For the doctor

Chronic back and leg pain

Appears often in patients that have undergone single or multiple spinal surgeries to solve the underlying anatomical problem but have failed to relieve the pain associated with the original condition. The patients suffer mainly of persistent or recurrent pain in the lower back and legs, most suffer from mixed back and leg pain.
The leg pain component seems to be predominantly of neuropathic origin and the low back component is predominantly nociceptive (activation of pain receptors by algogenic substances).

Treatment

Since chronic back and leg pain has very often both neuropathic and nociceptive pain components it is difficult to define a general treatment path for all patients. The best treatment should be one individualized to the patients needs. Generally, though, non invasive therapies are tested first and according to the results further methods are tested, following the WHO treatment ladder recommendations.

If a patient has already undergone corrective surgery with no results further surgeries should be avoided (scientific lit.). Nerve blocks and oral opioids can be tested and we recommend them to be screened for minimally invasive neuromodulation therapies. For more information on SCS see therapies.

 
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