Degenerated Discs; Bulging Discs; Herniated Discs
Injury of a disc in the low back is the most common reason for chronic low back pain in adulthood. VA I-Spine Physicians use research supported exam techniques and diagnostic procedures to accurately detect a symptomatic disc. Treatments for these painful discs range from steroid injections to injections of reparative medicines into the discs. Degenerated discs can herniate allowing the inner nuclear material to escape outward inflaming and placing tension on a nearby nerve causing leg pain or sciatica. Herniated discs can be treated with steroid injections and sometimes removal of the herniation through an x-ray guided needle.
Spinal stenosis can develop over time as we age or congenitally as our spines develop. Typically spinal stenosis will cause leg pain by restricting blood supply to spinal nerve roots resulting in lower limb pain that is worse with standing and walking. Selective nerve root blocks can alleviate leg pain due to stenosis. Persistent symptoms may require surgery.
Sciatica; Radiculopathy; Radicular pain
Injection of steroid and anesthetic around the inflamed and painful nerve root can effectively reduce nerve root pain from a herniated disc or stenosis. On average, close to 2 injections are necessary to reduce leg pain.
Whiplash injuries can occur to joints or discs in the neck resulting in neck pain and headaches after a motor vehicle collision. VA I-Spine Physicians utilize technically sound diagnostic injections to determine the source of the whiplash induced neck pain in order to optimally treat it. Steroid injections can help reduce disc related neck pain while a neurotomy can successfully reduce neck pain emanating from an injured facet joint. Dr. DePalma has conducted and presented research findings on the spinal structures injured by whiplash events.
Osteoporosis; Spinal and pelvic fractures
Insufficiency fractures of the vertebral bodies in the spine and bones in the pelvis can be debilitating. Such fractures can be a common occurrence due to osteoporosis. The risk of recurrent fractures and death is high after a fracture. Dr. DePalma has presented and published research findings of effective treatment for vertebral and pelvic fractures. Under x-ray guidance Dr. DePalma can inject synthetic bone cement into the fractured bone to stabilize the fracture and reduce pain and disability. Dr. DePalma works in conjunction with your primary care physician to improve the osteoporosis with proper medications.
Facet joint arthrosis
Dr. DePalma’s research has shown that the most common cause of chronic low back pain in patients over 55 years of age is facet joint arthrosis. Meticulous diagnostic injections will confirm whether low back pain is due to a symptomatic facet joint. A neurotomy procedure can profoundly reduce facet joint related low back pain.
Hip joint arthritis
Sometimes low back and leg pain may originate in the hip joint and mimic a spinal condition. X-ray guided hip joint injections can help verify if a hip joint is painful or not and alleviate hip joint arthritic pain.
Sacroiliac joint dysfunction
Steroid injections for painful sacroiliac joints can be effective at reducing low back pain. Dr. DePalma’s research has shown the sacroiliac joint pain occurs more so in adults over age 55 and in females than in males. In a separate research project, Dr. DePalma found that the sacroiliac joint was the most common source of chronic low back pain in patients having undergone a lumbar fusion surgery. In these patients after a fusion surgery, steroid injections may be less helpful.
Runners and cyclists may develop pyriformis syndrome and experience buttock and pain the back of the thigh and calf. Gentle stretching in combination with injections of anesthetic into the pyriformis muscle under x-ray guidance can help alleviate the symptoms when combined with physical therapy.