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Shoulder pain can significantly affect an individual’s quality of life, making daily activities difficult to perform. If left untreated, shoulder pain can become chronic and affect not only physical but also emotional health. One treatment option for shoulder pain is steroid injections, which have proven to be effective in managing pain and improving shoulder function.

Steroid injections contain a corticosteroid, a type of medication that reduces inflammation, and a local anesthetic, which provides immediate pain relief. The injection is administered directly into the shoulder joint or surrounding tissues, targeting the source of the pain. The procedure is relatively quick, and patients can usually resume their daily activities immediately after the injection.

Steroid injections are particularly useful in treating conditions such as rotator cuff injuries, frozen shoulder, and shoulder arthritis. These conditions cause inflammation in the shoulder joint, leading to pain, stiffness, and limited mobility. Steroid injections work by reducing inflammation, which in turn reduces pain and improves shoulder function.

Research has shown that steroid injections are effective in reducing shoulder pain and improving shoulder function in the short-term. However, their long-term effectiveness is still uncertain. Some studies suggest that repeated steroid injections may weaken the shoulder joint’s structure and increase the risk of developing other shoulder conditions such as tendon rupture.

As with any medical procedure, steroid injections do have some potential side effects. The most common side effects include temporary pain or numbness at the injection site, mild fever, and headache. However, serious side effects such as infection, nerve damage, or allergic reactions are rare.

Before undergoing a steroid injection, patients should discuss their medical history, including any allergies or underlying medical conditions, with their healthcare provider. Additionally, patients should be aware that steroid injections are not a cure for shoulder pain, but rather a management tool to reduce pain and improve function. Patients should continue to engage in physical therapy and exercise to strengthen their shoulder muscles and improve mobility.

In conclusion, injections for shoulder pain can be an effective treatment option for managing shoulder pain. However, it is important to weigh the potential risks and benefits with a healthcare provider and to understand that steroid injections are not a long-term solution for shoulder pain. With proper care and management, individuals with shoulder pain can find relief and regain their quality of life.

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Are you living with severe pain that just won’t leave your back? Having consulted with your doctor, you have decided to finally get spinal surgery. While traditional open spine procedures can help, there are no guarantees that they will provide relief, and there are plenty of other options.

If you are planning to get spinal surgery, you might want to consider minimally invasive spine surgery (MISS) as one of the options. Compared to traditional open spine surgery, MIS surgery has some note-worthy benefits.

Benefits of Minimally Invasive Spine Surgery

Since MISS uses smaller skin incisions to fix your spine, you get better cosmetic results. The small cuts are around a few millimetres, so they are barely noticeable. There is a reduced risk for blood loss, muscle damage, infection, and pain after the surgical operation.

Another advantage of MIS surgeries over traditional procedures is that the patient recovers faster. The incisions being small allow the body to heal at a faster rate. As a result, you rely less on pain medications while recovering from the surgery.

Since less invasive spine surgery is considered an outpatient procedure, local anaesthesia is used instead of general anaesthesia. There is no need for you to get knocked unconscious while the surgical doctor works on fixing your spine problem. MIS procedures can treat degenerative disc disease, disk herniation, disk pathology, disk bulge, lumbar spinal stenosis, spinal deformities (scoliosis), a pinched nerve (sciatica), neurogenic claudication, lumbar radiculopathy, and a variety of other spinal conditions.

Minimally Invasive Spine Procedures

MIS procedures involve gaining access to the spinal area by passing through muscle tissues. Once the tissues are out of the way, the doctor can work on the spinal nerves, vertebrae, and other spinal system parts requiring attention.

While it is quite known that lasers are used in less invasive spinal procedures, amplified light treatments are rarely used. In most MIS surgeries, small incisions are made to allow instruments and microscopic cameras to move through the cuts.

One technique to access the spinal area is through a tubular retractor. Instead of cutting the muscles, it attempts to dilate soft tissues by using tubes to nudge the muscles out of the way. This strategy clears a path for the surgeon to work on without exposing a huge part of the spinal area unnecessarily.

Sometimes, the surgeon uses a microscope or endoscope to perform the procedure with minimal access. Once the procedure is done, the tubular retractor is removed to allow the dilated tissues to come back together. There is a small chance that incisions might be made depending on what is needed for the surgery.

Sometimes, a procedure might require rods and screws to stabilize the spine when attempting spinal fusion. These instrumentations are inserted through small incisions without dissecting the muscle tissues. Using temporary extenders and navigation robots, they are safely placed more accurately.

Surgeries related to the lumbar spine access the affected area from the side of the body. Since there are fewer muscles from the side, the patient will experience less pain. This procedure uses a tubular retractor while the patient is on the bed in a sideways position.

