Back / Shoulder Pain

Back / Shoulder Pain

Back / Shoulder Pain

Back / Shoulder Pain

Back & Shoulder Pain

In addition to the back pain experienced, some individuals have other symptoms that accompany the spinal discomfort including spasms, cramps and stiffness.

Neurological symptoms can also be present, such as numbness, weakness and a tingling sensation. Others can also experience radiating pain from their backs that adversely affect their shoulders, arms, lower-back, buttocks and feet.

As mentioned, shoulder pain can be caused by spinal pain, however it may arise independently as well. Shoulder pain refers to any form of pain that originates from the shoulder or around its joint. This is a common area of the body to experience pain because the shoulder joint is the most mobile on a daily basis, with four tendons that function together. When there exists swelling, inflammation or tearing of any tendons in the shoulder joint, mobility of the arm in any direction can be painful. Most people use their arms throughout their day in more ways than they realize – until pain sets in.

Individuals who suffer from back and shoulder pain may find changes in their behaviour and psychological health. They may notice that they withdraw from physical and social activities, have a weakened immune system, and feel anxious, easily irritable or depressed.

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Cause and Treatment

As the problem of pain is generally caused by a group of nerves that innervate a specific body region, blockage of the nerve can resolve this chronic medical problem.

At our downtown Toronto clinic, we offer peripheral nerve blocks (PNB) to treat patients suffering from chronic back and shoulder pain. A PNB is an injection of anesthetics and steroids to or near a nerve that is causing severe discomfort and it block the nerve’s ability to sense pain.

As a minimally-invasive technique, a Toronto PNB can be an effective alternative treatment for back and shoulder pain. The injection of the anesthetic and steroid into or near the dysfunctional nerve dulls the pain to provide instant relief and reduces inflammation over time.

Although not a long-term solution, a PNB can provide dramatic therapeutic relief for periods of time compared to over-the-counter painkillers.

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How to prepare for a Toronto Peripheral Nerve Block procedure?

A PNB procedure is a simple and elegant solution for back and shoulder pain in Toronto. There is no special preparatory work required prior to the nerve block procedure in our clinic.

How is a PNB procedure performed?

In our clinic, a PNB procedure is performed as an outpatient procedure. However, if a patient requires admission, our physician will discuss the available possible arrangements.

A PNB procedure can be administered to the patient in a matter of minutes. First, our doctor identifies the target area for positioning the needle, using palpation and/or imaging diagnostics. Then, the treatment site is cleaned with an anti-septic solution and the needle is inserted. When administering the needle, the patient will experience a “pinch”. The depth of the needle will depend on the nerve being treated, as the medication should be delivered close to the problematic nerve for maximum effectiveness. Afterwards, patients are monitored for a short period of time in our comfortable clinic before returning home or resuming their daily routines.

More than one injection may be necessary depending on the pain experienced and severity of condition. This will all be discussed with our medical staff prior to a PNB procedure so that you understand what to expect.

What is experienced during a procedure?

As the needle is being inserted, a “pinching” sensation is felt. However, as soon as the medication is delivered, the anesthetic comes into effect and the level of discomfort and pain decreases.

Sometimes, a needle will need to be inserted fairly deep in order to reach the nerve. This can be temporarily uncomfortable but it’s important to stay still to prevent the mispositioning of the needle. We’ll always keep your comfort in mind with topical numbing and gentle techniques to make the experience as brief and easy as possible. Although rare, an injection may also be placed close to a major nerve or nerve bundle, resulting in a sudden jolt. If this occurs, please speak up as the needle needs to be retracted and re-positioned.

Once the peripheral nerve block procedure is complete, the treated area will experience instant therapeutic relief. As the anesthetic wears off, some pain may return. However, the pain will be resolved once the administered steroid comes into effect and reduces the inflammation of problematic nerves. A PNB procedure will typically last from weeks to months. In some cases, a PNB has provided a permanent solution to back and shoulder pain.

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What are the different types of PNB for back and shoulder pain?

