Chronic back pain, either caused by a chronic condition or accident related trauma, is a very common condition, about 90% of people suffering from it at some point in their lives. It is one of the leading cause of lost time at work and disability in Canada. There’s no doubt that those impacted by chronic back pain can suffer a reduced quality of life different life domains such as physical and mental wellbeing, social relationships, the ability to work and functional ability. Since 2003 our Hamilton personal injury lawyers have represented individuals who suffer chronic back pain conditions either caused by the traumatic event such as a car accident, motorcycle accident, pedestrians being hit by cars, trucking accidents or bicyclists hit by cars. We have also represented many disability claimants who have suffered from brutal back pain caused by degenerative or congenital conditions which prevent them from maintaining regular gainful employment. If your quality of life is been seriously reduced because of back pain, you have undergone back surgery or you have been denied disability benefits, please call us today. It never cost any money upfront to talk to our Hamilton personal injury lawyers. Over the years we have assisted individuals who have suffered major traumatic or non-traumatic back conditions – some of which are noted below:
Herniations or Herniated Discs – The back contains 33 vertebrae, each of which is cushioned by a soft disc. These discs allow the vertebrae (and the spine) to move and return to its place by absorbing any shock from movement. That is why humans are able to bend over or exercise. However, these discs can sometimes move our slip out of place, causing extreme pain to the individual. This condition is known as a herniated disc. When the back has a herniated disc, the part of the disc that protrudes from its position, the nucleus, affects the surrounding nerves by leaking material onto them. Those nerves then become irritated or pinched, and cause significant pain. The most common pain site is in the lower back, but a herniated disc could also cause pain in other areas of the body, from the calves to the neck. A herniated disc does not normally require surgery, but if the individual is in a significant amount of pain that cannot be managed by other means, a laminectomy may be applied.
Bulging Discs or Protruding Discs – Another type of serious back injury that could involve the vertebrae discs is a bulging disc. It is sometimes referred to as a slipped disc or a protruding disc. This occurs when the perimeter of a disc between the vertebrae is torn or ruptured and the nucleus of the disc begins to protrude outside of the thick cartilage around it. Bulging discs are slightly different than herniated discs because they generally only affect the outer layer of cartilage and not the internal aspect. Thus, they involve discs that are protruding, but not at the point where they are leaking onto the nerves. Therefore, a bulging disc causes significantly less pain than a herniated disc because it does not penetrate as deeply, and does not generally require surgery unless the situation is extreme. Treatment for a bulging disc may include wearing a back brace, avoiding physical exercise, or avoiding certain posture positions to allow the bones to heal properly.
Spinal Stenosis – Spinal stenosis is a medical condition where your nerve roots are compressed or constricted by a number of clinical factors, which can lead to severe pain, numbness, and weakness. It is the narrowing of one or more areas of your spine which puts pressure on the spinal cord or your nerves that exit or branch out from the squeezed areas. Your upper neck (cervical) and lower back (lumbar) areas are most commonly affected, although the thoracic spine also can be compressed most frequently by a disc herniation. For some people it’s congenital, for some it’s age related and for others – injury or trauma to the spine can also cause spinal stenosis. Trauma can cause herniated discs – or ruptured discs, which can then put pressure on the spinal cord or nerves. Accidents can also cause vertebral fractures or dislocations, which can also damage the spinal canal and put pressure on the open spaces wtihin the spine and cause them to become narrowed. Spinal stenosis can cause causes no symptoms, however, depending on the location and intensity of the spinal pressure, it can cause pain, numbness, weakness, and in severe cases bowel and bladder problems.
As Hamilton personal injury lawyers, we often work with clients who suffer from post-traumatic back pain caused by such accidents as pedestrian accidents, motorcycle accidents, car accidents, bicycle accidents, ect. Over the years, we have seen that back pain is a health condition which can be very difficult for doctors to treat – especially if a person’s post-traumatic pain persists beyond normal healing time and lasts for more than three to six months. Some back pain might better to physical therapy, while others might need more aggressive treatment like epidural steroid injections, selective nerve root block (SNRB), facet joint block or a sacroiliac joint block. Some might do better with surgery, such as laminectomy, discectomy,
Laminectomy – is a spinal laminectomy is sometimes referred to as spinal decompression, and is a type of surgery designed to treat spinal stenosis. During this procedure, parts of the vertebrae called the lamina are removed. The goal of a laminectomy is to make the spinal canal larger, which will relieve pressure on the nerves and eliminate pain caused in those areas. The lamina is the part of the vertebrae that covers the spinal canal. However, sometimes this area can become overgrown and overbearing, which means that the spinal cord and the nerves surrounding it now have less room. With less room, there is an increased pressure that can cause extreme pain, and in some cases it can cause numbness to the legs and areas below the spine. A doctor will recommend that you undergo a laminectomy only after other types of treatment options have been explored, as this is an invasive surgical procedure that requires significant recovery time. It may also be recommended if your pain and suffering has worsened.
