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Is failed back surgery a syndrome?

Failed back surgery syndrome often called FBSS is an inaccurate name used, basically it is not a syndrome, a very broad statement that is frequently used to explain the conditions of patients who had not reaped successful results with back surgery or spine surgery and feel continued pain after the surgery. There may be several reasons that may contribute to back surgery,  even if performed by the best surgeon with the best indication, spine surgery is not more than 95% anticipated of successful results

The spinal surgery basically addresses only two ailments;

  1. Decompress a nerve root that is pinched, or
  2. Stabilize a painful joint.

Usually a back surgery or spine surgery cannot completely eliminate the patients’ pain, however the surgery can only alter the physical structure and any damage caused to the anatomy of the spine. The most probable cause of back pain can be recognized prior to the surgery rather than following the failed back surgery

Expected Pain after failed back Surgery

Several types of failed back surgery are more expected regarding the patient’s pain symptoms than others. For instance

Discectomy for a lower disc herniation causing leg pain is expected to be successful, however, a discectomy for a lower disc herniation causing lower back pain is far less successful

A spine fusion for spinal impermanence is relatively less riskier operation, but a fusion surgery for multiple lower degenerative disc disease are riskier and less successful in reducing patient’s pain after failed back surgery

Hence the best way to avoid spinal surgery that may bring undesired consequences is to opt the surgeries that have a higher degree of success and make sure that any physical injury that can be treated must be identified prior to operation

Causes of failed back surgery and pain afterwards

Additional to the discussed above causes of the failed back surgery, there are many other potential causes of failed back surgery or persistent pain after surgery

  • Fusion surgery considerations
  • Lumbar decompression back surgery considerations
  • Scar tissue considerations
  • Postoperative

The failed back surgery syndrome is basically not a syndrome and there are no distinctive cases. Every patient is different, and a patient’s continued treatment and work up need to be individualized to his or her particular problem and situation.

In case you or any of your loved one is suffering from failed back surgery and looking for a safe and cost-effective treatment, get a professional advice from Dr. Zaki Anwar by placing an appointment at 815-464-7212. He is a world renowned Pain Medicine Physician who has been practicing regenerative injection therapies for the past several years with remarkable results.

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Know the symptoms of your Complex regional pain syndrome

The complex regional pain syndrome is a rare form of chronic pain that commonly affects the arm or the leg. The complex regional pain syndrome particularly develops after an injury, surgery, stroke or heart attack. The real cause complex regional pain syndrome is still not yet clear. The treatment is highly beneficial for complex regional pain syndrome if started as early as possible. Once the treatment is started earlier recovery even elimination is probable

Symptoms

Some common signs and symptoms of complex regional pain syndrome include:

  • Persistent burning or pulsating pain, usually in your arm, leg, hand or foot
  • Reactivity to touch or cold
  • Inflammation and bump of the painful area
  • Changes in skin temperature
  • Changes in skin color, ranging from white to red or blue
  • Changes in skin texture,
  • Changes in hair and nail growth
  • Joint stiffness, swelling and damage
  • Muscle spasms and weakness
  • Decreased ability to move the affected body part

The complex regional pain syndrome may spread from its source to other parts of the body such as opposite leg. Also the pain is aggravated by emotional pressure

In some cases the symptoms of complex regional pain disappear without any treatment. In others the signs and symptoms continue from months to years

When to consult a physician

If you feel severe and continuous pain that have an effect on the limb and mobilizing or touching the limb becomes extremely painful, immediately consult your doctor to diagnose the underlying cause

Complex regional pain syndrome occurs in two types, with similar signs and symptoms, but different causes.

Types of complex regional pain syndrome

Type 1

The certain type of the complex regional pain syndrome, this type is observed after an illness or injury that does not damage the nerves directly in the affected limb. Most of the people experience the type 1 syndrome

Type 2

The certain type of complex regional pain syndrome can also be referred to as Causalgia, this type occur after a certain nerve injury. The symptoms occur after certain trauma or crash injury to the arm or the leg. Other minor traumas such as surgery, heart attack, infections and even sprained ankles

What might be the complications?

If the complex regional pain syndrome is not diagnosed and treated earlier the disease may aggravate to enfeebling signs and symptoms; that may include;

Tissue wasting;

If due to severe pain you have difficulty in moving your leg due to stiffness, your skin bones and muscles may get worse and weaken

Muscle contraction

Also muscle contraction may occur. The hands fingers of your hands and foot may fix to a fixed place

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Know the cause of your hand pain

Hand pain can be caused by several reasons, one can be a carpal tunnel syndrome is the numbness, itchiness, weakness and other ailments in your hand as a result of pressure on the median nerve in your wrist

The median nerve and many other tendons spread from your forearm to your hand covering a small space in your wrist called the carpal tunnel. The median nerve is responsible in controlling the movement and sensation in your thumb and the first three fingers except the little pinky

What causes carpal tunnel syndrome?

