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Nothing ruins a great day of golf like low back pain. Swinging a golf club uses forceful, repetitive lateral rotation in the lower back and the lumbar spine. This may cause a variety of low back pains including discogenic pain, muscle strains, sacroiliac dysfunction, and facetogenic pain. Facetogenic pain is arthritis in the lower back.
What are the symptoms of arthritic back pain?
Symptoms are usually in the lowest area of the back, just above the buttocks. Pain does not extend into the legs, nor the pelvis. It generally appears as stiffness and difficulty standing up straight. Patients with arthritic back pain frequently walk hunched over for relief and have trouble getting up out of a seated position.
What causes this?
Most often, it is part of degeneration. In golf, your pivot increases the likelihood of arthritic back pain.
How is arthritic back pain diagnosed?
Your doctor will listen to your history of the pain and perform a physical exam. You may also have imaging, such as an MRI, to confirm the diagnosis.
What is the anatomy?
In simple terms, arthritis is joint inflammation. Arthritis can affect the back, similarly to any other joint in the body.
The lumbar facets, also known as zygapophysial joints or Z-joints, are areas where the individual lumbar vertebra (spinal column bones) touch each other. The medial branch nerve of the spinal dorsal ramus, or MBN for short, provides sensory information of the facet joint. Each facet is innervated by two levels of MBN’s.
What are MBN injections?
MBN block injections involves injecting local anesthetic near the MBN, thus blocking the nerve from sending arthritic pain sensation signals to the brain. If successful, some patients are eligible to progress to Radiofrequency Ablation (RFA).
What are RFA injections?
RFA results in ablating the sensory medial nerve through the heat of 80 degrees Celsius for 90 seconds. Results typically last 6 months to a year, but in many cases, they last even longer.
Are these procedures covered by insurance?
Always check with your doctor and your insurance company, but most commercial insurances and Medicare do cover the injections.
Dr. Josephine Clingan is Double Board-Certified in anesthesiology and pain medicine in Miami, Florida. To learn more call us today at 305.974.5533.
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