Interventions for spinal pain Flashcards
What are the NICE recommended guidelines for general spinal pain?
Examination patient for neurological signs- if none, X-ray imaging needed
Safety net e.g. when they need to seek further advice
Patient education- how to among lower back pain w/ & w/out sciatic & encourage normal activities
Group exercises
Manual therapy or physio e.g. spinal manipulation or massages
Exercise- resting can cause chronic disability & oedema
Hot & cold packs- short term release
Psychological therapies - e.g. CBT
Analgesia - NSAIDs or weak opioids
What does NICE recommend you not do?
Belts or corsets- can cause muscle weakness as people rely on them than using their muscles
Foot orthotics or rocker sole shoes
Traction
Acupuncture
Ultrasound & TENS machines
Paracetamol on its own or strong opioids e.g. morphine
Antidepressants &anticonvulsants don’t help w/ pain but can help mood.
What are some NICE approved recommendations?
Radiofrequency denervation - heating & denaturing the nerve providing relief for 6-12 months.
Epidural - targeting a nerve root using CT scan & using (steroid) injections & local anaesthetic - to help target inflammation around a specific nerve root.
- injected into region called epidural space
Spinal fusion - used in very severe cases (especially of spinal stenosis) where 2 or more vertebrae are connected again together stopping any movement.
Spinal fractures that are stable can be mobilized & unstable ones could require immobilisation possibly using internal fixation
