For patients suffering from chronic pain, frequent visits from their primary care physicians, specialists, and other therapists all over Baltimore can be overwhelming , difficult to schedule, and cause more pain from all of the traveling.
Pain relief shouldn’t be that difficult. The Pain Doctors use a multidisciplinary treatment approach for chronic pain sufferers, removing the need to regularly travel to a variety of doctors in order to start feeling better.
Each patient will have access to medical pain management specialists from a variety of fields that will work together as a team to build a customized treatment plan for you.
The Pain Doctors is currently accepting new patients at our Baltimore office for advanced interventional pain management.
The dura is a protective covering of the spinal cord and the nerves surrounding it. The space around the dura is called the epidural space. In the lower back, this is called the lumbar epidural space.
The lumbar area of the spine has five vertebrae. Soft discs found between these vertebrae cushion them, hold them together, and control motion. If a disc tears, chemicals inside may leak out. This can inflame nerve roots or the dura, and cause pain. A large disc tear may cause a disc to bulge, inflaming nerve roots or the dura, and cause pain. Bone spurs, called osteophytes, can also press against nerve roots and cause pain.
If you have pain in your low back when you bend your back, you may have lumbar disc and dural inflammation. If pain travels to your leg when you move your back, you may have nerve root inflammation.
Common tests such as MRIs can show disc bulges and nerve root compression, but may not show a torn and leaking disc. A lumbar epidural injection may provide relief if disc problems, or dural, or nerve root inflammation are causing your pain.
Facet joints connect the vertebrae, the bones of the spine. They help guide your spine when you move.
The lower back area of the spine is called the lumbar region. It contains seven vertebrae.
Facet joints are found on both sides of the spine. Each is about the size of a thumbnail.
Lumbar facet joints are named for the vertebrae they connect and the side of the spine where they are found. The right L4-5 facet joint, for example, joint the 4th and 5th vertebrae on the right side.
Medial branch nerves are found near facet joints. They transmit pain signals from the facet joints to your brain.
You may feel pain if a lumbar facet joint is injured. Sometimes it feels like muscle tension. Other times it can be severe pain. The cartilage inside the joint may be injured.
Other times, only connecting ligaments surrounding the joint are injured. Facet pain also depends on which facet joint is affected.
Lumbar facet pain can occur in an area from your lower back down to your buttock.
Myofascial Pain Syndrome, also known as trigger points, is localized to sensitive areas of the skeletal muscles that contain taut muscle bands. They are sensitive to pressure and can be referred pain.
Trigger point injections are an injection into these taut muscle bands.
The injection consists of a mixture of local anesthetic (like lidocaine or bupivacaine) and the steroid medication.
The purpose of the injection is so that it will help the muscle relax. When the muscle relaxes, the blood flow to that muscle will increase and wash out the painful toxic metabolites that were building up. This may break the cycle of pain.
Studies show that physical medicine patients who receive regular physical therapy treatments heal faster.
Physical therapy works to improve a patient’s flexibility, strength, and balance, leading to better coordination and posture. Patients who develop greater coordination are more likely to avoid further injury. By stretching and strengthening muscles, therapy also minimizes a patient’s pain.
After an initial consult with The Pain Doctors, our physical therapists will work with you to develop a physical therapy plan based on your individual needs. Our therapists will schedule in-office sessions and will also suggest exercises you can do at home to speed up the healing process.