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4 Reasons Spinal Arthritis is Harder to Treat Than Hip or Knee

July 10, 2012 , , , , , , , ,
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When dealing with spinal arthritis, it is more complicated than extremities such as the hip, the knee or the ankle. It might not be intuitive to think about arthritis in one joint being more difficult to treat than another since they both result from the loss of cartilage ending up in a painful situation.

There are four reasons why spinal arthritis is simply more complicated and difficult to treat than that of the extremities.

1. There are many more spinal joints. At every level of the spinal column from the skull all the way down to the sacrum, there are spinal joints on eachflorida pain clinic side and then at every level of the spinal column. These joints are called facet joints, and contain cartilage just like any other joint in the body including the knee or the hip.

They are prone to arthritis as they are weight-bearing joints, and they end up causing significant pain in any one of the facet joints. The pain emanating from one of these tiny joints may be just as severe as that coming from the much larger knee or hip joint in the case of severe arthritis. So the concise answer is there are many more facet joints than extremity joints and lots more chances for pain from spinal arthritis.

2. Surgery for spinal arthritis is not as successful as extremity surgery. According to surveys done around the world on the most successful operations performed for quality of life, both hip replacement and knee  replacement rank in the top five. The same simply cannot be said for spinal arthritis surgery.

A spinal fusion procedure has a success rate anywhere from 50% upwards to 80%. Hip and knee replacement surgeries are much more successful and on average get rid of much more of a person’s pain with a joint replacement. No joint replacement procedure exists for facet joints, so the current gold standard is a fusion procedure. Due to the fact that if a person has arthritis in one facet joint they often have it in quite a few, is unreasonable the fuse multiple levels of the spine for good old wear and tear spinal arthritis.

radiofrequency ablation

Radiofrequency Ablation Procedure

Spinal arthritis procedures are often performed for scoliosis that results from arthritic degeneration, or instability that may end up with a condition called degenerative spondylolisthesis. But by and large, spinal arthritis surgeries are not as successful as your typical joint replacement procedures done for extremity arthritis.

3. The joints are much smaller than the hip or the knee. The reason this makes treatment difficult is that it is harder for a pain management doctor to get a needle into the joint for injection. When a spinal joint suffers from arthritis, bony overgrowth occurs and it can be very difficult to enter it with a steroid injection. Pain management doctors use fluoroscopy to do these injections and are typically successful, but not always.

Thankfully, there are multiple pain management procedures that can bring relief to spinal arthritic joints which do not involve a needle into the joint. The medial branch block involves an injection around the arthritic joints which can stop the transmission of pain from the surrounding nerve endings. A radiofrequency ablation procedure can also deaden the surrounding nerve endings and allow for pain relief in arthritic spinal joint. So it does make treatment slightly more difficult, but pain management doctors in Florida are often very successful in achieving the goal of pain relief without surgery.

4. It is often very difficult to delineate the exact source of a person’s pain in the spine. When you have just one knee joint that is arthritic, and a doctor does an injection that provides immediate pain relief, it makes it fairly straightforward. However, when the pain doctor has to inject multiple levels of the spine in order to figure out exactly which arthritic levels are causing the pain, the diagnosis is often much more difficult to specifically achieve. So spinal arthritis is more of a diagnostic quandary, and it takes considerable thought process and diligence for the pain management doctor to work through.

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Even a great looking spinal fusion may still see the patient experiencing significant post-operative pain.

Despite these four reasons for making spinal arthritis more difficult to diagnose and treat then your typical chili arthritis, pain management doctors are often very successful at achieving nonsurgical pain relief for their patients.

If you live in Florida and are having significant neckk, mid back or low back pain, let the Florida Pain Network help you. The network connects those in pain with pain relievers including pain clinics in Florida, chiropractors and physical therapy practices.

For instance, there are pain clinics in Orlando, pain management Fort Myers clinics, Tampa pain management clinics, Port St. Lucie pain management practices, pain management Ocala Fl clinics, and many more. Simply go to this page and the pain clinics closest to you will show up first, or you may call 877-877-8556 for assistance.


What Makes for a Successful Back Surgery Result?

July 9, 2012 , , , , , , , ,
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Over the last 10 years, there has been an increase of 15 times more back surgery procedures being performed. Hundreds of thousands of back surgery procedures are performed every year in United States, and the population of the country did not increase 15 fold over the last 10 years!

What exactly makes for a successful back surgery result and what should the expectations be for someone considering undergoing the knife? In order to answer this question, it is essential to understand the different reasons that a person undergoes back surgery. The best outcomes achieved with back surgery is when it is performed for a pinched nerve.

