Frequently Asked Questions
The Pain Center
of Western Washington
What is spinal stenosis and how is it treated?
Spinal stenosis is a condition where the spinal canal, which the spinal cord and the nerves attached to it pass through, is narrowed. It can occur anywhere in the spine but usually occurs in the low back and neck. It can be present from birth, but more often occurs in later years due to degenerative arthritis. It may also occur secondary to trauma, infection or cancer. The symptoms include low back pain relieved by bending forward or sitting, and leg pain or cramping. Treatment includes physical therapy, oral medications, or cortisone injections to the affected area of the spine. If those are ineffective it may require surgery for decompression.
If you think you have this condition, or have already been diagnosed with it, please contact us for an evaluation.
I have low back pain and it was recommended to me by my doctor to have a cortisone shot. Should I be worried about cortisone?
Cortisone is a generic term for a class of medications used to treat pain and inflammatory conditions. It can refer to hydrocortisone, prednisone, dexamethasone and several other medications, all of which are a form of steroid known as glucocorticoids. These have different functions than anabolic, or growth steroids, such as testosterone.Cortisone relieves pain by reducing inflammation, and also by inhibiting transmission through special nerve fibers called C-fibers. It reduces inflammation by inhibiting an enzyme, which is active in inflammatory conditions. When used in large doses and/or for long periods of time, side effects can occur, such as water retention, weight gain, dry mouth, and it can exacerbate hypertension, temporarily raise blood sugar in diabetics and cause thinning of the bones and skin in long-term use. Cortisone can be given orally, by inhalation or injection. Cortisone can be very effective in treating low back pain, as long as it is used in moderation and for the proper condition.
I sprained my ankle 6 months ago, and have developed reflex sympathetic dystrophy (RSD). What is RSD and how is it treated?
RSD is also known as Complex Regional Pain Syndrome (CRPS), and is a painful nerve problem that usually occurs in the hand or foot. It can be triggered by something minor, like a cut or sprain, or something more severe, like a bone fracture or surgery. If left untreated it can spread to involve the whole limb and other body regions, and can be potentially disabling. It starts with severe burning pain and skin sensitivity, with swelling and discoloration. It can advance and the skin will shrivel and dry out, the limb will weaken and there will be lost function of the limb. It should be aggressively treated with physical and occupational therapy, oral medication, nerve blocks and possibly surgery to destroy the affected nerve, or an implanted spinal electrical stimulator. See us for an evaluation if you think this may be affecting you, or your doctor has diagnosed you with this condition.
I recently had shingles, and now the rash has healed and it still hurts. What should I do?
Shingles is a rash that occurs in a specific area of the body. It is caused by the same virus that causes chicken pox, which lies dormant in certain nerve cells in the body after a person has had chicken pox. The virus is reactivated in response to stress, trauma, or with a weakened immune system. It should be aggressively treated by your doctor with anti-viral and anti-inflammatory medications, and pain relievers. If pain persists after the rash heals, it may be a condition called Postherpetic Neuralgia, or PHN. This is a severe, burning pain in the area of the scar from the rash, and may persist for up to a year or longer. It is difficult to treat, but may respond to cortisone injections, topical creams or ointments, or nerve blocks. It should also be treated by your doctor with pain relievers.