Nerve & Muscle Pain
It's the most common type of musculoskeletal pain out there. It's debilitating, it prevents people from working, and it prevents them from participating in exercise, as well as all the activities of daily living. I'm here to tell you that it's treatable. In many cases, it's very easily treatable, and this is not just PT and acupuncture, or chiropractic. It's in addition to all these things.
Hi, my name is Dr Jennifer Stebbing and I would like to talk to you about other alternatives to treating back pain. This includes prolotherapy and sometimes PRP. If your back pain is related to disk disease, or facet arthritis, or issues with the nerves coming out from the spaces between the bones. These are all potentially treatable. Some people do better, and some people don't do well at all. But I'm here to tell you, that I can assess these type of things and give you a reasonable way to maneuver through the medical system, so that you could get treated as best you can.
I'm Dr Jennifer Stebbing. I'm border certified in Family practice and Sports Medicine. If you'd like to look at my website, it's drstebbing.com and I can be reached at email@example.com. Please reach out to me, I'd like to help you. Hi, I'm here to talk to you a bit more about back pain. There are reasons for back pain and the reasons behind the back pain can be anything from, for example, that you're out of alignment, or that you have trigger points, or that you have early arthritis, or you have scoliosis, or a leg length discrepancy that's causing a scoliosis. It's really important to evaluate all these things with x-rays, possibly MRI's and an ultrasound that I can do in the office. This helps us determine a more complete idea of why you're having pain. Sometimes the x-ray findings, if you just rely on them, will lead you astray, because they may not be the cause of your pain.
I'm Dr. Jennifer Stebbing. I'm an Osteopathic Family Physician with a Board Certification in Sports Medicine and I use all different types of modalities to evaluate and treat back pain. I'm here to tell you that you can get back to work, you can get back to exercise, as we evaluate you more thoroughly with some diagnostic imaging that's available. If you'd like some more information, you can look at my website, drstebbing.com, or email me firstname.lastname@example.org Hi. I'm here to talk to you a little bit more about back pain. There are reasons for back pain. And the reasons behind the back pain can be anything from for example that you're out of alignment, or that you have trigger points, or that you have early arthritis, or you have the scoliosis, or a leg length discrepancy that's calling a scoliosis. <br/> It's really important to evaluate all these things with X-rays, possibly MRIs, and an ultrasound that I can do in the office. This helps us determine a more complete idea of why you're having pain. And sometimes the X-ray findings, if you just rely on them, will lead you astray, as they may not be the cause of your pain. <br/> I'm Dr. Jennifer Stebbing, I'm an osteopathic family physician with board certification in sports medicine. And I use all different types of modalities to evaluate and treat back pain. I'm here to tell you that you can get back to work, you can get back to exercise, as we evaluate you more thoroughly with some of the diagnostic imaging that's available.
If you'd like some more information, you can look at my website, drstebbing.com, or email me at email@example.com, and I will send you two more videos, from which you can get more information to help you feel comfortable about coming in to see me. Hi. Do you have pain going down your legs that you think is coming from your back? Sometimes this is a sign of nerve damage, or nerve compression, or an issue where the nerves exit at the spinal column. But it can also be indicative of a ligamentous referral pattern. There's other referral patterns like sclero patterns and trigger points have referral patterns, as well. Referral patterns are simply where you receive pain, but the pain may be coming from something else. It's really nice to have a doctor that can evaluate you in terms of these different pain patterns because it can change your pain drastically if the reason behind it is evaluated and treated appropriately.
I'm Dr. Jennifer Stebbing. I'm Board Certified in Family Practice and Sports Medicine. I'm here to tell you that, although, back pain is difficult to treat, it is treatable, in many cases. And I'd be happy to evaluate for those. I can be reached at firstname.lastname@example.org, where I'll send you two additional videos that give you more information on back pain. I hope this makes you feel a little bit more comfortable about coming in and seeing me. Thank you. Hi. This is Dr. Jennifer Stebbing. I'm so happy that you're looking at this video. This is a further informative video on back pain, and I'd like to talk to you about causes. There are many different causes for back pain. The most common cause is probably called mechanical back pain, and there is no x-ray changes with mechanical back pain. It's pain that's caused by movement, and for this reason we usually treat people with physical therapy, chiropractic, acupuncture, and other different types of modalities that are aimed at strengthening the core, which includes your abdominal muscles, part of your psoas, your multifidi in your back, and some of the other smaller muscles that help support it.
Because the back has so many different bones in it, there's a lot of room for something to go wrong. On one hand it allows us to have the flexibility, so that we can bend over and bend backwards, side bend and rotate in a whole bunch of directions in the low back. This is an incredible advantage that we have. However, because each of those areas moves, there's a potential injury at each attachment from one vertebrae to the next. The attachments, our joints are called facets and the facets can develop arthritis. When arthritis occurs, it is actually indication that the ligamentous structures that hold the spine together are a little bit lax. So what happens is you have additional movement from one vertebrae to the next, and this can cause the facets to widen as your body tries to stabilize it.