1. Pinched Nerve Surgery

Pinched nerves occur in the low back due to a lumbar disc herniation, or an arthritis situation that pinches one or multiple nerves. This problem is called spinal stenosis. When a low back surgery is performed to free up pinched nerves, a successful result can typically be expected over 80 to 90% of the time. Complications can occur and may consist of an infection, bleeding, anesthesia complication or nerve injury in unusual circumstances.

herniated disc

Surgery for a pinched nerve typically has excellent outcomes.

2. Spinal Fusion Surgery

The second type of back surgery procedure is a spinal fusion. This may be done for a degenerative disc disease or for a degenerative scoliosis condition. Another reason would be for a degenerative spondylolisthesis which comes from arthritis and is often associated with spinal stenosis. This article does not apply to when a spinal fusion is done for trauma with fractures.

The outcomes for the various types of final fusion procedures are all over the board. Usually fusions done for degenerative disc procedures produce results that are approximately 50 to 70% satisfactory. The satisfactory results obtained from a spinal fusion performed for a degenerative spondylolisthesis condition are better than that and are probably overall are around 80%. For a degenerative scoliosis the results are between 60 to 80% effective.

An effective result from a spinal fusion does not mean the patient ends up in a pain-free situation. Most of the time, even a technically successful spine surgery performed with a proper indication will not get rid of all of a persons back or leg pain. Usually it is successful at getting rid of 50 to 80% of the persons pain. What this means is that a person with a successful result may get rid of half of their pain and still end up needing narcotic medication a year or more after the surgery.

This is unfortunate and the best that modern medicine has to offer. Patients need to understand and have appropriate expectations for their back surgery being undertaken. The goal of a spinal fusion is to alleviate pain from the movement by welding together the bones of the spine and hoping that takes care of the associated pain so that the patient can increase his or her activity and not be so disabled every day.

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Even a great looking spinal fusion may still see the patient experiencing significant post-operative pain.

Unfortunately, modern spine surgery is simply not always able to provide those “home run” types of results. Hopefully in the future something better will come along for this, but even artificial disc replacement has not been shown to provide better surgical outcomes than a spinal fusion. For this reason it is best for those dealing with pain in Florida to exhaust conservative treatment options such as with pain management Tampa clinics, pain clinics in Orlando, Port St Lucie Pain Management clinics, or help wherever one lives.

If you have had a back surgery with residual pain in the right after the procedure or a few months to years afterwards, let the Florida Pain Network help you. The network connects those in pain with pain relievers including Florida Pain Clinics, Florida Chiropractors such as with a Fort Lauderdale chiropractor, and Florida Physical Therapy practices around the state. Simply go to THIS page and push whether you need a pain doctor, chiropractor or physical therapy provider and those closest to you will show up right away.

Or simply call 877-877-8556 for assistance.


Overview of Failed Back Surgery Syndrome from Florida Pain Network

June 25, 2012 , , , , , , , ,
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Hundreds of thousands of Americans undergo spine surgery each year at a rate that is 15 times higher than it was a decade ago. Exactly how successful are the spine surgeries being performed today and what is Failed Back Surgery Syndrome?

The reasons that back surgery are performed in United States vary widely. Maybe for a reason as simple as a lumbar herniated disc which is causing a pinched nerve situation. Or it may be an extensive spinal fusion

Artificial disc replacement

Artificial disc replacement

procedure at many levels for degenerative scoliosis. Overall, the simplest spine surgeries such as those done for a herniated disc or a simple laminectomy procedure for spinal stenosis work exceptionally well.

The results of simple decompression procedures where a nerve or a few nerves are being pinched are typically over 90% good to excellent. But what about for spinal fusion procedures? The definition of success for spinal fusion procedures does not mean 100% pain relief. What is typically considered success is if the surgery eliminates at least 50% of an individual’s back and leg pain.

When the FDA was evaluating whether or not to approve artificial disc replacement for the lumbar spine almost 10 years ago, they compared it to a one level spinal fusion procedure for degenerative disc disease. Numerous centers around the country participated in the study and looked at just how much pain relief was achieved between these two procedures. A one level spinal fusion for degenerative disk disease has been considered the gold standard for success with getting rid of back pain.

The results may very well surprise you. Over half of the individuals in both categories, either those that obtained an artificial disc replacement versus a spinal fusion, were still taking narcotic medications one year after their respective procedures and needed pain management at Florida pain clinics or elsewhere. The surgeries were both effective at relieving typically half of a person’s back pain, but with the residual amount it was severe enough to necessitate continuing to take narcotic pain medications. A person may need to be seen at a pain management Orlando clinic or a pain management Miami clinic or somewhere in the state of Florida.

