast dye is administered to the affected disc, which shows the structure of the disc and also allows us to provoke pain in the patient’s body. It may be followed by intradiscal electrothermal therapy, i. e. application of heat to the tissue of the damaged disc using a special needle.

Diagnostic procedures:

Provocation discography

Therapeutic procedures:

Thermal radio-frequency ablation

 

Pain caused by nerve-root irritation
Pain coming from the nerves in the lumbar area generally radiates as far as below the knee. Back pain may be localized between the last ribs and above the sciatic muscle. Even back and leg pain is common, in case of the folk term “ischias”, the leg pain is greater than the back pain. The treatment options include an injection into the epidural range in the area of the damaged nerves or a targeted injection into canal to the actual damaged nerve. Another treatment option is the pulsed radio-frequency therapy – application of moderate heat and intermittent electric current.

Diagnostic procedures:

Nerve-root block

Therapeutic procedures:

Pulsed radio-frequency

Lumbar spine

Pain coming from facet joints
The pain comes from the lower-back area and may radiate towards buttocks, groin and legs, usually no further than the knee. The pain is blunt, deep and hard to describe. The backward bend and side bend worsen it, usually bending forward does not pose a problem. The symptoms worsen with prolonged sitting or standing, moderate exercise may alleviate the pain. Morning stiffness is quite common and so is pain along the sides of the back, which may be accompanied by muscle spasms.

To confirm that the facet joints are the real source of pain, it is necessary to perform the so-called diagnostic medial branch block. During this procedure, an anesthetic is administered to the proximity of these nerves. In case of significant alleviation of pain following this procedure, we can proceed with a treatment with a more long-term effect – the radio-frequency ablation of these nerves. This procedure applies heat to the respective nerves, thus interrupting their ability to carry pain signals to the brain.

Diagnostic procedures:

Medial branch blocks

Therapeutic procedures:

Thermal radio-frequency ablation

 

Pain coming from the disc
The intervertebral fibrocartilages or discs are flexible pads, which are located between individual vertebrae. They allow the spine to bend and rotate. If the disc is damaged, its inner part presses outward and may irritate spinal nerves. The pain coming from the disc is usually linked to activities which increase the pressure on its interior, like sitting, bending forward, coughing or sneezing. Discogenic pain may be accompanied by leg pain, caused by the irritation of surrounding nerves, especially when sitting, getting up or walking. Back pain is generally permanent, day-to-day, as opposed to root pain, which changes its character.

To confirm the diagnosis, a test called provocation discography is used. During this procedure, a contrast dye is administered to the affected disc, which shows the structure of the disc and also allows us to provoke pain in the patient’s body. It may be followed by intradiscal electrothermal therapy, i. e. application of heat to the tissue of the damaged disc using a special needle.

Diagnostic procedures:

Provocation discography

Therapeutic procedures:

Disc FX

Thermal radio-frequency ablation

Epiduroscopy

 

Pain caused by nerve-root irritation
Pain coming from the nerves in the lumbar area generally radiates as far as below the knee. Back pain may be localized between the last ribs and above the sciatic muscle. Even back and leg pain is common, in case of the folk term “ischias”, the leg pain is greater than the back pain. The treatment options include an injection into the epidural range in the area of the damaged nerves or a targeted injection into canal to the actual damaged nerve. Another treatment option is the pulsed radio-frequency therapy – application of moderate heat and intermittent electric current.

Diagnostic procedures:

Nerve-root block

Therapeutic procedures:

Pulsed radio-frequency

Epiduroscopy

 

Pain coming from the sacroiliac joint
The sacroiliac joint (or the SI joint) is an issue by itself in the lower-back area pain. This joint connects the sacral and pelvic bones. The pain worsens when sitting, bending forward, or prolonged sitting as a guest passenger in the car. Standing or walking may result in pain-alleviation. The pain is most commonly localized in the back part of the joint and in the central area of buttocks and it may radiate towards the groin, back part of the thigh and sometimes even as far as below the knee. It is often caused by lifting a heavy object while rotated or when misstepping on a curb.

To confirm this type of pain, an anesthetic and anti-inflammatory drug is injected in the joint. The recommended therapeutic procedure is the radio-frequency ablation of the nerve supplying the joint.

Diagnostic procedures:

SI-joint block

This block is performed by administering a local anesthetic to confirm or disconfirm the possibility that the sacroiliac joint is the source of the pain condition. Above all, it is a diagnostic test, where the pain alleviation depends on the duration of the effect of the anesthetic.

Therapeutic procedures:

Thermal radio-frequency ablation