Your body's very smart, it says, how can I make this a more stable joint? What I'm going to do is lay down calcium, make the joint wider. And when this happens, what can occur next is that it can make the space between the bones where the nerves exit the spine smaller, and this is called a foraminal stenosis. And when this happens, you can get pain that goes down into your butt or into your leg that is a result of the nerve being compressed.
Additionally, if the disc is affected, meaning that the ligamentous structures or these capsular structures that hold it in place are injured. For example, a whiplash injury or if your bio mechanics are such that over time you get an overuse injury that creates the disc to slide forward or backwards or partially to the side, the disc can cause compression near or onto the spinal column. And when that happens, you get a condition called spinal stenosis. <br/> All the literature suggests that if we wait, your body does a good job of trying to fix itself over the course of a year. But sometimes people in their haste to get out of pain, and in some cases, this may not be unwarranted, they pursue surgical options. And when this happens, depending on the type of surgery, you can get further decompensation of the spine over time. So understanding that there are different causes of pain in the spine is important and can be evaluated by MRI.
When we talk about the different causes, then we direct treatment accordingly. For example, we know if the spine is stiff or tender with rotation one way or the other, we may have to use a little bit of manipulation to get that the facets so they're moving better. On the other hand, there may be some soft tissue injury. For example, an injury to the muscle that may cause pain right there, because the muscle then can't do its job properly. Under ultrasound we can sometimes see these defects or these areas where there's tears in the muscle or tears in the fascia, and we're able to treat those simultaneously.
What do we treat these things with? And that's a great question, because sometimes the trigger points can easily be treated with an acupuncture dry needling. On the other hand, if the trigger point comes back again, it really suggests that the spine is hyper mobile and the muscle tightness that is occurring and the trigger points that are occurring are in direct response to try to stabilize that spine. In that case, prolotherapy or PRP can be used to help repair or heal the ligamentous structures or the capsular structures that surround the spine. And there are quite a few of them. For example, the supraspinous ligament can be injured with whiplash. Interspinous ligaments can also be injured with whiplash or any flexion or extension injury. The facet has a capsule around it. The capsules have pain fibers. The muscle itself can be injured, and there's ligamentous structures that we can treat on the backside of the spine.
In addition, there's a huge role for physical therapy which is geared towards getting the back strong. I like massage. I love acupuncture. I like chiropractic. I'm an osteopath. I do manipulations, and we know that there is also probably a psychological cause of pain that can be treated at the same time.
The thing about mechanical back pain is that if we don't treat it, the injury gets worse. So many times people will come in and say, oh yeah, I've had days where I'd lie on the ground for 24 hours and after that it gets better. What happens over time is that there are more days involved, it takes longer to recover, and you get more days lost from work. This is an ideal time to treat with prolotherapy. Once the disease has progressed more, then you start to get arthritic changes in the joint, and you may end up having more larger muscle tears and other things, in which case the PRP becomes really important in terms of treatment.
If there's disc disease or if there's bone marrow changes and things like that, that's when stem cells and other higher level of options exist. And although I don't treat these specifically, I have colleagues across the country that I know that do a great job with treating disc disease. And I can help refer you to that if that's what you need.
In the meantime, a very nutritious diet with lots of fruits and vegetables is important. Supplements such as vitamin D, lots of minerals, fish oil, and probably there's a role for glucosamine in there as well. It can help improve your healing. Obviously avoiding smoking and drinking alcohol plays a benefit in terms of your overall health. And exercise every day is really, really important. You don't have to run. You can do non weight bearing exercises if that's all you can tolerate, which includes pool work or exercise bicycle or an elliptical machine. You don't have to do weights. There are other ways to get your abdomen strong.
The side effects to prolotherapy and PRP have to do with the anaesthetic and also where you are injected. You have to make sure that your needle is in the right place. And for that reason ultrasound is very important in terms of guiding treatment along the way. The following video is going to be about prolotherapy. And if you want additional information about PRP, there's a video on my website that you can look and get general information about that. Thank you for listening to the video. My website: https://drstebbing.com Please email me at email@example.com if you have any further questions. Thank you.
– Greater Occipital Nerve
– Cervical Plexus
– Brachial Plexus
– Axillary Nerve Pain/Injury
– Suprascapular Nerve Pain/Injury
– Ulnar Nerve Entrapment or Injury
– Radial Nerve Entrapment or Injury
– Median Nerve Entrapment or Injury
– Superior Cluneal Nerve
– Iliohypogastric Nerve
– Ilioinguinal Nerve
– Lateral Femoral Cutaneous Nerve
– Femoral Nerve
– Genital Femoral Nerve
– Saphaneous Nerve Injury
– Obturator Nerve Injury
– Peroneal Nerve Entrapment or Injury
– Tibial Nerve Entrapment or Injury