Strain on the median nerve causes carpal tunnel syndrome. The strain can arise from swelling or any such ailment that makes the carpal tunnel narrower. Several problems can cause the swelling around the carpal tunnel including;

  • Ailments such as hypothyroidism, rheumatoid arthritis and diabetes
  • Repetitive movements of the hand specifically the wrist is bent, or repetitive movements of the wrists
  • Pregnancy

The symptoms of carpal tunnel syndrome?

The carpal tunnel syndrome can cause severe itchiness, numbness, instability and pain in the fingers or hand.  Most of the people experience pain in the area between their hand and their elbow. The symptoms are mostly observed in the thumb, index finger, middle finger and half way of the ring finger. If  you feel pain and other problems in your fingers except the little pinky, this may be an indication that you have a carpal tunnel syndrome as the little finger is provided by different nerves. Initially the symptoms are noticed at night and are relieved by shaking the hand

Diagnosis of the carpal tunnel syndrome

The doctor will inquire if you have any medical history, such as arthritis, hypothyroidism and diabetes or if you are pregnant. The physician might ask if you have undergone any recent injury in your wrist, arm or neck. During the physical examination, the physician will monitor the strength, appearance of your neck, shoulders, arms, wrists and hands. Several tests such as blood tests or nerve tests are also conducted

Home care 

Minor symptoms of the carpal tunnel syndrome can be easily treated with home care treatments;

Avoid activities that cause strain on the wrists, causing numbness and pain

Treat with ice for 10 to 15 minuted

Wearing a wrist splint specifically at night, that takes pressure off your  nerve.

The earlier you start the treatment the more chances of governing the symptoms and preventing the long term damage to the nerve. The carpal tunnel syndrome also needs medications or any other health condition arising from carpal tunnel syndrome

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Get rid of post operative back pain with Epidural Lysis procedure

When you experience a back injury that affects the spine, a band of dense scar tissues is formed naturally in the epidural cavity as a factor in the natural healing process. The epidural space is the region between the spinal cord and the vertebral bones that encircle it. The band of scar tissues applies pressure on the nerves in their excess and restrain their movement causing severe pain and inflammation

The epidural Lysis procedure is an  outpatient approach carried out to reduce the amount of scar tissues or sometime remove it permanently, thus releasing pinched nerves and relieving pain. The procedure includes the use of a small plastic tube called a catheter to help delivering various medications into the epidural space that dissolves the scar tissue formation. The combination of the drugs may vary in some treatment, however, mostly steroids are used to relieve inflammation encircling the pinched nerves along with the local anesthetic. The epidural Lysis procedure is medically safe and effective method to reduce pain and inflammation

Who are the candidates?

The Epidural Lysis procedure is mostly recommended for the patients who experience chronic back pain and leg pain due to the formation of epidural adhesion, after a lower spine surgery or a sudden injury or fall. The symptoms might include severe pain in the lower back along with a burning sensation, sciatica pain that sparks from the spine and spreads into the thighs, calves and feet, muscle spasms, reflex change and lower range of motion in the legs

Along with treating excessive scarring the epidural Lysis procedure also treats a variety of spinal problems including;

  • Herniated disc
  • Compression fractures
  • Degenerative spine
  • Spinal Stenosis
  • Cervical Stenosis
  • Failed back surgery syndrome
  • Arthritis of the spine

The Epidural Lysis procedure may not be the first option, the patients who opt this therapy have usually tried several other traditional treatments including medications and epidural steroid injections and failed to reduce pain

 Procedure

The Epidural Lysis procedure is an outpatient approach and can be performed in a surgery center, the patient is usually given local anesthesia. The procedure takes 30 to 60 minutes. The epidural Lysis procedure is initiated by  cleaning the patients lower back with an antiseptic solution before exposing it to the numbing medications. Soon after the numbing a small cut is made and with the help of an X-ray guidance a catheter is inserted and guided into the Epidural space. The catheter may release a contrasting pigmentation to confirm the exact location of pain

Once the confirmation of the affected area is made the catheter is used to deliver the blend of medications into the targeted area that will aid in dissolving the formation of scar tissues reducing swelling and pain. During the whole procedure the catheter is being monitored with the X-Ray guidance to ensure safe and effective positioning of the catheter. As all the medications have been delivered, the catheter is removed and the cut is cleaned and covered with a bandage

