Low back pain when using lead apron

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Cruiser

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I'm new to the forum and wanted to see if I could get some advice. I have low back pain a lot of times when wearing the lead apron when doing procedures. I was wondering if anyone else had the same problems, and if they tried anything that helped.

Specifically, are there more comfortable or lighter lead aprons out there that are easier on the low back? Thanks in advance.

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Good question. I'll skip the HPI and physical and get right to the diagnosis: discogenic LBP. At times it bothers me during the day, but not enough to warrant interventions right now. Wearing a heavy lead apron doesn't exactly help.

Epidural, thanks for the links.

I've never purchased an apron myself before. Does anyone know how much "protection" in terms of the apron ratings one should look for?
 
One millimeter lead equivalent is the minimum protection safely used for routine C-arms. 1/2 mm may be used for mini-C arms, but these are not used in pain management. See the fluoroscopy tutorial at algosresearch.org to look at ways to reduce scatter radiation...
 
this is a topic i have a lot of experience with.

i have the same problem (degeneratieve disk disease-discogenic pain) and I spent about $500 for a 2-piece lead alternative that was apparently the lightest you can buy...prestige true-light...and i feel i wasted my money.

how heavy the skirt part is is irrelevant to your back (it can bother knees hips i guess)...but the vest is almost as heavy as all the regular vests i could find in the hospital.

i don't even use it...i just grab a bib with a thyroid shield nowadays, it's much lighter.

the best solution, i think, would be to find a "bib/vest", essentially a 'cut-off' bib, b/c that would minimize back pain. thyroid, gonads, and femurs are the biggest organs we have to worry about, and they would be covered when you turn your back.

this is a serious issue...i know firsthand an interventional rads guy who only does diagnostic for this reason...the interventional cards fellows have mini MIs whenever they get any back pain b/c they worry their days of internvention will be over (angio suites have a lot of radiation)

Here is a very important question:

-Will wearing lighter lead may be disease-modifying in discogenic LBP?

I think not, b/c

1) the literature shows "bedrest" etc is worse for all types of back pain

2) IDET works by frying the nerve endings (purportedly) so deranged disk architecture continues unabated...you just don't feel it

3) if it did we would probably know already



please feel free to correct any inaccuracies here, i'm open minded to any helpful perspectives

-j, ca-1
 
try radmart.com. the apron i bought from them was about 7 pounds. my previous one was almost 15 lbs.
 
I'm new to the forum and wanted to see if I could get some advice. I have low back pain a lot of times when wearing the lead apron when doing procedures. I was wondering if anyone else had the same problems, and if they tried anything that helped.

Specifically, are there more comfortable or lighter lead aprons out there that are easier on the low back? Thanks in advance.

Invest in the Orthotrac pneumatic vest and you will thank me. The lumbar braces that the aprons come w/ are useless. Insurance will pay for this. It is also a good option to know about for patients. I have a patient who sits and transcribes in a static position for 6-8 hrs per day; she refused fusion (for lots of good reasons -- mostly bc she only has axial back pain). She kept her job bc of this brace. It is custom fitted to your body.

http://www.medcompare.com/spotlight.asp?spotlightid=152

Orthotrac Pneumatic Vest - Orthofix, Inc
The new Orthotrac Pneumatic Vest effectively alleviates intervertebral compression and chronic back pain. In fact, associated leg pain is often relieved within minutes of application. The Orthotrac is the only ambulatory treatment shown to decompress the spine. Using patented, patient- administered pneumatic lifting, the vest is designed to lift a weight equal to 30% to 50% of body weight from the lumbar spine onto the iliac crests. A recent study of over 300 patients resulted in a significant (p< 0.01) functional improvement of 70% along with a significant (p<0.01) decrease of 28% in reported pain. Orthotrac can can also decrease the cost of low back pain treatment. A recently published study showed that the Orthotrac vest reduced the total overall cost per patient from $6,138 to $3,699. The Orthotrac vest is designed to provide ambulatory treatment and reduce pain; allowing patients to return to work and to their daily lifestyle with improved quality of life.

Now mind you, I am not a brace-kinda-prescribing doctor -- usually folks become dependent on those silly corsets as symbols of their disability. Most braces are at best proprioceptive reminders to keep your spine in neutral. They also foster a cycle of passive approaches to spine pain. This brace is in a category by itself. It works.
 
So I've been doing a little surfing and it looks as if Greenlite is the material of choice based on the below chart. Demron sounds great but it is even heavier than Greenlite.

Demron does not sell its material to other apron manufacturers, so you can only buy from them. Greenlite is available to other apron manufacturers such as radmart.

HOWEVER, Greenlite and Demron are only .5mm lead equivalent. Do you all agree that 1mm lead equivalent is the minimum acceptable for pain procedures?

Here is a nice comparison chart of the available materials:

http://www.radmart.com/radmartglobal/pages/product_information/lab_reports.php

http://www.radmart.com/radmartglobal/downloads/gl-test_results.pdf

I'd appreciate any feedback.

