June 11, 2001
Methodist Rehab procedure may help relieve back pain for some patients
By Collin Johnson
Health and Research News Service
JACKSON, Miss.—Lynn Goff’s back pain was so severe he couldn't walk 15 feet without his legs going numb. But a procedure being performed at Methodist Rehabilitation Center has helped Goff, 35, of Clinton, go back to work and countless others like him do battle with back pain.
It’s called transforaminal epidural steroid injection and works for about 80 percent of patients, said Dr. Jeff Summers, MRC pain management specialist.
At the MRC outpatient clinic off of Lakeland Drive, Dr. Summers uses a small pliable needle and an x-ray machine to make certain the needle goes where it should. Using the view from the x-ray as a roadmap, he is able to curve the needle around and into the spinal canal and direct it into the proper nerve to deliver the medication—an anesthetic for numbing and a steroid for reducing inflammation. Patients often see results by the next day, Dr. Summers said.
After his first shot, Goff who is a self employed electrician said he was able to return to work. "Three days later I hurt just every now and then. After the second shot, it got to where I wasn't hurting hardly any," he recalled.
"What I'm trying to do is manipulate the needle directly between the nerve and the disc,” Dr. Summers said. “The reason that could be important is because the disc is the part of the anatomy that's causing the pain and inflammation in the first place."
Patients are given a drug to numb the area of the back where the needle will enter, Dr. Summers said. Once they’ve been prepared, a contrast dye is injected to help the physician see the x-ray images more clearly.
The needle used is less than half the size of a regular epidural needle and is small enough to actually slide through one.
The procedure treats pain related to inflammation of the nerves of the spinal system. With this injury pain radiates down the leg. “Or, if the problem is in the neck, the pain may radiate down the arm and this treatment will help that pain too,” Dr. Summers said.
Patients typically undergo anywhere from one to three injections. While some with back pain still require traditional surgery, the injections offer an alternative for many.
"With back surgery, I was looking at having back problems the rest of my life and now I’ve got a second chance," says Goff. "If I take care of my back and don't hurt it, I've got the chance to continue doing the work I enjoy. That chance was very slim before this treatment."
The transforaminal technique has been around since the early 90s, but a recent study presented at the North American Spine Convention showing how effective it is has caused it to become a more widely used procedure.
Most of Dr. Summer’s patients are referred by other physicians after most other options, except surgery, have been tried. For more information about transforaminal epidural steroid injection, call 601-932-0238.