In case you or any of your loved one is suffering from any severe back pain and looking for a safe and cost-effective Epidural Lysis treatment, get a professional advice from Dr. Zaki Anwar by placing an appointment at 815-464-7212. He is a world renowned Pain Medicine Physician who has been practicing regenerative injection therapies for the past several years with remarkable results

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Epidural steroid injection and your back pain

Epidural steroid injections are the most accepted therapeutic alternate for several kinds of back pain and leg pains. The epidural steroid injection has been used for decades as a remedy for back pain and has become a significant non invasive treatment for sciatica and lower back pain.

The basic purpose of epidural steroid injections is to provide temporary relief of lower back pain. In addition to relieving back pain the epidural steroid injections have worked wonders in treating cervical pain and pain in the mid of the spine

Conditions in which epidural steroid injections are helpful

Epidural steroid injections have proved to be helpful in several conditions that cause back pain either  it is chronic or acute back pain. Or pain arising from pinched nerves. The specific conditions may include;

  • Lumbar disc herniation; the nucleus of the disc leaks out from the outer hard surface and spreads into the spinal canal pinching the nerves
  • Degenerative disc disease; where the disc space is crumpled between the two discs causing severe pain  and inflammation by the pinched nerves
  • Lumbar spinal stenosis; where the spinal canal has been shrunk pinching the spinal nerves
  • Compression fracture; fracture caused due to severe injuries and lifting heavy weight
  • Cyst; tumors in the spine deforming the whole spinal structure
  • Annular tear; a painful, tear presented in the outer layer of the spinal disc

Epidural steroid injection procedure

The epidural steroid injection procedure is initiated by cleaning the targeted area, the injections may take 15 to 30 minutes and is followed by standard steps;

The patient is allowed to lay on the  examination table laying face down with a pillow beneath the belly to give it a slightly curved shape. If the said position causes pain, then the patient might sit or lie on a side in a little curled position The skin is cleaned and the patient is given with local anesthetic

The patient lies flat on an X-ray table or with a small pillow under their stomach to slightly curve the back. If this position causes pain, the patient can be allowed to sit up or lie on their side in a slightly curled position. The skin is cleaned and the patient is given with local anesthesia. The needle is injected using the X-ray guidance  directly into the epidural space. Once the needle reaches the correct position  a contrasting dye is  injected to make sure the needle has reached the correct position. The steroid solution is slowly injected which may be experienced by some patients as putting pressure on the spinal cord, however, the pressure felt by the patients are not usually painful. The patient is observed for 15 to 20 minutes after the procedure and is allowed to go home soon

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Facet block injections and your pain symptoms

A facet block injections are comparatively simple and direct procedure, can be easily performed in a pain management clinic. As with other spinal injections the, facet block injections are the most recommended they works well with the guidance of X-ray to help the needle reach the targeted nerve  and avoid maximum damage to other nerves

The procedure of facet joint injections 

The facet block injections can be carried out by the following steps:

Traditionally, the process is carried out without any numbness or local anesthesia, only an IV injection is given if needed. The procedure is initiated by the patient lying on the examination table. The skin of the area to be treated is cleaned with an antiseptic. A numbing medication is given in a selected area of the skin, which may create a stinging  effect for a few seconds. The practitioner takes help from the X-Ray to place the needle in the correct position. A small amount of pigmentation is given through the thin needle in the facet joint to confirm the nerve that is pinched. Along with the pigmentation a small amount of  anesthesia and steroid is given into the facet joint. The facet joint injection only takes a few minutes, however, the whole procedure takes fifteen to thirty minutes

What to expect immediately after the  facet block injections

Soon after the facet block injections the candidate is allowed to rest in the recovery area for about twenty to thirty minutes and is observed upon certain movements or actions that might have a chance of stimulating pain. In some cases, patients may not be given pain relievers, however, this depends upon the joints that are aimed. If the certain facet that undergo facet block injection joints are not the source of pain, the pain relievers are not given. In some cases, patients might feel numbing effect or might feel weakness in the neck or back for a couple of hours after facet block injections. Patients are advised to avoid any intense activities, pain killer drugs must be reduced from the initial four to six weeks after the facet block injections so that the information obtained for diagnostic purpose is accurate. The patient might avoid driving unless it is  approved by the physician, if any seductive medication is used, then it is highly prescribed to avoid driving for 24 hours of the facet block injections

In case you or any of your loved one is suffering from a severe back pain  and looking for a safe and cost-effective treatment, get a professional advice from Dr. Zaki Anwar by placing an appointment at 815-464-7212. He is a world renowned Pain Medicine Physician who has been practicing regenerative injection therapies for the past several years with remarkable results.

