Nerve burner op to relieve chronic lower back pain

BURninG away nerves in the spine may help ease chronic back pain. A recent study showed that the technique, which uses radio-frequency waves, is 90 per cent effective and may work by blocking pain signals from the spine travelling to the brain, reports the european spine Journal.

Lower back pain affects around a third of UK adults.

treatments range from painkillers and physiotherapy, to surgery, but many patients do not respond, and long-term disability as a result of lower back pain has been estimated to affect around one in six sufferers.

traditionally, chronic lower back pain has been largely blamed on the rubbery shock-absorbing discs that lie between the bones that make up the spine.

these discs, which have a soft centre encased in a tougher shell, can deteriorate with age and wear and tear.

A slipped or herniated disc can also cause pain by compressing nerves in the spine.

but recent research has suggested that, in many cases, the pain may be linked to the vertebra, the 33 bones that make up the spine, rather than the discs.

the so- called vertebral end plate, a layer of cartilage and bone that acts as a buffer between the disc and the boney vertebra, can also be damaged by age-related degenerative changes, leading to inflammation and pain.

sensation to the endplates is provided by the basivertebral nerve, which sends pain signals to the brain that are interpreted as lower back pain.

so far, no treatment has targeted this nerve specifically, which is thought to be the cause

of lower back pain in a significant proportion of patients.

but a new treatment is designed to stop these messages by using radio-frequency energy to destroy parts of the basivertebral nerve. For the procedure, a patient lies face down on an operating table, and a thin tube is inserted through a puncture hole in the back and tunnelled to the painful area previously identified with scans. More than one area can be treated if necessary.

once in place, a radiofrequency generator is attached to the tube and switched on to deliver blasts of energy to target the nerves for 15 minutes.

these are emitted at a temperature of 85c and effectively burn the nerves responsible for generating pain signals.

AstUdy at the University of texas in the U.s. of 28 patients with lower back pain who received the radiofrequency treatment, found that 26 out of 28 patients — 93 per cent — had what were classed as clinically successful results. Half of those on strong opioid painkillers no longer needed them.

Commenting on the research, ian Harding, an orthopaedic consultant at north bristol nHs trust, said: ‘this is an interesting study of a technique to treat a specific group of patients with back pain and has shown some improvement in outcomes, which is good news.

‘the study is well designed but has small numbers with a short follow up, so further analysis of this technique in the long term is awaited.’