Our goal through Pain Management is reducing and eliminating chronic pain while restoring function and quality of life.
Spinal Cord Stimulation
Spinal cord stimulation may help relieve pain and improve quality of life in people with chronic (long-lasting) pain, such as low back and leg pain. Spinal cord stimulation (SCS) may help reduce and manage chronic pain that does not go away with physical therapy, pain medications, injections, or other non-surgical treatments. Advances in SCS technology have allowed people with chronic spine-related pain to reduce or eliminate their need for pain medications and return to comfortable, productive lives. SCS is best at treating neuropathic pain from a pinched or injured nerve, and is also good at treating mechanical back pain from such conditions as degenerative disc disease, radiculopathy (pain that radiates down an arm or leg), spinal stenosis (narrowing of the spinal canal), failed back surgery (pain that remains following surgery), and sciatica. In addition, SCS is useful in treating nerve pain from hernias, intercostal neuralgia (rib pain following surgery), and complex regional pain syndrome (CRPS), which is a relatively uncommon form of chronic pain. Spinal cord stimulation is used to treat chronic peripheral neuropathic pain, which is damage to nerves outside of the spinal cord (typically in the hands or feet) that is caused by an infection, trauma, surgery, diabetes, or other unknown causes. Each patient should undergo a SCS trial before the device is implanted to make sure that the pain is relieved by this treatment.
During the trial period, a temporary SCS is placed in the back for a period of 5 to 10 days. The trial allows the patient to learn how to use the system, become familiar with the way it feels, and see what degree of comfort and pain relief it provides. The SCS trial is the best prognostic guide to how much pain relief will be provided with a permanent SCS system. While you might not have complete pain relief, a greater than 50% decrease in pain with SCS is considered successful. You may be eligible for permanent placement of a spinal cord stimulator if your trial is successful.
Sciatica is not a disorder itself but is a general term used to describe leg pain that occurs when nerve roots in the low back become compressed (pinched), irritated, or inflamed, often from a herniated or bulging disc, or other narrowing of the spinal canal. Sciatica may be accompanied by numbness/tingling and muscle weakness of the leg. Pain is the hallmark sciatica symptom.
Although sciatica symptoms may be felt anywhere along the sciatic nerve, classic sciatica radiates from the low back into the butt, and down the leg to below the knee. Less commonly, sciatica pain may be felt starting in the buttocks or hip area and radiates down the leg. Sciatica pain is often described as electric, burning, or sharp. The nerve pain can vary from mild to excruciating and can worsen when you bend down, twist your spine, or cough. Although you have two sciatic nerves (one on each side of your body), sciatica symptoms typically only occur on one side of the body.
Common causes of sciatica are herniated discs, degenerative disc disease, bone spurs, spondylolisthesis, vertebral fracture, and piriformis syndrome. Other conditions like sacroiliac joint dysfunction and iliotibial band syndrome can mimic the symptoms of sciatica, but are not truly caused by sciatic nerve impingement or irritation. The cause of sciatic is diagnosed by medical history, physical exam, and imaging studies. Non-surgical treatment includes physical therapy, medications, epidural steroid injections, and other interventional procedures.
Symptoms and Causes
Bone Health Osteoporosis
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Osteoporosis is commonly called the “fragile bone disease.” It is due to loss of bone density caused by a deficiency in such bone-building nutrients as calcium, vitamin D, magnesium and other vitamins and minerals. One of the most common results of osteoporosis is vertebral compression fractures. In people with advanced osteoporosis, compression fractures can occur as the result of coughing, sneezing, bending, carrying heavy loads, or experiencing a fall. Compression fractures occur when the vertebrae collapse, decreasing their size by 15-20% or more. This compression causes chronic back pain, loss of height, deformity, and in severe cases neurological symptoms such as numbness, tingling, or weakness. If there are multiple compression fractures along the vertebral column, difficulty walking and a loss of balance is common. Compression fractures are often diagnosed only after a person seeks medical attention either for pain relief or after a fall. However, many compression fractures go undiagnosed and their symptoms are attributed to being an inevitable part of aging. Traditional treatment for compression fractures include pain medications, bed rest, bracing or, in very severe cases, surgery. Today there are two minimally invasive treatments for compression fractures called vertebroplasty and kyphoplasty.
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Dr. Boeckman and his team of specialists will work with you to develop an interventional pain management plan to provide relief and an improved quality of life.