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Get rid of your chronic back pain by Intradiscal electrothermal therapy

Intradiscal electrothermal therapy is a slightly intrusive therapy for chronic low back pain that arise from certain type of  painful degenerated disc syndrome and disc herniation. The Intradiscal electrothermal therapy is also called IDET, after successful completion of Intradiscal Electrothermal Therapy  most patients experience a potential reduction in pain without any surgery of disc removal and spinal fusion. The Intradiscal electrothermal therapy is carried by fusing a small tube called catheter directly into the disc and heating the disc. The whole procedure takes an hour to be completed, the process is done on an outpatient basis and many discs can be treated within  a single session

The process

The process of Intradiscal electrothermal therapy is initiated by an introductory discogram test in which the lower disc or discs that are considered the cause of back pain is scanned with the MRI and injected with a contrasting pigmentation, the examination helps identify the small tears and disc herniations in the back of the disc. Once the problematic disc is recognized the patient is taken to the procedure room and is allowed to lay face down on the examination table, a moderate sedation is given intravenously to make sure the patient feels comfortable during the entire process, a soft catheter is infused into the aimed disc under the guidance of an X-ray and placed into the correct position, the catheter is heated to 90 degree Celsius for 15 to 16 minutes. The catheter is removed and soon the disc is injected with local anesthetic and antibiotics to avoid any uneasiness and risk of infections

Soon after the procedure the patients are usually allowed to wear a lower back brace in the early recovery period, after two months of wearing braces the patients undergo four weeks of physical therapy including the exercises that strengthens the muscles of the lower back and are encouraged to carry on with the light routinely activities

Potential Risks and Complications with IDET

The risks are attached in very rare case to Intradiscal electrothermal therapy if performed by an expert physician, however the risks arise in very rare cases the risks might be easily controlled and include;

  • Disc space infection
  • Nerve root injury
  • Post treatment disc herniation
  • Worsened back pain

Contraindications to IDET

  • Obesity
  • Significant reliance on narcotic pain medications either before or after IDET treatment
  • Significant disc space narrowing
  • Large disc herniations
  • Diffuse disc degeneration
  • Three or more symptomatic discs

In case you or any of your loved one is suffering from any chronic back pain and looking for a safe and cost-effective treatment, get a professional advice from Dr. Zaki Anwar by placing an appointment at 815-464-7212. He is a world renowned Pain Medicine Physician who has been practicing regenerative injection therapies for the past several years with remarkable results.

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Intercostal nerve block and your rib pain

Overview

An intercostal nerve block is a medical procedure followed  by injections given with a small amount of local anesthetic in the intercostal  nerves to relieve severe pain arising from rib fractures, nerve damage, injuries to the chest wall, postoperative pain along the rib nerves, and shingles

The intercostal nerves are placed under each rib, the pain arises when one of these nerves gets inflamed or irritated. The steroid medications and local anesthetic intercostal nerve blocks  can help reduce pain and inflammation

The procedure

The procedure is done with  the patient lying face down with the arms stretched upwards, if convenient. The blood pressure and the oxygen level are constantly observed, the physician will ask questions to make sure if the patient is not feeling any discomfort during the whole procedure. The area to be treated around the ribs is cleaned with an antiseptic solution, a  very small, thin and lightly blunt needle is attentively placed under the rib and a different colored substance is injected to the intercostal nerves, the injections are guided by X-ray

The intercostal nerve block injections are a blend, of local anesthetic and steroids, the injections only take a  few minutes, however, the whole procedure takes about an hour to complete. The intercostal nerve blocks feels like a little pinching and stinging effect soon after the skin in numbed the feeling fades, the injection needle exerts a little pressure at the site of injection

What to expect after the intercostal nerve block injections?

Soon after the intercostal nerve block the patient will experience a potential reduction in pain, the patient will be kept in observation for a short period. The physician might advise to take rest for a few days, however, the patient can carry with light activities. The intercostal nerve block will provide relief for the period of effectiveness of the local anesthetic

Risks and side effects

The intercostals nerve block exhibit a minimal amount of risks, however, any procedure that involves injection brings some complications that  may include pain at the site of injections, a puncture in the sack containing CSF because of mishandling that may result in headaches, infection, excessive bleeding, nerve rupture or sometimes no reduction in pain. In very rare cases there might be a complication of collapsed lungs. If you experience difficulty in breathing soon after the procedure of the intercostal nerve block, call your doctor immediately

If you or your loved ones are suffering from rib pain, and looking for potentially safe and affordable treatment, know the benefits of intercostal nerve block by a professional advice from Dr. Zaki Anwar, by placing an appointment at 815-464-7212. He is a world renowned Pain Medicine Physician who has been practicing regenerative injection therapies for the past several years with remarkable results.

