Spine surgery is rarely the first course of action for a patient who is
experiencing back pain. Typically, an
orthopaedic surgeon in Miami will recommend that patients try non-surgical treatment options first,
such as medications, injections, and spinal cord stimulation. If non-surgical
treatment options fail to relieve pain and other symptoms, then patients
might consider undergoing surgical spinal procedures.
Often, patients with back pain will first try over-the-counter pain relievers,
such as nonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen.
If these drugs do not bring sufficient relief of symptoms, an orthopedic
surgeon might prescribe stronger medications such as muscle relaxants,
which are particularly helpful for relieving back spasms. Some examples
include cyclobenzaprine and carisoprodol. Steroids, which are anti-inflammatory
drugs, might be prescribed for short periods of time. Another option is
narcotic painkillers, such as oxycodone, hydrocodone, and codeine. Patients
should carefully review the potential side effects with their physicians
before taking any prescription medications.
Some individuals with back pain can benefit from injected medications.
Steroid injections can deliver the medication directly to the area where the pain originates, which means they may sometimes
be more effective than oral medications. Additionally, an orthopedic surgeon
can use injections to inform the diagnosis. For example, if a numbing
medication is injected into the facet joint and the patient experiences
relief of pain, it is likely that a problem with this structure is the
source of the problem.
Spinal Cord Stimulation
If oral medications and injections aren’t enough, patients might
consider spinal cord stimulation. This involves the transmission of electric
impulses to relieve chronic pain. The spine specialist will insert an
epidural needle into the space around the spinal cord. One or more insulated
wire leads are placed through the needle. These leads are then connected
to an external trial stimulator. The patient will go about his or her
typical routine for a week to determine if electric stimulation is helping.
If so, the patient might opt for permanent implantation of the leads.
Permanent implantation can be performed under sedation; however, some
patients may prefer general anesthesia.