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Aurora Health Center

Aurora Medical Clinic getting to the bottom of back pain

Judy Von Rueden of Watertown had all kinds of plans when she retired. With 21 grandchildren ranging in age from six to 20, there's always an opportunity to have some fun, she says with a laugh. She's also an avid golfer and gardener, and thoroughly enjoys the active roles she and her husband have in the local Lions and Lioness Clubs.

“My vision for retirement was to stay busy,” says Judy.

Just over two years into it, however, she found herself spending a lot of time sitting around.

"I started having severe pain in my lower back,” she explains. “I lived with it for awhile, but it got to the point where I could hardly do anything. I could barely get through a trip to the grocery store. The pain would just stop me in my tracks.”

Judy's primary care physician suspected her problem could be related to spinal stenosis, a narrowing of the spinal canal related to arthritis of the spine. Compression of the nerves from the condition can be extremely painful, and Judy was referred to David Tylicki, MD, a specialist in physical medicine and rehabilitation (also called physiatry) at the Aurora Wilkinson Medical Clinics in Hartland and Oconomowoc.

“Back pain is an all-too-familiar problem that can be caused by a multitude of reasons,” notes Dr. Tylicki.

It can occur suddenly in a traumatic incident such as a car accident or fall, or it can develop slowly, perhaps as the result of age-related changes to the spine. According to the National Institutes of Health, approximately eight of every ten people experience back pain at some point in their life.

As a physiatrist and fellowship-trained pain management specialist, Dr. Tylicki enjoys helping patients understand what's causing their back pain and what can be done to relieve it.

“A lot of times, people jump to the conclusion that they're going to have to have back surgery,” he says. “In reality, that's not usually the case. There are many reasons for back pain, and multiple non-operative options for treatment. Even with arthritis,” he adds.

“You get to a certain age and you just think you have to live with it. But there are better ways to manage arthritis today.”

In Judy's case, Dr. Tylicki determined that her pain was more consistent with facet dysfunction rather than spinal stenosis.

“Facet dysfunction,” he explains, “is basically arthritis of the small joints that are located in the back of the lumbar (lower) back.”

The condition is treated differently than spinal stenosis. Using X-ray guided imagery in the Ambulatory Surgery Center at the Aurora Health Center in Waukesha, Dr. Tylicki gave Judy a “facet joint injection” to block the pain at the source with long-lasting medication. The immediate relief that Judy experienced from the injection confirmed Dr. Tylicki's diagnosis and allowed her to comfortably participate in physical therapy to strengthen the back and help prevent future episodes of pain.

For most people, facet injections provide relief for three to four months and can be repeated up to three times a year, notes Dr. Tylicki. If patients continue to have pain, a more lasting approach to treatment of facet dysfunction is a procedure known as radio frequency ablation, a technique where the nerves that supply the facet joint are destroyed by radio frequency energy (similar to microwave heat) rather than surgery.

This procedure also is available at the Aurora Health Center in Waukesha.

For now, however, Judy says she has experienced significant relief and is back on track to enjoying her retirement. Recently, while taking a break from gardening on a beautiful summer afternoon, Judy tells how Dr. Tylicki has given her hope for a normal life again.

“The exercises I learned in physical therapy continue to help, and it's reassuring to know that if the facet injection doesn't last, there are other options out there.”

That's a good thing, she adds, because she's got a lot on her agenda in the coming months, including a 15-day Mediterranean cruise.

“I couldn't have imagined all that sightseeing a few months ago,” she says. “Now I can finally look forward to it.”

If you're suffering from back pain, talk to your physician. A thorough evaluation and diagnosis is the first step to getting to the bottom of the problem. For an appointment with Dr. Tylicki at Aurora Wilkinson Medical Clinic in Oconomowoc, call 262-569-2300, or in Hartland, call 262-369-7040.

The Ambulatory Surgery Center at Aurora Health Center in Waukesha is a department of the Aurora Medical Center of Washington County, Inc.