Discectomy – individuals who are experiencing severely painful herniated discs may undergo a discectomy to remove the abnormal disc entirely. A discectomy is often performed alongside a laminectomy, as the lamina is located above the disc and therefore often needs to be removed beforehand in order for the doctor to properly see the disc. A less invasive type of discectomy, called a microdiscectomy, involves a similar operation but utilizes a smaller incision with less recovery time. Microdiscectomies have become more common wherever possible, as this procedure has a lower risk of damaging the surrounding tissues and nerves. By removing the herniated disc, the individual is able to experience pain relief and eventually return to their regular activities. However, it does not completely reverse the conditions that allowed the herniated disc to occur, and may not be completely permanent in this regard.
Vertebroplasty – another type of procedure that may be recommended for individuals with severe back injuries if non-surgical methods are not effective is vertebroplasty. During outpatient vertebroplasty, the surgeon will typically insert a needle into the back using three-dimensional imaging software to guide it to the vertebrae. Once the needle reaches the vertebrae, it will apply a bone cement to the area that will harden. After this cement hardens, the bone will become stronger because the bones will be fused together, creating a central core to fix the ruptured area. Approximately 75% of individuals who have undergone vertebroplasty report being able to become more active and return to full mobility after the healing process. The more active an individual can become after the procedure, the more they will be able to strengthen their bones and increase mobility.
Kyphoplasty – if you suffer a compression fracture it can be very, very painful. It can also make it very difficult to move properly and freely because a break can result in bone fragments rubbing against one another. A kyphoplasty is used to treat compression fractures. Similar to vertebroplasty, kyphoplasty is a surgical procedure during which bone cement is injected into the vertebrae. However, in this case, before the bone cement is inserted, a special type of balloon is inserted. The balloon will then inflate to create an enlarged space, or cavity, within the bone. After the balloon is removed, the bone cement is placed within the hollowed area and is able to harden, strengthening the bone. Both kyphoplasty and vertebroplasty are minimally invasive due to the fact that the incision from the needle is small in size, and therefore does not require any stitches. Therefore, it may be a viable option if the vertebrae has been fractured or worn down. However, kyphoplasty and vertebroplasty are not used to treat herniated discs, as that condition requires more invasive treatment.
Spinal Fusion – otherwise known as a “welding process” – is performed with the goal of removing the vertebrae disc that has been herniated, ruptured, or otherwise injured. After the disc is removed, the remaining vertebrae are permanently fused together either by grafts from the remaining bones or by insertingpedicle screws and metal devices. Essentially, they are “welded” together so that they heal together and create one larger bone, eliminating the injured area and the pain. This procedure can be performed in order to benefit a variety of symptoms and injuries, ranging from tumors to scoliosis and herniated discs. For individuals who experience significant back pain when moving, this type of surgery can eliminate those issues and allow you to return to the level of mobility you enjoyed before your injury. However, this does not happen instantaneously and the area should be immobilized during the healing process.
Trigger Point Injections – are outpatient procedures often used by orthopedic surgeons and physiatrists to help reduce, lessen or relieve back pain. Trigger points are often used to treat chronic muscle pain related to myofascial trigger points – often referred to as knots in the muscle. Myofascial trigger points are often a major cause of pain and overall dysfunction of health. It’s reported that trigger point injection therapy is not a miracle cure for chronic pain although it does provide temporary relief. Trigger point injections are a type of therapy that your doctor would more or less prescribed for chronic pain after a certain amount of time, after you’ve attempted rehabilitation or physical therapy and medication relief. Trigger point injections are often made up of an anesthetic component, such as lidocaine, bupivacaine, or corticosteroid mixed with an anesthetic component.
Epidural injections – epidural injections, often notice epidural steroid injections (esi) is an outpatient treatment often used to help relieve or reduce back pain caused by inflammation or inflamed spinal nerves due to disc herniation, disc bulges or spinal stenosis. In epidural injection is often made up of a corticosteroid and an anesthetic numbing agent and delivered into the epidural space of the spine, which is between your vertebrae and the protective dura sack which surrounds your spinal nerves. Epidural injections can reduce inflammation but unfortunately it does not make your herniated disc smaller or relieve any type of herniated or bulging disc. Epidural injections only work on spinal nerves by flushing away the proteins that cause swelling in the area. Typically, epidural injections can provide short-term relief from back pain anywhere from 3 to 5 months.
Chronic back pain is a common, disabling and very costly health problem in Ontario and no doubt a complex medical condition to manage for most doctors. The treatment of very serious chronic low back is difficult and is often ineffective – sometimes leading to surgery, which can cause a lifetime of change for an accident victim – and a loss of income. Often times, chronic back pain results in individuals not being able to return to work and applying for long-term disability benefits. Since 2003, our Hamilton personal injury lawyers have represented hundreds of accident victims obtain compensation and claimants obtain the disability benefits they deserve.
If you or a loved one has suffered a serious back injury which required any of the therapies as mentioned above, or if you are unable to work because of your back pain and you have been denied long term disability benefits, call us today at 905-333-8888 or fill in a contact form today. Our consultations are free and we never charge money upfront.
This information is derived from Peer Reviewed Orthopedic Journals and Pubmed, as well as the medical text “Orthopedics Today”
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