Diagnostic blockages:
Where does the pain really lie?
Questioning. Understanding. Acting.
Perhaps you also experience sudden back pain with increasing intensity when you exert yourself on one leg. The suspicion of a herniated disc expressed by your doctor is apparently confirmed by the magnetic resonance imaging. The images show the typical changes.
But beware! Quick conclusions can lead to ineffective treatments and unnecessary surgeries! Whether there is actually another cause for the complaints can be determined with diagnostic tests.
The principle is comparable to local anesthesia in a dentist’s office: The dentist interrupts the pain pathway by nerve blockade. Because the tooth nerve is an obvious source of pain, pain is relieved for the duration of the local anesthesia.
Diagnostic blockages in the spine work on the same principle. Based on the initial consultation, the physical examination, and the results of imaging, possible pain-inducing structures such as nerves, tendon attachments, or spinal joints are identified and anesthetized individually under X-ray control. If pain reduction is expected following this procedure, a pain generator is identified. If a blockage does not lead to the expected pain relief, it is obviously another structure that is the source of the pain.
Most often, two to three injections are necessary to find the actual sources of pain. The goal is always to create an individual pain map that accurately shows where action is needed. It is the foundation of a treatment plan tailored to each patient individually.
As the duration of the disease progresses, not only does the level of suffering increase, but so does the complexity of the disease and, consequently, the complexity of the diagnosis. Chronic pain that persists for longer than 3 to 6 months and that is inherently prone to becoming self-sustaining—the pain becomes a symptom of an independent disease.
While initially only an anatomical defect of the spine was present, chronification means a vicious cycle of pain, pain-inducing rest, and psychological impairment due to the increased stress level caused by the disease.
Identifying the individual causes of pain is becoming increasingly difficult. The greater the importance of precise diagnosis becomes, which has left behind the concept of a single cause of pain and takes into account the multitude of different factors in the context of an individual pain map. In the case of back pain, our basis for this is the Munich back pain model.
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