When you come to EuroPainClinics to see a specialist in minimally-invasive and endoscopic treatment, the first step in your treatment is to accurately diagnose back pain.
For a successful treatment, it is essential to find the main source or sources of pain, choosing the most effective procedure and the most appropriate treatment method for effective pain relief, or a significant reduction in the perception of its intensity, based on precise diagnostics of the spine.
After careful patient history taking, clinical examination and evaluation of the findings on imaging methods, we determine the diagnosis, which is then verified by an interventional test (needle, precise insertion of local anesthesia to the structures) and confirmation of the correct diagnosis (interruption of the pain pathway and its significant reduction to disappearance), we choose the least invasive option to treat the structures in order to achieve subsequent pain relief in the patient.
In order to accurately determine the location of the pain, we perform several types of diagnostic-prognostic procedures. Some of them can already in this step cause a long-lasting relief of pain.
How does the diagnostic procedure work?
Diagnostic procedures are performed on the basis of a decision by a specialist in minimally-invasive and endoscopic treatment of the spine, to detect and confirm the source of the back pain. This is carried out by injecting a substance to the specified structures of the spine, nerve root, intervertebral joint and intervertebral discs.
Where does the procedure take place and who performs it?
The diagnostic procedure takes place on an outpatient basis, in the operating theatre directly at EuroPainClinics. The procedure is performed by a specialist in minimally-invasive and endoscopic treatment of the spine under the control of a mobile X-ray (C-arm), which ensures its safe, accurate and targeted procedure.
How to prepare for the procedure?
No special preparation is required. It should be taken into account that you will lie on your stomach with the lower back exposed, so that the doctor has the best possible access to the spine (we therefore recommend a lighter diet before the visit). The duration of the procedure is up to 30 minutes.
Is the procedure painful?
The procedure is performed in most cases without anesthesia. Except for the small injection that the patient feels, the procedure is not painful. With precise X-ray guidance, the physician targets the exact area to which the medication will be applied, a thin needle is inserted at the nerve root or joint, a small amount of contrast is administered to ensure that the drug is applied to the correct area, and the medication is administered. The physician treats the injection site after removing the needle. After the procedure, the patient may sometimes feel mild back pain or pressure, but this will subside.Pri diagnostickom výkone „Provokačná diskografia“ sa do vnútra platničky vstriekne kontrastná látka, ktorá umožní zobraziť jej štruktúru. Tu, naopak, pacient pociťuje tzv. konkordantnú („svoju“) bolesť, ktorá je potvrdením toho, že zdrojom bolesti je práve poškodená platnička.
During the diagnostic procedure – provocation discography, a contrast agent is injected inside the intervertebral disc to show its structure. Here, on the contrary, the patient feels concordant pain, which is a confirmation that the source of pain is the damaged intervertebral disc.
When can you go home?
After the procedure, you will stay in the resting room for about 15 minutes and then you can (ideally accompanied) go home.
Can complications occur during a diagnostic procedure?
During diagnostic procedures, complications occur rarely due to the sterility and safe administration of the medication to the area under the control of a mobile X-ray (C-arm), which targets this site precisely to the “hundredth” of millimeters.
Exceptionally, transient pain in the area of the procedure, nausea, fainting, or vomiting may occur.
What happens next?
The injection is given to reveal the source of your pain. During the following days, you will observe the post-procedure pain relief effect on the VAS (Visual Analogue Scale) pain scale at regular intervals and inform our workplace of the result.
During your check-up at EuroPainClinics, your doctor will decide if you need to perform another minimally-invasive therapeutic or endoscopic procedure. In outpatient care, the doctor may also decide that no procedure is required.