So effectively it is possible to have a “successful” low back pain surgery and still necessitate Florida pain management. It all comes down to modern medicine’s inability to treat back pain to the extent that we want.

When you talk about Failed Back Surgery Syndrome, it is a bit of a waste basket term. This means that for any number of reasons, the person had back surgery that did not work at all, or worked somewhat and the person still ends up with significant back pain and leg pain afterwards.

There are some effective treatments for failed back surgery syndrome that did not involve further surgery. First of all, doing a repeat surgery with a failed back surgery syndrome needs to be decided upon very

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A lot of spinal fusion patients still need pain medication long after the surgery.

carefully between the surgeon and the patient. What could easily happen is you take a sub optimal spine surgery result and make it worse. However, if there are clear indications for the need for the operation, then it should be undertaken to try and relieve the individuals severe pain.

Essentially what needs to be understood is that by and large, most spine surgery procedures are not going to be 100% effective. This comes down to patient expectations. If he or she understands what the goal is, which is usually a realistic 50 to 70% pain reduction, then the outcomes can be better managed if in fact the individual is still requiring pain medication 6 to 12 months afterwards. This may be at a south Florida pain clinic.

The other essential thing to understand is that another surgery is not always indicated if there is residual pain. Only if there are clear indications as to whether there is potentially another adjacent level causing the pain, or a disc herniation above or below or something of that sort that has a clear-cut reason for the next procedure.

If you live in the state of Florida and have had back or neck surgery with a sub optimal result, let the Florida Pain Network help you. The network connects those in pain with pain relievers throughout the state including pain clinics in Florida, chiropractors, and physical therapy practices. Simply go to the website and click on whether you need a pain doctor, Chiropractor, or physical therapy provider and those closest to you will pop up right away.

Or simply call toll-free 877-877-8556 today.


When Should a Spinal Fusion be Added to a Lumbar Discectomy?

February 11, 2012 , , , , , , , ,
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The most common spine surgery in the US is a lumbar discectomy procedure. It is a surgery that is done hundreds of time a day in America, and the risks are fairly low compared with major spine surgeries.

The surgery itself takes about an hour and patients either go home the same day or often times the next day. At what point would a surgeon consider adding a spinal fusion to that level as opposed to just doing a discectomy? This addition to the surgery adds risk to the procedure along with increased blood loss and potential for further surgery in the future. But there are indications for adding it to the procedure.Pain Management Boca Raton

The 1st reason for adding the procedure is if there have been multiple discectomies  done at that level. Every time a lumbar discectomy is performed the surgeon takes out a piece of the disk at that level. The disc does not then go and regenerate the removed tissue. It undergoes a degenerative process which can cause severe back pain in those patients. Each subsequent time a surgeon does a discectomy procedure, more disk is removed and the chances for degenerative disc disease with severe pain go up considerably.

The chances of a recurrent disc herniation at the same level are about 10%. So it does happen a significant part of the time, and if it does the patient needs to be asked how much back pain are they having? The reason is that if the disk pinches a nerve it may cause significant sciatica and leg pain. But often times patients do not have any back pain.

So if there is a considerable amount of back pain present and this is not the first disc herniation at that particular level, then it may be that the patient has significant degenerative this disease and while removing the piece of disk pinching a nerve, consideration should be given to fusing that level. That can address the leg pain with the discectomy and then the back pain by fusing that Boca Raton Pain Cliniclevel.

Any time a patient has a recurrent disc herniation, nonoperative treatment should be attempted in a similar fashion to how it was done the 1st time. This may include treatment with a pain management Boca Raton doctor including epidural injections, physical therapy Boca Raton, and potentially chiropractor Boca Raton treatment. A person may need medications from a pain management physician and if nonoperative treatment over a period of 6 to 8 weeks does not work effectively, surgery should then be considered.

So that is a significant question to ask and consider is how much back pain the patient is having at that level. Even if it is a first-time disc herniation and the patient has just as much back pain as they do leg pain, an MRI can show how much degenerative disc disease a patient has and maybe a discogram should be performed to see how much pain is reproduced from the disk. That may help guide the surgeon and help tell what kind of surgery should be done, simply a discectomy or maybe addition of a spinal fusion at that level.

Spinal fusion, as mentioned, increases the risk of blood loss, infection, and need for further surgery in the future. So it is not a decision to be taken lightly. However, it should be considered in a patient who has a lot of back pain because a simple lumbar discectomy is not a back pain operation.

The Florida Pain Network connects patients in pain with the best pain relievers around the state of Florida. Pain Management doctors, chiropractors, and physical therapy clinics in all major cities. Help is just one click away!