Neuropathic pain can be defined as a nerve pain or disorder. There are complex nerve disorders such as Multiple Sclerosis and general nerve pain disorders such as what is commonly referred to as a "pinched nerve." This article focuses on treatments for nerve pain in the back. Injuries to the spine can cause a nerve to swell or compress by either a disc within the spine, or bony changes in the spine pressing on it.
The Lumbar Vertebra in the Spine
There are five bones in the low back with each one called a vertebra. Between two vertebra is a disc. The disc helps to cushion the spine and define space for nerves of the spine to exit from the spinal cord out to parts of the body. Heavy lifting, falling or motor vehicle accidents can cause damage to the disc, pushing it out into a bony canal of the vertebra. Nerve damage can result.
Conservative Treatment for Neuropathic Pain
Each nerve has a tremendous and complex blood supply to nourish it. If it is compressed or pinched pain happens immediately. Left compressed it begins to deteriorate and can lead to permanent muscle damage, chronic pain and loss of sensation. Rest, pain medication, physical therapy, chiropractic care and back braces are used often as treatment to relieve nerve pain. The use of oral steroids is often prescribed to reduce disc and nerve inflammation and pain.
Lumbar Spine Traction
Medical traction devices can reduce pressure on the disc pressing on the nerve. This allows the nerve to regain circulation, reduce inflammation and provides pain relief. A harness is used to hold the hips and pelvis region; which is like buckling a large secure seat belt. Another harness supports the upper chest region. The patient lies down as a specialized machine pulls on the hips to reduce pressure on the disc and nerve.
Steroid Injection
Long lasting intense pain often leads to nerve damage. To reduce nerve pain or inflammation at the site of injury a type of injection can be performed. This injection formally called an epidural injection involves the use of steroids injected directly to the site of the swollen disc or compressed nerve. The symptom relief may be short term or long lasting. After the injection the patient typically continues with other types of therapy.
Arthroscopic Surgery
When conservative treatment is not effective in reducing nerve pain or improving muscle strength, the patient may elect to have surgery. One type of surgery formally called arthroscopic surgery involves a tiny camera and cutting tool inserted into the area of the low-back muscle region to access the spine. The tool can cut bone or parts of the disc away from the nerve to relieve pressure and promote nerve healing.
Expert Insight
There are other treatment approaches to reduce neuropathic back pain. It is important to seek medical advice if you experience ongoing nerve pain that is not relieved with rest, or occurs often. Repetitive motions or heavy lifting can cause damage to the spine. Over time these activities can cause the vertebra to develop what is formally called a bone spur. Bone spurs are like sharp spikes that irritate the nerve. Left untreated neuropathic pain can be permanent.
References
- "Foundations of Clinical Orthopaedics;" Stanley Paris, PT; 1990
- "Guide To Physical Therapy Practice;" American Physical Therapy Association; 2003
