Cleveland's Pain Management for
Back, Neck & Spine
“Doctor Kozmary and his whole crew are the best pain management crew in Cleveland. I have gone to a lot of doctors trying to find a good Doctor that cares about the patients’ pain relief instead of just handing out pain pills. They try injections and other procedures to try to get rid of the pain. I like the fact that they drug test to make sure they know people are not trying to just get pills that don’t need them.”
Get Relief for Spine, Neck & Back Pain in Cleveland
It is estimated that ninety percent of people will suffer from back pain at some point during their life. Usually, these episodes of back pain are acute and typically resolve themselves within one to two weeks of onset, but there are people who suffer with persistent, chronic low back pain for months … maybe even years. The personal, economic, social, and functional impact of persistent low back pain can be substantial, so it is important to address this pain as soon as possible.
The common causes of low back pain include trauma, ageing, degeneration, and fractures. The specific anatomic sources of low back pain include muscles, tendons, ligaments, joints (including the facet and sacroiliac joints), intervertebral discs, nerve roots, bursa, and the coccyx. The spine can also become affected by disc herniations, protrusions, bulges, or extrusions.
There have been many studies which have recently helped us to better understand the common causes of low back pain. Many of these causes can be pinpointed by specifically blocking the nerves that travel to the joints, muscles, tendons, ligaments, and discs, and in doing so, enable us to accurately diagnose low back pain. Until recently, many people have suffered with low back pain without a clear diagnosis … doctors have simply diagnosed their pain as “low back pain”. And while this is a description, it does not offer a diagnosis or specific cause. There can also be other anatomic structures that are confused with low back pain, such as pain that originates in the hip joint, so they must be ruled out as well during the diagnosis process.
"The personal, economic, social and functional impact of persistent low back pain can be substantial."
Accurate diagnoses help us to better understand the causes of low back pain and eventually treat their specific causes. Diagnostic tests that are used to help us make an informed diagnosis include MRI scans, radiographs (x-rays), EMG nerve conduction studies, CT scans, diagnostic injections, myelograms, and CT myelograms.
Low back pain is a common health issue which can cause debilitating pain as well as functional impairment. Accurate diagnosis is the key to effective treatment and conservative therapy should be utilized before considering surgery.
Chronic Neck Pain
The prevalence of patients reporting a Grade 2-to-4 pain level, which is defined as “high pain and dense intensity with disability”, has increased. In other words, more people are experiencing a long-lasting pain that impairs their daily function and is associated with significant health, social, and economic impacts as well.
Causes of neck pain can include traumatic events, degeneration, fractures or dislocations, tumors, and infections. Some of the structures that can cause pain in the neck include the discs, nerve roots, bones, muscles, tendons, bursa and ligaments. Facet joints have been implicated as the source of pain for nearly half of all patients who suffer from chronic neck pain, and the reason is simple … they have a significant and abundant nerve supply which can cause pain to be referred to the back of the head, neck, shoulders, and upper arms. But despite the recent explosion in popularity of imaging studies such as x-rays, MRIs, and CT scans, facet joint pain doesn’t always show up. In fact, most of these studies are not reliable for an accurate diagnosis of facet-related pain, so other measures must be taken.
"Long lasting pain relief can be obtained by radio frequency ablation, which is commonly known as burning of the nerves. This gives anywhere from 9 to 18 months of continuous pain relief."
A diagnostic tool that can also help diagnose the source of neck pain (in addition to x-rays, MRI scans, and CT scans), is an EMG nerve conduction study. Where MRI scans utilize magnetic waves in order to image soft tissues, and CT scans and x-rays are better at imaging bones and high density structures, an EMG nerve conduction study helps to evaluate the integrity of the nervous system and the conduction of both motor and sensory nerves.
Treatments for neck pain include non-steroidal anti-inflammatory medications (NSAIDs), anti-depressant medications (Elavil, trazodone), anti-convulsants (Lyrica, Neurontin), opiate pain medications, physical therapy, chiropractic care, neck braces, gravity inversion therapy, stretching, manipulation therapy, injection therapy, radiofrequency ablation, and spine surgery.
Spinal surgery should be a last resort and should be embarked on only after conservative therapy has not alleviated the pain. An accurate diagnosis is the key to successful outcome for patients suffering from chronic neck pain.