Also called an opioid, a narcotic is a very strong pain medication whose source is the opium poppy plant. Narcotics are considered to be the most powerful of all pain relievers. Narcotic medications are used frequently to relieve post-operative back pain and acute back pain. Narcotics sometimes produce serious side-effects and should be used with a physician’s supervision.
A nerve is a bundle of fibers containing motor and sensory neurons which operate between the brain, spinal cord, and other parts of the body. The nerves, brain, and spinal cord make up the entire nervous system. The nervous system can be categorized into the peripheral (sensory and motor effectors) and central nervous system (brain and spinal cord). There are 31 pairs of spinal nerves that exit through openings in the vertebrae. Damage to any of these nerves may cause neuropathy pain, although it is not yet scientifically established that this is true.
A nerve block is an injection at the site of a problematic group of nerves (plexus or ganglion) that blocks the pathway of signaling from the nerve to the brain. There are different categories of nerve blocks based on what they are used for. These include therapeutic nerve blocks, diagnostic nerve blocks, prognostic nerve blocks, and preemptive nerve blocks.
A nerve root is the part of a spinal nerve that exits out of a vertebra at each vertebral segment of the spinal cord. Any external pressure on the nerve roots, such as a herniated disc compressing the roots, causes back pain known as radiculopathy. Non-surgical treatment for this pain includes physical therapy, exercise, epidural steroid injections, and nerve blocks. A more invasive surgery can also be performed to treat back pain from radiculopathy.
A neural arch is formed by the two pedicles of a vertebra and two laminae which join to form a triangle shape. The neural arches of adjacent vertebrae join together to form an archway called a foramen. The foramen is the passage-way for spinal nerve roots exiting out of the vertebral column. These spinal nerve roots divide further into peripheral nerves that contain motor and sensory neurons for different organs and structures in the body.
Neural Foraminal Stenosis
Neuroforaminal narrowing, also referred to as neural foraminal stenosis, is a narrowing of the passage-way (foramen) through which spinal nerves to exit the vertebral column. This narrowing can put pressure on the spinal nerve roots. This narrowing can occur on both sides (bilaterally) or only on one side (unilaterally). Causes of neuroforaminal narrowing include herniated discs, bulging discs, bone spurs, spondylolisthesis, and facet joint problems. Treatments include both conservative treatments such as physical therapy and pain medications, and minimally-invasive surgery.
A neurologist is a medical specialist trained to diagnose, treat, and manage medical conditions related to the nervous system. Neurologists are not trained to perform surgery; surgery on the nervous system is the job of a neurosurgeon. Neurologists may serve as either principal care providers or consultants to other specialists.
A neurosurgeon is a physician with extensive training for performing surgeries on patients with nervous system disorders. A neurosurgeon can tell whether a patient needs to bypass conservative treatments and go straight to the surgical table. Some indicators for neurosurgery are numbness, muscle weakness, and loss of bowel and bladder control.
Neurosurgery is indicated for patients with more severe symptoms of a nervous system disorder. Symptoms include numbness, muscle weakness, and loss of bowel and bladder control. Some procedures of neurosurgery include discectomy, laminectomy, and spinal fusion surgery. There are higher risks of complications with neurosurgery than with conservative treatment.
Nociceptive pain results when pain receptors in either surface or deep tissues receive an external stimulus such as pressure, extreme temperatures, and nerve irritation. There are two types of nociceptive pain – somatic and visceral nociceptive pain. Somatic pain occurs from stimulation due to injured skin, muscles, bones, joints, or connective tissue. Visceral pain occurs from direct stimulation to the viscera of internal organs through stretching, distension, or ischemia of the viscera. Localization of somatic pain is more precise than visceral pain.
A non-invasive procedure does not involve making incisions or cuts to gain access into the human body. Instead non-invasive procedures incorporate conservative treatment methods such as chiropractic manipulation and physical therapy over an extended period of time. For lower back pain, non-invasive procedures are done first while surgery only comes into the picture if these non-invasive procedures fail.
Non-Steroidal Anti-Inflammatory Drugs – NSAIDs
Non-steroidal anti-inflammatory drugs are used to treat symptoms of pain, fever, and inflammation. NSAIDs are effective because most episodes of back pain involve a form of inflammation as well. The three main classes of NSAIDs used to treat back pain are ibuprofen, naproxen, and COX-2 inhibitors. COX-2 inhibitors present fewer side effects than other traditional NSAIDs.
Non-union, also known as a failed spinal fusion, occurs when the segments of a vertebra do not fuse accordingly after a spinal fusion surgery. During surgery, internal and external bone growth stimulators can be added at the site to increase the activation of fusion. A successful spinal fusion leads to healing of back pain symptoms. Notwithstanding, final fusion does not have to be perfect for pain to be reduced.
Nucleus pulposus is the part of the vertebra that makes up the inner core. The components of the nucleus pulposus include water (main component) and loose collagen fibers. Due to the looseness and elasticity of the inner core, the vertebral disc can withstand pressure from compression and torsion.