 

 

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What you need to know about the benefits and risks of Intrathecal pump therapy?

Overview

The Intrathecal pump therapy is the process of providing medications directly into the spinal cord. The therapy is followed by the use of a small device attached to a thin tube called catheter. The device is surgically implanted under the skin the basic purpose of the pump is to relive pain and  reduce side effects from oral medications

Advantages

There are several advantages of Intrathecal pump therapy that may include

Immediate and long term pain relief, Increased mobility of the spinal cord, participation in routinely activities and physical workouts,  Less intake of oral medications, resulting in lower side effects and reducing dependency on oral medications. The Intrathecal pump therapy is potentially safe and highly effective. The Intrathecal pump therapy does not include any permanent changes in the spinal cord or the nerve network.  The therapy is reversible and easily testable and can be adjusted according to your needs

Risks of the Intrathecal pump therapy

Since the Intrathecal pump therapy is surgically implanted under the skin, there might be complications  that may include; infection, cerebro spinal fluid leakage and headaches. In case of any active infections or allergic reactions it is strictly advised to avoid the Intrathecal pump therapy

The implantation of the drug pump can create several complications that sometimes require surgery to settle, the complications can also be caused by inadequate dosage of the drug an can bring life threatening consequences

The most observed complications include;

The displacement of the drug pump, the leakage from the catheter, tearing or loosen contact of the catheter with the device. The device stops working or in some cases growth of inflamed tissues at the end of the catheter that may result in paralysis

Intrathecal Pump therapy and other chronic pain treatments

Intrathecal pump therapy enjoys priority over other treatments offered for chronic pain due to its uncommon benefits

Prior to implanting the drug pump for permanent bases, a temporary testing period is considered to check if the pain is relieved. The therapy is not permanent such as back pain surgery and can be easily adjustable and reversed, if not needed by the patient, Intrathecal pump therapy dissimilar to oral medication release potentially small amounts of dosage  straight into the spinal cord, reducing pain abruptly. The Intrathecal pump therapy works wonders when all the other medications have failed

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Get rid of the spinal fracture pain by Kyphoplasty

The Kyphoplasty procedure is done to alleviate the pain arising due to spinal compression fractures, to support the bone and to bring back significant lost spinal body height due to compression fracture

Performing Kyphoplasty Surgery

The Kyphoplasty surgery is carried out by making a very minimal incision in the back by the means of which the physician places a slim tube under the guidance of fluoroscopy so that the tube can reach the fractured part of the spinal disc cutting through the skin into the bone

With the guidance of  an X-ray images the physician injects a specialized balloon with the help of a tube and delicately blow up the balloon. As the balloon enlarges, it raises the broken pieces of the fracture bone, restoring it to the correct position, also the balloon tightens the soft inner bone to produce a gap in the spine. The balloon  is taken out by the physician using a specialized tool exerting a small amount of stress and fill up the cavity with a cement resembling substance. The material hardens soon after supporting the bone. The procedure usually takes an hour to be completed for each disc. The procedure is less complicated and need patient to stay one day at the hospital. The Kyphoplasty is generally works best for the patients undergoing fractures  from osteoarthritis

Recovery

For some patients the pain can be easily and instantly eliminated, however, some patients experience relief  within a day or two. Soon after the therapy the patients can return to their routinely activities, though heavy exercises and weight lifting should  be avoided for a period of two months.

Candidates for Kyphoplasty

Kyphoplasty does not give permanent relief from certain abnormalities of the spinal column, and certain  patients with osteoporosis are not recommended for Kyphoplasty

Risks and Complications of Kyphoplasty

As with the invasive procedure, there are some risks attached that may generally include reactions from anesthesia and infections. Other risks that are particularly associated with Kyphoplasty treatment may be;

  • Nerve damage or a spinal cord injury from wrongly inserted instruments placed in the back
  • Nerve injury or spinal cord compression from leaking of the cement into veins or epidural space
  • Allergic reaction to the solution used to see the balloon on the X-ray image as it inflates

Patients suffering from Osteoporosis are certainly at risks of more fractures with the procedure due to weakened bones from Osteopororsis.

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