Intradiscal Electrothermal Therapy: A New Treatment for Low Back Pain
Mr. Swanson has been suffering from low back pain for many years. When his pain began, his doctor gave him medications and ordered physical therapy. When there was no improvement after several months, he was seen by a neurologist. The neurologist ordered an MRI and several other tests. However, the results were normal and no further treatment was recommended. Later, he visited a pain clinic where he had several injections (nerve blocks), again without improvement. He started losing hope. His work performance deteriorated and he became depressed. Finally, he heard about IDET treatment for back pain.
Intradiscal Electrothermal Therapy (IDET) is a relatively new treatment for low back pain. It is very important to mention at the start that IDET is not intended to cure every type of back pain. As a matter of fact, only a minority of people suffering from low back pain may benefit from this procedure, since use of IDET is limited to the reduction of pain related to disc disease.
The disc is the soft tissue located between segments of the spine. It acts as a “shock absorber” and also enables us to bend our spines. One of the two most common causes of disc disease is a prolapsed or “herniated” disc. When herniation occurs and is severely compressing the adjacent nerves, surgery might be required to correct the problem. A herniated disc can usually be identified on MRI. However, this kind of disc problem is not correctable with the IDET procedure.
The second case of disc-related low back pain occurs when a disc is “deranged” from inside. A deranged disc can look normal on MRI, but can be a potential cause of low back pain. Because of internal disc injury, the disc tissue itself becomes sensitized and it produces pain when any pressure is applied to it. Therefore, this type of back pain can be made worse by sitting.
The definitive method for diagnosing internal disc problems is a procedure called discography. During discography, each suspicious disc is separately tested for sensitivity to pressure. Certain patterns of disc sensitivity found on discography are a sign that IDET treatment can be beneficial.
IDET treatment consists of a small tube (catheter) placed into the disc tissue under x-ray guidance. Once in the proper position, the catheter tip inside the disc tissue is heated by radio frequency energy. The heat repairs injured disc tissue and decreases its ability to produce pain. Almost immediately after the procedure, the patient can go home. However, it is important to mention that it may take several months for complete healing of the disc to occur and for pain to be relieved. During that period, limited physical activity is recommended.
After seeing a pain doctor familiar with the IDET procedure, Mr. Swanson once again felt hopeful. The doctor performed a discogram and determined that he is an excellent candidate for this procedure. Mr. Swanson is now waiting for his appointment to have the procedure done. He is optimistic but at the same time realistic. He knows that chances are good that IDET will significantly decrease his pain, but also knows that some minor pain may continue.
Stojanovic, M. (2013). Intradiscal Electrothermal Therapy: A New Treatment for Low Back Pain. Psych Central. Retrieved on April 1, 2015, from http://psychcentral.com/lib/intradiscal-electrothermal-therapy-a-new-treatment-for-low-back-pain/000493