Neck Pain Treatment Techniques
For short-term problems, manual treatment (chiropractic or physiotherapy) and pain-relieving medicine are recommended. With longer-term pain ( three months or more) there is the following choice of treatment:
1 : Chiropractic treatment 2 : Intensive muscle training 3 : physiotherapy. 4 : Acupuncture provides relief for significant numbers of people with chronic neck and shoulder pain, although this is not routinely available on the NHS.
Translaminar technique
Steroids are injected in close proximity to nerve bundles and small blood vessels in the spine. The translaminar technique avoids the risk by injecting the steroids into the epidural space in the neck, allowing the drug to spread up and down the spine to reduce the inflammation and subsequently reduce pain. This safer translaminar approach is an outpatient treatment, requiring only a small amount of local anesthesia.
Long term treatment
The neck pain treated by these steroid injections was due to aging of the spine. This includes degenerative changes such as osteoarthritis of the spine, bone spurs, disc degeneration and narrowing of the spinal canal. Additional alternative treatments for neck pain are physical therapy, traction, narcotic and non-narcotic pain medication and, in some cases, surgery.
During the procedure, an interventional radiologist utilizes real-time, continuous X-ray imaging to guide a small needle into the base of the neck between the C7 and T1 vertebrae, the largest epidural space in the neck, and injects a small amount of medication. The medication then spreads up and down the spine to reduce the inflammation in the spine, reducing pain.
The patient is kept awake to enable communication with the physician, but the skin is numbed. After a brief observation period, the patient is released the same day. Patients receive between one and three injection treatments with approximately three to four weeks between the procedures.
Typically, patients who will be the most responsive to the translaminar injection will notice the greatest amount of pain reduction after the first treatment. The translaminar steroid injection is ideal for patients who are not receiving adequate relief from over-the-counter pain medications, but who are not ready for spine surgery.
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