Thanks!
 
I have intermittent LBP from a bad facet (and it's pissing me off for the past few days). I use a 3/4 length lightweight, that has straps that cross in back and then clasp in front. When my back is hurting me more, I tighten it a little more and it helps a little. Most days it weighs too little to have much effect, and it's been passed by a rad inspector.
 
my days of back pain are almost all gone since switching from apron to 2 piece (vest and skirt) system... what a difference...
 
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I switched to a 2 piece system which helped my neck pain as well as my low back pain. The lumbar RF addtionally helped.
 
0.5mm - couldn't find 1mm

the interventional cardiologists use 0.5 -
 
From

Fluoroscopy: basic science, optimal use, and
patient/operator protection
William J. Davros, PhD
From The Cleveland Clinic Foundation, Section of Medical Physics, Division of Radiology, Cleveland, Ohio.

Techniques in Regional Anesthesia and Pain Management (2007) 11, 44-54



The minimum recommended thickness for protective
appeal is 0.25 mm lead, but many vendors offer 0.35 as
well as 0.5 mm lead. When choosing what thickness of
personal protective apparel is appropriate for a practice,
it is recommended to think of relative use. An occasional
user, say a few cases per week and short “beam-on” times
may consider 0.25 mm; a moderate user, say up to 2 full
days per week and modest “beam-on’ time may consider
0.35 mm; and for a dedicated user, say 3 or more days or
nearly full-time work, 0.5 mm might be prudent to pur-
chase.
 
Quick follow up question to this thread. I am in the process of ordering lead for my practice next year. I tried on some 0.25mm lead aprons and let me tell you, it was very light (about 3.5 lbs). That's just a little more than a big meal for me. in reference to the above post from ligament, has anyone used the 0.25mm lead or the 0.35mm lead and does anyone have any thoughts about its safety?
 
Do your McKenzie/core strengthening exercises du jour and by the thickest one that is comfortable.

That's my plan.
 
my days of back pain are almost all gone since switching from apron to 2 piece (vest and skirt) system... what a difference...


I agree! I was having a lot of back pain, then went with the 2 piece...

then my back was better. Now im lazy, because its a pain to get in and out of a 2 piece 5-10 times a day, so i have been using my one piece, and guess what, my back has been hurting again.

whatever should i do...
 
do what i do --- schedule all of your procedures in block time - that way you don't have to constantly be changing... also FAR more efficient use of your time (and the time of your staff) in my opinion
 
Hey so I am looking at buying aprons and glasses for my pain practice soon. I found this thread from a good 10+ years back. Has anything changed since you guys talked about this topic? Mind you, I do not have low back pain, so I want as much radiation protection as possible. Having said that, what is the standard lead thickness for lead aprons and lead glasses for an interventional pain physician nowadays?

I talked to a Wolf x-ray representative the other day and was told 0.5 mm of lead for aprons and 0.75 mm of lead for glasses are what they make. Apparently there is also 0.35 mm lead aprons in addition to light-weight lead, and lead-free options out there for aprons as well. I am assuming lead weighs more and is cheaper than either light-weight lead or lead-free options. As for the glasses, you can get ones with and without the lead side shields. Do the lead side shields (0.5 mm lead) make any difference in protecting the eyes from scatter radiation, or are they not really necessary?

From

Fluoroscopy: basic science, optimal use, and
patient/operator protection
William J. Davros, PhD
From The Cleveland Clinic Foundation, Section of Medical Physics, Division of Radiology, Cleveland, Ohio.

Techniques in Regional Anesthesia and Pain Management (2007) 11, 44-54



The minimum recommended thickness for protective
appeal is 0.25 mm lead, but many vendors offer 0.35 as
well as 0.5 mm lead. When choosing what thickness of
personal protective apparel is appropriate for a practice,
it is recommended to think of relative use. An occasional
user, say a few cases per week and short “beam-on” times
may consider 0.25 mm; a moderate user, say up to 2 full
days per week and modest “beam-on’ time may consider
0.35 mm; and for a dedicated user, say 3 or more days or
nearly full-time work, 0.5 mm might be prudent to pur-
chase.

Have the recommendations from Ligament's referenced article changed any in the past 10 years?

The next part of my post is on pricing. I looked at several distributors' pricing on lead aprons, and they typically run about $250 or so for just the 0.75 mm Velcro strap-on lead apron, $50 or so for the thyroid shield, and about $500 for the combination of 0.75 mm Velcro strap-on lead apron and thyroid shield. Maybe I am missing something here, but why would anyone buy both together if the cost of buying them separately is $200 cheaper for a set of lead apron and thyroid shield? Does the combination have the clip that connects the thyroid shield to the apron that you would not otherwise get if you bought them separately? How much is everyone spending for lead aprons/vests/skirts and glasses? Any recommendations on sellers that are selling these accessories at more affordable rates would be most appreciated. Most of the links in this thread are no longer active.
 
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