Spine-Pain

Myofascial pain syndrome (MPS) is a fancy way to describe muscle pain. It refers to pain and inflammation in the bodys soft tissues.

Myofascial pain is a chronic condition that affects the fascia (connective tissue that covers the muscles). Myofascial pain syndrome may involve either a single muscle or a muscle group. In some cases, the area where a person experiences the pain may not be where the myofascial pain generator is located. Experts believe that the actual site of the injury or the strain prompts the development of a trigger point that, in turn, causes pain in other areas. This situation is known as referred pain.

http://www.medicinenet.com/muscle_pain/article.htm

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Myofascial pain is not a fatal condition, but it can cause significant reduction in quality of life (QOL) and is a major cause of time lost from work. Costs associated with MP sap millions, perhaps billions, of dollars from the economy.

Acupuncture may be helpful.

Osteopathic manipulation techniques may include integrated neuromusculoskeletal release, myofascial release, strain-counterstrain, muscle energy, and high-velocity/low-amplitude manipulation.

http://www.emedicine.com/PMR/topic84.htm

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The precise cause of MPS is not fully understood and is undergoing research in several medical fields.

A fairly new form of therapy called Myofascial Release, using gentle fascia manipulation and massage, is believed by some to be beneficial and pain-relieving.

http://en.wikipedia.org/wiki/Myofascial_Pain_Syndrome

In the DVD titled “The Fight Against Pain” it was mentioned Army Regional Anesthesia and Pain Management Initiative.

I found the following which explains the initiative.

ARAPMI staff are focused on finding and implementing the most effective methods of relieving acute pain from combat trauma. Their comprehensive approach makes use of many pain relief techniques, from traditional opioids to continuous nerve blocks and multimodal drug therapy.

The groundbreaking efforts of Buckenmaier and his team, which are funded through the John P. Murtha Neuroscience and Pain Institute, have not gone unnoticed. The group’s work in general, and Buckenmaier in particular, have been recognized by several high-profile media outlets, including WIRED magazine, NPR and an ABC News special report, for which Buckenmaier was interviewed.

http://www.arapmi.org/news1.html

http://www.arapmi.org/

http://www.hjf.org/research/arapmi_web.html

Epidurolysis (RACZ) Procedure is used to dissolve some of the scar tissue from around entrapped nerves in the Epidural space of spine, so that medications such as cortisone can reach the affected areas. Dr. Gabor Racz pioneered this procedure.

What causes scarring (adhesions)?

Scarring is most commonly caused from bleeding into the Epidural space following back surgery and the subsequent healing process. It is a natural occurrence following surgical intervention. Sometimes scarring can also occur when a disk ruptures and its contents leak out

http://www.reddinganesthesia.com/Epidurolysis.htm

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The advent of injectable medications such as Clonidine, a drug originally used for high blood pressure, and Wydase, a protein which can dissolve scar tissue, have allowed epidural procedures to be at the forefront of modern pain management programs.

Often the invasive nature of back surgery causes adhesions or scarring in the epidural space. Some experts firmly believe this is the reason for pain associated with failed back surgery syndrome.

A new review of medical literature on adhesiolysis, an invasive pain management treatment that breaks apart the scar tissue, has shown that this procedure may have value in relieving low back pain due to epidural scarring. Specifically, the reviewers concluded that in the short term, evidence is strong that it can relieve pain and help improve function. For long term benefits, the evidence is moderate. The review was published in the January 10, 2007 issue of Pain Physician. The review was conducted according to the criteria of the Cochrane Library and the Agency for Healthcare Research and Quality.

As procedures go, adhesiolysis is minimally invasive. It is performed with the use of an endocscope inserted into the epidural space to help the doctor visualize and reach the area she or he is addressing. But adhesiolysis is only given after conservative measures to relieve the back pain have been tried with no luck. Adhesiolysis allows epidural injections to more effectively deliver medication to the area it is needed.

http://backandneck.about.com/b/a/257787.htm

This involves passing a flexible catheter through a needle into the painful disc. Wires inside the catheter then heat the disc wall resulting in toughening as well as desensitization of the disc.

The procedure is also being used along with surgical fusion in complex spine problems in hope of achieving better total symptom improvement.

http://www.orthoassociates.com/IDET.htm