Back Pain In Cincinnati

On an annual basis back pain is the number one cause of missed work and workman's compensation claims in the U.S.  It can cost workers and employers over $50 billion dollars a year between diagnosis and treatment for the different causes of damage to the spine.

Different working environments have different dangers that can cause back injuries and pain. Manual labor such as working in construction or factory environment can be a physically demanding occupation, and along with those physical demands come the potential for injury to the neck and back. Rpetitive movements or lifting can strain or pull muscles and tendons, herniate discs in the back, or lead to compression fractures and broken vertebrae all of which cause back pain. It is very important to follow all the safety & lifting guidelines provided by your empoloyer to aid in preventing injuries of the back and spine from occuring.  A physician should be consulted at the first sign of back pain. Working with an injury to your back will worsen the issue and make diagnosis, treatment and healing more difficult, timely, and possibly more painful.

Office Workers have some potential for back injury as well. Hours spent in front of a desk, hunched over a keyboard, has the potential to lead to several back and neck problems.  Leaning over the keyboard for hours at a time for consecutive days, weeks, months or years can lead to strained tendons and muscles of the spinal column, which can cause moderate to severe chronic back pain.  Good posture, not leaning while working at your desk and using good office and computer ergonomics, the design of making the workplace fitting the worker, can prevent these injuries.  When lifting of computer parts, monitors, reams of paper, other supplies, boxes or moving office equimpent in the office, it is important to use proper lifting techniques. Improper lifting can pull, streat or tear tendons & muscles. 

The older worker, or senior can have additonal hazzards due to their age. Over time the body breaks down and is more suseptible to injury.  As we age it is impotant to remain cognizant about back pain and potential issues that  as a younger person we would normally overcome. These injuries become more difficult to treat the older we get, and the more likely we are to develop vertebral fractures or conditions that cause severe back pain and require surgical intervention.  As we age, being mindful of the added risk and carfeully doing everyday activities can prevent spinal injury and pain.  A physicians should be consulted at the onset of chronic back pain. 

Diagnosing Back pain

There are many conditions that can cause common back pain and testing is needed to determine both the nature of the injury as well as the location of the injury.  There are many differentypes of imaging or diagnostic tests that can be used to determine the location and extent of spinal injury or damage. Magnetic resonance imaging (MRI) is the most common diagnostic test used to determine not only the location & extent of damage but to assess what treatment is the best for your type of injury. MRI uses radio waves & magnetic fields to create detailed images of internal structures of the body.  Imaging capabilities include: the bones, muscles, tendons, and various soft tissues in detailed images.  With MRI physicians are able to detect issues in the soft tissue as well as a vertebral spinal fracture, a nerniated disc or other abnormality causing back pain.

A CT or CAT scan is another imaging diagnostic used to identify the cause of back pain.  Computed Tomography commonly known as CT or CAT scan, utilizes specialized x-ray equipment to take multiple images of the spinal column called slices. These slices are then transformed into cross sectional images that show the exact area of damage or irritation.  The CAT scan is useful for detecting many causes of back conditions or injury that cause pain including arthritis, fractures, tumors, infection, etc.

Treating Back Pain

Once the cause of injury or pain has been determined, there are many varied non-invasive medical treatments available to deal with pain.  An interventional radiologist performs non-invasive procedures using imaging guidance that eliminate the need for lengthy or painful surgeries.

• Epidural Steroid Injection (ESI) - a combination or steroidal medication and lidocaine are injected into the epidural space of the spinal column using image guidance to ensure that the medicaion is delivered to the specific injury site can reduce irritation of the soft tissue and nerves of the spine.  The external injection site is numbed with a local anesthetic. The needle is then advanced into the epidural space, or the area between the dura or thecal sac which holds ispinal fluid, and the surrounding bone of the spinal column, under fluoroscopic or x-ray guidance. The steroid medication reduces the inflammation and the patient will begin to experience relief of their back pain.  Some patients require a second or third injection, normally two weeks apart.
• Vertebroplasty and Kyphoplasty are minimally invasive procedures used to treat Vertebral compression fractures or fractures of the spine. VCFs can becaused from some type of trauma like a fall or accident or from osteoporosis or weakened bone due to medical issues or treatments such as chemotherapy. VCFs can cause severe back pain.  These procedures have been developed over many years in order to avoid open surgery on the spinal column with the same desired treatmetn result.  These treatmetns can be as effective and sometimes more effective than surgery. Both procedures begin with a local anesthetic to numb the injection site. A needle is inserted through the skin into the fractured bone using fluoroscopic guidance or or real time x-ray.  With Vertebroplasty, bone cement is injected through the needle into the damaged area of the vertebra, stabilizing the fracture, and usually eliminating the pain it caused by the fracture within just a few days. Kyphoplasty is a similar to vertebroplasty, but also involves creating a space in the vertebra either by guiding a small introducer instrument into the collapsed vertebra to create a cavity for the bone cement or with the insertion of an inflatable balloon catheter device into the vertebral compression fracture to possibly restore the vertebra to a more normal shape and also create a void for the cement to collect, which helps stabilize the bone and reduce pain caused by the fracture. Once the cavity is created a high density bone cemetn is injected to stablize the fracture. Most patients tend to experience a reduction or elimination of pain within 2-3 days of the treatment.

PRI: Seeking Treatment

Professional Radiology, practices in Cincinnati OH. Diagnostic and treatment services are available at The Christ Hospital, The Jewish Hospital, Fort Hamilton Hospital, and West Chester Medical Center.

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