NECK-BACK-PAIN-1Knots In Back – Pain in the back area can range from mild discomfort to severe pain. The muscle knots you feel, also referred to as trigger points, don’t have to be a way-of-life. Muscle knots in the back are places in the muscle where contracted fibers cannot release. These trigger points do not get enough blood flow int he area causing an excessive amount of metabolic waste and oxygen. The brain sends signals to the muscle directing it to relax causing a lack of usage. The result is a muscle area that becomes tight – creating the knot.

Treatment is available but a thorough medical evaluation and diagnostic testing procedures should be performed prior to beginning any treatment in order to determine the treatment process that will be most effective. The following describes some of the evaluation testing procedures that can be performed to help confirm the cause of back pain.

The causes of back pain can be very complex, and there are many structures in the lower back that can cause pain. The following are used to test for the cause pain:

  • X-RAYS – An X-Ray provides an image that can be used to evaluate bones, joints and degenerative lesions in the spine.
  • CAT SCAN (CT) – Used primarily when problems are suspected in the bones or when a patient can?t obtain an MRI.
  • MAGNETIC RESONANCE IMAGING (MRI) The most common test to evaluate the lumbar spine. Evaluates:
    • Vertebral bones
    • Discs
    • Joints
    • Nerves
    • Soft tissues
  • MYELOGRAM – where dye is injected into the spinal column and then the area is flexed and x-rayed.
  • DISCOGRAPHY – Discography is a diagnostic procedure used to determine the level of the painful disc.
  • EMG – The EMG/Nerve Conduction Study is a useful test to study the nerves in the arms and legs.
  • BONE DENSITY – Bone density testing is fast, painless, and noninvasive. During a test, patients lie fully clothed on a padded treatment table while the machine scans one or more areas of bone. The entire test normally takes only minutes.
  • BONE SCAN – A Bone scan in Nuclear Medicine is a procedure which involves two steps:
    1. The patient is asked to arrive 3 hours before their actual scan to receive an injection of a small amount of radioactive tracer that is “tagged” to a calcium like material. Usually the tracer is injected in a vein in the arm of the patient. In some instances, other sites of injection are used especially for those patients that had difficult veins to find. The “radiopharmaceutical” has no side effects and because of this, the patient can be released from the department for 3 hours to give the calcium time to circulate and be taken up by the bone. There are no dietary restrictions so the patient may eat before and after the injection.
    2. After the three hours has elapsed, the patient returns to the Nuclear Medicine department for their scan. The patient is placed on a table a head to toe scan is performed by a “gamma camera”.

Whether you are an athlete or a desk jockey, a knot in the back or other back pain may be a reoccurring issue. At Apex Physical Medicine, the team is equipped to work with chronic back pain and refer you to other professionals that run testing. Contact Apex for a consultation.

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