New study – Effectiveness of epidural amniotic fluid injection for low back pain

February 4, 2021/in Back Pain, News /by Matthew Thorson

A study was recently completed on the use of epidural amniotic fluid for lower back pain. Dr. Matthew Thorsen was involved in the study, which was published in The Spine Journal Volume 20, Issue 9, Supplement, September 2020, Page S82

The study concluded that AF epidural injections are most effective for patients with lumbar HNP and moderately effective for those with stenosis. AF injections for DDD patients gave inconsistent results. See below for complete details or click here.

BACKGROUND CONTEXT

Epidural corticosteroid injections have long been used to treat pain and inflammation associated with lumbar HNP, DDD and spinal stenosis symptoms. amniotic fluid, AF, is rich in the components that are believed to contribute to healing by minimizing inflammation. AF injections in nonspinal conditions have been shown to be safe and avoid adverse effects related to steroids.

PURPOSE

To investigate the efficacy and safety of a single amniotic fluid injection into the epidural space for the treatment of low back pain. Specifically, this pilot study is to define indications for future large-scale comparative studies. Three diagnostic LBP patient groups were evaluated, HNP, stenosis, and DDD.

STUDY DESIGN/SETTING

IRB approved prospective three cohort clinical study.

PATIENT SAMPLE

Patients were enrolled who had LBP and leg symptoms for more than 3 months with clinical and MRI findings for HNP, stenosis or DDD. Inclusion criteria necessitated that patients had not responded to medications, physical therapy, and chiropractic.

OUTCOME MEASURES

Back pain and leg pain VAS, ODI, PROMIS, pain medication usage.

METHODS

After obtaining consent, 20 patients in each diagnostic group, had 2mls transforaminal epidural AF injected at symptomatic level using fluoroscopy. Pre- and postprocedure outcomes were obtained with follow-up outcomes obtained at 2 weeks, 6 weeks, 3-4 months, 6 months and 1 year.

RESULTS

The average age (± SD) of HNP, stenosis, and DDD patients was 39±13, 57±10, 44±14 respectively. There were no complications or other adverse effects. HNP patients had the greatest reduction in symptoms with average LBP VAS improvement from 6.5 to 2.4, leg VAS from 5.7 to 1.5, and ODI from 35 to 6. Stenosis patients had LBP VAS from 6.1 to 3.7, leg VAS from 6.0 to 2.2, and ODI from 41 to 29. DDD patients had LBP VAS from 6.8 to 4.6. Within groups, HNP had significant improvement at all follow-ups for VAS back & leg pain, Pain Diagram, ODI, and PROMIS-Phys. Stenosis patients had significant improvement at all FU <8 months for VAS back & leg pain, Pain Diagram, ODI, and PROMIS-Phys. DDD group had significant improvement at all FU for VAS back pain. Between groups, there was no difference in pretreatment measures. HNP had significantly greater improvement in VAS back & leg pain, & ODI compared to DDD.HNP had significantly greater leg pain improvement compared to Stenosis. Stenosis patients had significantly greater improvement in VAS leg pain compared to DDD. HNP patients had the greatest reduction in pain medications. Of patients that failed AF, 2 HNPs had discectomy and 4 DDDs had fusion/TDR which is dramatically less surgery than in prior steroid injection studies by the authors

CONCLUSIONS

AF epidural injections are most effective for patients with lumbar HNP and moderately effective for those with stenosis. AF injections for DDD patients gave inconsistent results. Future prospective studies of AF vs steroid injections are warranted for HNP and stenosis patients.

Dr. Matthew Thorson Featured by Mpls.St.Paul Magazine for Expertise in Regenerative Medicine

November 25, 2019/in News /by Matthew Thorson

Mpls.St.Paul Magazine recently released its 2019 ‘Faces of Minneapolis-Saint Paul’ special edition, which features our own Dr. Matthew Thorson as the face of Regenerative Medicine. Dr. Thorson is one of the leading regional experts using Stem Cell Therapy and Regenerative Medicine to treat chronic pain and illness, helping patients avoid surgery by offering a wide range of conservative but safe, effective treatments. View the feature below to learn more – to schedule a consultation with Dr. Thorson or any of our expert providers, call (612) 207-7463.

Best Places to Live if you Have Chronic Pain

August 25, 2019/in News /by Matthew Thorson

Although many people assume it’s a myth, the climate in which you live can have an impact on your chronic pain. In this article, we will talk about how weather and climate can affect your pain, and some of the best areas to live if you are in chronic pain.

How Weather & Climate Impact Pain

You may have heard your grandpa complain about knee pain when it gets cold or right before a storm. It’s been parodied in movies, tv, books, etc. for decades, and many people assume it’s just an old wives tale (i.e. not true).

But the truth is that cold weather can lead to an increase in joint pain. Changes in air pressure can also lead to headaches and pain in the joints – especially in people who suffer from arthritis or chronic pain conditions.

Knowing that, you may assume that warm weather climates are the best for people who suffer from chronic pain. Many older patients do migrate to warmer climates when they retire, and one of those reasons is often to ease their chronic joint pain. However, there are many other considerations you need to take into account before packing up your life and moving.

Other Considerations

Of course, weather should not be your sole criteria when you are considering a move to lessen your pain. Family, friends, work, and other considerations should take precedent. One of the most important things you need in the fight against chronic pain is a pain management doctor who understands your condition. If you already have a trusted pain doctor in your area, that may be reason enough to stay put (even if you live in a frozen tundra like Minnesota). A great doctor in a cold climate is better than a bad doctor in a warm climate.

If you have any questions about how to treat your chronic pain, contact a pain management physician as soon as possible. At Advanced Spine & Pain Clinics of MN, our board-certified pain doctors have been treating Minnesotans with all manner of pain conditions for over 20 years. Call our office today to set up your appointment.

How Pain Impacts Your Vital Signs

May 8, 2019/in News /by Matthew Thorson

Vital signs are measurements of the body’s basic functions. Doctors routinely check these vitals in emergency situations, as well as during routine checkups to get a sense of the patient’s overall health and well-being. There are four basic vital signs: temperature, pulse, blood pressure, and respiration. In this article we will talk about how pain can influence a patient’s vital signs.

Temperature

Testing your internal body temperature is a good way to tell if your body is suffering from an infection or other malady. Pain often goes hand-in-hand with an increased body temperature. When your body is dealing with an injury, illness, or infection, your temperature goes up as your body attempts to resolve the issue at hand.

Pulse

Pulse is a measurement of your heart rate. Doctors, nurses, and other medical professionals often check your pulse by holding two fingers to your wrist or neck and counting the heart beats. An increase in heart rate is a typical response to pain in the body.

Blood Pressure

Blood pressure is a measurement of the pressure of the blood within the body’s circulatory system. Increased blood pressure is another common bodily response to pain.

Respiration

Respiration is a test of your ability to breathe. When your doctor uses his or her stethoscope and tells you to breathe in and out during a clinic visit, they are checking your respiration rate.

At Advanced Spine & Pain Clinics of MN we treat the full scope of a patient’s pain and other symptoms. Our pain management physicians have over twenty years of experience helping Minnesotans reduce their pain and keep it at bay. If you are going through life in pain, stop dealing with it and get the medical attention you need. Call today to set up your own appointment with a pain physician who can diagnose and treat your pain. Our primary clinic is located in Edina, but we treat patients throughout the Twin Cities and surrounding suburbs.