FAQ   |   
Lenchig Spine & Pain Institute

Back Pain

Facet Joint Arthropathy

Do you feel that your pain is worse as the day progresses? Standing up straight makes it worse? Do you feel like you want to bend over to get relief, and when you’re in bed you actually feel better sleeping in the fetal position? This could be a form of axial spine pain from a degeneration of your facet joints. Our facet joints are basically the joints that stabilize our spine and don’t allow us to overextend backwards. Even wonder why we can bend over all the way to the floor but not do the same backwards? The facet joints are responsible for this, and every time we actually bendbackwards, we hit them over and over, eventually causing an arthritic reaction and chronic pain in the lower back.

» TREATMENT:

Medial Branch Nerve Blocks and/or Radiofrequency Ablation
These are the nerves that innervate the facets, by doing a series of blocks, both for diagnostic as treatment purposes, eventually they can be denervated by radiofrequency ablation, creating a longer lasting relief of that aching back pain you have suffered for so long.

Radiculopathy

You know this one! Most patients already know the diagnosis before we even mention it. It’s that shooting pain that comes from the back, down the buttocks, all the way down to the foot. Sometimes this can progress from a simple discomfort to a numbness and motor weakness of the leg or arm involved.

» TREATMENT:

Epidural Injections
These are the series of injections done under x-ray guidance at the level where the pain in coming from with the purpose of lowering the inflammatory process as well and the nerve excitatory mechanism giving you a relief from the shooting pain you are suffering at this moment.

Lumbar Spinal Stenosis

Ever felt like the day begins okay, and then after just a few blocks your feet just get tired and in pain making you stop walking. Do you feel that the only way to get relief is leaning forward against a desk or something to support you? Do you feel that pushing the grocery cart actually relieves the pain? You could be suffering from spinal stenosis. A common condition compelled of many factors but in essence, a narrowing of the spinal duct where the spinal cord and nerves travel along within the spinal vertebrae. This channel gets narrowed even more when we extend the back, and it opens up when we bend forward, giving you some relief to the compression.

» TREATMENT:

Epidural Injections
These are the series of injections done under x-ray guidance at the level where the pain in coming from with the purpose of lowering the inflammatory process as well and the nerve excitatory mechanism giving you a relief from the shooting pain you are suffering at this moment.

MILD®Procedure
Minimally Invasive Lumbar Decompression or MILD®Procedure, is a new simple outpatient procedure with a minimally invasive approach to reduce pain and improve mobility in lumbar spinal stenosis (LSS) patients. Thousands of patients have been treated by mild, which is enabled by an innovative new technology and can only be performed by specially trained physicians. If you suffer from the pain and physically limiting effects of LSS, there has never been a better time to get help. For more information visit www.mildprocedure.com

Sacroiliitis

Have you been pregnant? Have you had vaginal delivery? Or are you a runner? Or have you gained or lost weight recently? Do you have history of scoliosis “S” spine? Are you a weight lifter?

Sacroiliitis or Sacro-Iliac Joint disease (SIJ disease) is a commonly underdiagnosed disease of the spine. Usually creates an aching pain that can be in both sides of the very lower spine, but commonly one side more than the other. Usually you “pin point” where the pain is with one finger, right on top of the SIJ. The type of pain is described more as a discomfort that will not subside with any position and you’ll move over and over while sitting down, laying in bed, or standing, trying to find a position that gives you rest to this discomfort.

» TREATMENT:

Sacroiliac Joint Injection
These joints are very accessible and easy to block. Most of the times the block is more for diagnostic purposes, giving you relief that if temporary, it can be denervated with Radiofrequency Ablation of the Medical Branch Nerves that innervate the joint, creating a longer lasting relief of that aching back pain you have suffered for so long.

Coccydynia

The tailbone! Usually there is trauma related to this pain and you remember it. But it can happen sporadically. Not always there is a fracture, most of the time there is a subluxation (a displacement that corrected itself) causing detriment of the ligaments involved and subsequent pain in the coccyx bone.

» TREATMENT:

Ganglion Impar Block
Just below the tailbone, it lays the Ganglion Impar. This ganglion is the receptor of very low sensory fibers, including the tailbone sensory innervation. With a simple, virtually painless procedure, we block this ganglion for diagnostic purposes, giving you relief that if temporary, it can be denervated with Radiofrequency Ablation creating a longer lasting relief of that aching back pain you have suffered for so long.

Vertebral Compression Fracture

Had a recent fall? Have a pain in the spine that will not go away with any pain medication? Do you sometimes feel it’s hard to breathe from this pain? Have history of osteopenia or osteoporosis? Or simply feel pain all over your back after a recent fall or trauma?
This could be a compression fracture of a vertebral body. A common, but often overseen cause of back pain that can be easily treated with a simple outpatient intervention.

» TREATMENT:

Percutaneous Vertebroplasty
Is a simple outpatient procedure that consists of a percutaneous insertion of a needle into the fractured vertebral body, a subsequently an injection of cement into it, stabilizing the fracture and eliminating any painful sensation. This procedure is performed in our own office, without any need of hospitalization. You will go home the same day, and usually takes 1-2 hours to perform.
Percutaneous Kyphoplasty
Kyphoplasty is a variation of the Vertebroplasty by restoring the height and angle of a fractured vertebral body, by inflation of a balloon prior to the injection of bone cement like in the Vertebroplasty. This procedure is performed in our own office, without any need of hospitalization. You will go home the same day, and usually takes 1-2 hours to perform.

Post-Laminectomy Syndrome or Failed Back Syndrome

Do you have history of back surgery? Do you feel like you got back your neurological deficit but not the control of your back, and extremities pain and been told there is no more surgery it can be done?

Post-Laminectomy Syndrome or better known as Failed Back Syndrome (FBS)
It refers to chronic back and/or leg pain that occurs after back (spinal) surgery. Common symptoms associated with FBS include diffuse, dull and aching pain involving the back and/or legs. Abnormal sensitivity may include sharp, pricking, and stabbing pain in the extremities.

» TREATMENT:

Spinal Cord Stimulator (SCS)
A spinal cord stimulator is a device used to exert pulsed electrical signals to the spinal cord to control chronic pain. An implantable system delivers electrical pulses via a lead to nerves in the dorsal aspect of the spinal cord. Pain signals are inhibited before they reach the brain and replaced with a paresthesia that covers the specific areas where the pain was felt.
SCS procedure involves a trial period of 4-5 days, placement of electrodes in the epidural space are done in the office as an outpatient procedure. After this, the patient will have a generator to control the stimulation, giving this procedure the uniqueness that no other medical intervention has. Giving you the control, to “test drive” the device before having it done, making you “your own doctor” in deciding if the product is going or not to work. If the results are satisfactory in the trial period the leads are removed in the office and the implantation is done as an outpatient procedure in the operating room. Usually is a one-hour procedure.