For patients
Back pain
Interventional radiologists treat many different kinds of back pain, including degenerative disc disease, herniated discs, spinal stenosis and vertebral compression fractures.
Pain Management
Overview
Treating low back pain
Most people suffer from low back pain at some point in their lives. In most cases, the back pain gets better on its own. When it doesn’t, there are several steps you can take.
The best treatment for low back pain includes, staying active; trying alternatives like heat, massage, acupuncture and chiropractic care; and using over-the-counter medications such as anti-inflammatories, which may help.
Although many patients want to stay in bed when they have back pain, doing so can actually slow the healing process or even make things worse. A physical therapist can provide therapy or recommend exercises designed to relieve back pain. If these techniques don’t help, interventional radiologists can provide minimally invasive treatments using imaging guidance.
Signs and symptoms
How do I know if my low back pain requires more than the standard over-the-counter treatments?
If your low back pain is accompanied by any of these symptoms or risk factors, it is important to get medical attention:
- Recent high-impact trauma
- History of cancer or osteoporosis
- Intravenous drug use
- Use of medicines that weaken your immune system or make your bones thinner
- Age 70 or older
- Unexplained weight loss or fever
- Weakness in the legs
- Numbness or tingling in the legs
- Strong spasms or stiffness in the legs
- Difficulty controlling your bladder or bowels
IR treatments
Minimally invasive options
What kinds of back pain can IRs treat?
Interventional radiologists treat many different kinds of back pain, including:
- Degenerative disc disease
- Herniated discs
- Spinal stenosis
- Vertebral compression fractures
How do IRs treat back pain?
An interventional radiologist will perform a physical examination to determine if you need advanced imaging of the spine such as CT, nuclear medicine or MRI. Depending on the imaging results and the source of your back pain, they may recommend a minimally invasive procedure to help treat your back pain. These include:
- Epidural steroid injection: Inserting a needle into the soft tissue around the spinal cord or spinal nerves and injecting medications to relieve pain.
- Facet joint injections/denervation: Inserting a small needle into the small joints in the back and injecting medication to provide temporary pain relief. If this works and there is continued pain, special needles may be inserted that heat and inactivate the nerves.
- Percutaneous discectomy: Inserting a needle through the back, into a herniated disc, to remove portions of a herniated disc allowing the bulge to reduce.
- Vertebroplasty/kyphoplasty: Inserting needles into a fractured vertebral body and injecting cement directly into the bone to stabilize the fracture and allow it to heal.
- Interspinous spacer placement for spinal stenosis: In certain patients, placing a small spacer through a small incision, which props the vertebrae open and unpinches the nerves.
- Spinal cord stimulation: Placing small electrical leads outside the spinal cord through a small needle, which give signals to the spinal cord that decrease the pain signals transmitted to the brain.
- Targeted drug delivery: Placing a catheter into the spinal fluid and connecting it to a medication pump that delivers pain medication directly to the pain receptors through the spinal fluid; the medication has a far lower dose and is much more effective than oral medication in decreasing pain.
Follow up and recovery
What is the treatment’s recovery like?
Once the treatment is completed, the interventional radiologist removes the needle or microsurgical tools and applies pressure to the tiny incision in your back. You will then be kept for several hours or even overnight in some cases. Due to the minimally invasive nature of the treatments performed by an interventional radiologist, the recovery time often ranges from just a few minutes to a few days, depending on the procedure.
After the treatment, your interventional radiologist may prescribe a short course of pain medication, physical therapy or other treatments. During a period of regular follow-up appointments, which may include follow-up imaging tests, your interventional radiologist will monitor your progress after the therapy.
Last review
Last reviewed by D. Thor Johnson, MD, and George Zlotchenko, MD. November 2024