PINPOINT HEAT TREATMENTS STOP LOW BACK PAIN COLD
NEW ORLEANS -- Applying heat to a sore back has long been known to provide temporary relief from minor back pain. But what if there was a way to deliver heat treatment with pinpoint accuracy that could relieve severe back pain for weeks or months at a time?
Long-term relief for the nation's number-one pain complaint, lower back pain (LBP), is being refined by anesthesiologists and pain management specialists at The Cleveland Clinic using a technique called intradiscal electrothermal therapy (IDET). The procedure, which precisely delivers heat into the affected disk or disks between the vertebrae that are causing the pain, reduced pain by 75 percent in a study conducted by The Cleveland Clinic Foundation.
The treatment, pioneered at Stanford University two-and-a-half years ago, restores the quality of patients' home, social, professional, recreational and sex lives, according to the Cleveland Clinic study. Researchers found that most patients experienced significant pain relief after two to three months and remained relatively pain-free thereafter.
IDET works only for a specific type of LBP called internal disk disruption (IDD), but since IDD causes about 40 percent of LBP cases, the method could benefit thousands of Americans, anesthesiologist Nagy Mekhail, M.D., Ph.D., said at the American Society of Anesthesiologists annual meeting.
Disk disruption occurs when collagen fibers surrounding the disks begin to deteriorate, usually as a normal part of aging. This tissue layer surrounds the center part of the disk, called the nucleus pulposus. It has a high water content that acts as a shock absorber, but with age, it looses its water content and degenerates.
IDD causes leakage from the nucleus pulposus, which irritates the spinal nerves. It also stimulates the growth of new tissue that contains a large number of pain receptors. Both processes lead to severe discomfort for the patient.
IDET is used to apply heat internally, directly on the ring surrounding the nucleus of the affected disk. The treatment softens and shrinks the collagen tissue, curbs the release of irritating substances and destroys the surrounding pain receptors, Dr. Mekhail said. The method offers a less invasive alternative to surgery for the treatment of chronic and severe IDD, he said.
The procedure takes about 45 minutes to perform. During this time, the patient lies on his or her stomach while the pain management specialist, through the use of X-ray, guides a needle into the affected disk. The physician then navigates a treatment wire through the needle to place it in the ring surrounding the nucleus pulposus. Once in place, the wire is heated gradually for about 17 minutes using an external generator.
Pain management specialists usually treat only one or two disks at a time. Patients then undergo a rehabilitation program for about eight to 12 weeks after the procedure.
"We plan to follow patients for at least two years after treatment," Dr. Mekhail said. "We want to know how this treatment compares to surgery. Do we improve the quality of life long-term?"
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During the meeting a press room will be set up in the Morial Convention Center, room 283-284. The press room will be open from 8 a.m. to 5 p.m. Saturday, October 13, through Wednesday, October 17. The media can call the press room during the dates of the annual meeting at (504) 670-6512. Before the meeting, ASA staff members can be contacted by e-mail, [email protected] or by calling (847) 825-5586. Phil Weintraub, [email protected].
This news release is protected by copyright. American Society of Anesthesiologists attribution is required.Copyright 2001American Society of Anesthesiologists. All Rights Reserved
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