  1. Paravertebral nerve block:

A paravertebral nerve block (PVB) is a PNB injection that targets the space that is adjacent to the spinal nerves emerging from the intervertebral foramina, at any vertebral level. A PVB results in a unilateral block of the spinal nerve, affecting the dorsal and central rami, as well as the sympathetic chain ganglion.

This type of PNB has gained popularity due to its ease and efficaciousness.

  1. Facet nerve block:

Facet joints are small joints that are found at the back of the spine. They provide support when rotating or bending the back. Each facet joint contains two nerves, identified as the medial branch nerves. Arthritis, injury and physical stress can cause irritation and inflammation to these joints and their nerves, leading to back pain.

A facet nerve block is an injection containing an anesthetic, such as lidocaine, and a steroid. The injection will initially numb the area to provide pain relief and then, gradually decrease the inflammation to result an in improvement of the pain.

Facet nerve blocks can last for several months and are offered to patients suffering from a number of spinal pain conditions.

  1. Sacroiliac joint injection:

The sacroiliac joint is located below the lumbar spine and above the tailbone. An injection of anesthetic and steroid into this joint is used as a treatment for sacroiliac joint dysfunction that causes spinal pain and discomfort. Once injected, patients experience several weeks to several months of therapeutic relief.

  1. Intercostal nerve block:

The intercostal nerves are the front nerve branches emerging from the first eleven thoracic spinal nerves that primarily assist the diaphragm with deep breathing. Each nerve is located under its respective rib and help to flex the ribs together.

When irritated, these nerves cause a painful sensation that can be treated with an intercostal nerve block – an injection of anesthetic and steroid that provides pain relief.

  1. Trigger point injections:

Stress-induced knots in the neck and back are commonly known as trigger points. These tight knots are often the cause of pain experienced in the back. With trigger point injections, the administration of an anesthetic and a steroid can effectively calm the knots and address the pain.

  1. Spinal accessory nerve block:

The spinal accessory nerve runs along the back of the head, down the neck and into the shoulder blades. It innervates the sternocleidomastoid and trapezius neck muscles, which are responsible rotation of the head, flexion of the neck and elevation of the shoulders. A compressed or inflamed spinal accessory nerve can thus result in chronic pain and reduced mobility of the head, back and shoulders.

To treat this condition, a PNB procedure known as the spinal accessory nerve block can alleviate or minimize the pain caused by this nerve.

  1. Transcapular nerve block:

The transcapular (or suprascapular) nerve begins in the cervical spine and travels outward to the shoulders. It runs underneath the trapezius muscle, across the shoulder blade and innervates the supraspinatus and infraspinatus muscles.

When this nerve is damaged, irritated or inflamed from injury, trauma, arthritis etc. individuals experience pain in the upper back, neck and chest. Sometimes, insults to the transcapular nerve are associated with poor functioning shoulder joints as well.

Therapeutic relief can be provided for pain caused by the transcapular nerve through a PNB injection called a transcapular nerve block. The mixture of an anesthetic and a steroid dissipates the pain, reduces inflammation and improves the range of motion for up to twelve weeks at a time.

A peripheral nerve block in Toronto is often a powerful treatment solution for anyone experiencing chronic back and shoulder discomfort. To see which PNB procedure is most appropriate for your medical need, come speak with our team to learn more.

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Go Painless

Our team at Painless Medicine and Therapeutics focuses on improving our patient’s pain conditions.

Our goal and philosophy is to make the patient’s therapeutic experience as painless as possible by finding a therapeutic plan that best treats their symptoms and lifestyle. We truly believe in collaboration and working closely with patients so that they have control over their medication, and so that the treatment aligns with our clinic’s values.

In cases where chronic pain cannot be cured, but instead must be effectively managed, our team’s purpose is to limit the complications and to minimize the severity of the symptoms experienced by the patient. We wish to optimize our patients’ control over their pain so they feel enabled to be the best possible version of themselves and enjoy life again.

If you are suffering from a chronic pain condition, we highly suggest that you visit our clinic in Toronto to see what we can do for you.