If the procedure demands it, the spinal area is accessed through the chest near the lungs and heart. Again, small incisions allow cameras and instruments to perform the surgery. There is no need to open the chest or remove some ribs like how traditional spine procedure is usually done.

Recovery After Minimally Invasive Spinal Surgery

Patients who choose less invasive spine surgery recover faster than those with traditional open spine surgery. MISS patients can go back to their regular activities within six weeks. During this post-surgery period, patients are restricted from doing certain activities. The restrictions depend on your health, recovery procedures, and recommendations from your spine surgeon.

Why is it faster for patients to recover from minimally invasive spine surgery than traditional open spine surgery? First, incisions are less than half an inch compared to open surgery cuts that are usually 5-6 inches long. The smaller the cuts, the less time it requires for your body to heal.

Another reason why MISS recovery times are faster is that the muscles attached to the spine were not removed. In open spine surgeries, the muscles are moved out of the way to access the affected area. The muscles are reattached once the procedure is done. Because the muscles are subjected to a remove-reattach process, more healing time is required for open spine surgeries.

Lastly, a speedy recovery is possible with less invasive surgery because the post-surgery pain is greatly reduced. MISS patients experience less pain because the incisions are smaller. The muscles and surrounding soft tissues are not irritated because there was less intervention than in traditional open surgery. All the mentioned factors above also mean less time and medication are required for the patient to fully recover from the surgery.

While traditional open spine surgery can fix spine issues, you might also want to consider less invasive spine surgery. MIS surgery has some advantages over open spine surgery that are worth looking into. Talk to your favourite spine surgeon to address concerns before going through any type of procedure.

About the author, Dr. Mohamed M. Abdulhamid is a neurosurgeon and the Founding Director and CEO of Royal Spine Surgery in Phoenix, Arizona. He is certified in total cervical disc replacement, or artificial disc replacement, in minimally invasive Coflex® procedure, in minimally invasive discectomy and in intraoperative navigation and image-guided surgery. In addition to travelling for work, Dr. Abdulhamid enjoys travelling with his family.  He also enjoys photography and he uses his camera to capture the beautiful landscape surrounding him locally and while travelling

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Cauda Equina Syndrome is classed as a ‘Spinal Emergency’.

The spinal cord extends from the brain down through a canal inside the vertebral column. At each level of the spine, there are nerves branching off from your spinal cord. These are called nerve roots. They are responsible for sending signals to and from the muscles and other structures throughout the body.

The area which we need to concentrate on is the area of the spine which is approximately just above the waist. This area of the spine is where the spinal cord finishes. Below this is the group of nerves which are called the Cauda Equina.

The nerves of the Cauda Equina are responsible for the supply of nerves to the bladder, bowels, and lower limbs and also supply sensation to the skin around the bottom and back passage.

Cauda equina syndrome (CES) occurs when there is dysfunction of multiple lumbar and sacral nerve roots of the cauda equina.

Cauda equina syndrome usually results from a massive herniated disc in the lumbar region. A single excessive strain or injury may cause a herniated disc, however, many disc herniations do not necessarily have an identified cause. The size of the disc herniation that results in cauda equina is often much larger than normal; however, if the spinal canal is smaller due to conditions such as arthritis, a smaller disc herniation can produce CES.

Patients with CES may experience some or all of these “red flag” symptoms.

  • Urinary retention: the most common symptom. The patient’s bladder fills with urine, but the patient does not experience the normal sensation or urge to urinate.
  • Urinary and/or faecal incontinence. An overfull bladder can result in incontinence of urine. Incontinence of stool can occur due to dysfunction of the anal sphincter.
  • “Saddle anaesthesia” sensory disturbance, which can involve the anus, genitals and buttock region.
  • Weakness or paralysis of usually more than one nerve root. The weakness can affect the lower extremities.
  • Pain in the back and/or legs (also known as sciatica).
  • Sexual dysfunction.

If a patient is experiencing any of the “red flag” symptoms above, immediate medical attention is required to evaluate whether these symptoms represent CES.

Cauda equina syndrome typically requires prompt surgical decompression in order to reduce or eliminate pressure on the impacted nerves. Most surgeons recommend decompression as soon as possible, within about 8 hours of the onset of symptoms if symptoms develop suddenly.

Recovering from a spinal decompression procedure such as lumbar laminectomy or discectomy can take about four to six weeks. This timeline depends on individual health factors such as age, general health and the cause of the compression. During that time, activities are gradually increased over time while the incision heals and stitches are removed. People who have sedentary jobs that don’t require much lifting or bending can generally get back to work in about four weeks, but people with physically demanding jobs might need to recover for up to four months before returning to work.

Source: Neurosurgeons, Spine Health Aans, Cauda Equina UK