Treatment Options For My Lower Back Pain

Lower back pain causes more disability than nearly 300 other health conditions. It is the most common reason that people seek medical help, striking two-thirds of Americans at some point in our lives, preventing us from getting the exercise we need, caring for our loved ones, finishing our daily tasks, and sleeping soundly.

Why do so many of us suffer from lower back pain—and why can it be so debilitating? When we stand, the lower back supports one-third of our weight. And over time, our spines and their associated structures (including 33 vertebrae. 23 discs and 31 pairs of nerves) begin to degenerate. Due to aging, people can not only develop temporary strains and sprains in the lower back, but chronic pain caused by the ligaments loosening and by the discs that cushion the vertebrae drying up and losing their capacity to absorb shock.
Pain Specialist
When discs in the lower spine are out of alignment or become herniated (the outer coating tears and the jelly-like material in the center protrudes into the spinal canal), this can compress or irritate the surrounding spinal nerves, leading to pain that can radiate through part or all of the lower back and legs. In the case of sciatica (compression of the sciatic nerve in the lower back), pain and tingling may radiate through the buttocks and the legs.

In addition to disc problems, other common causes of lower back pain include:

  • bone spurs—bony outgrowths that protrude and can irritate surrounding tissues
  • facet disease—degenerative arthritis affecting the facet joints between the individual vertebrae
  • osteoporosis—decreased bone density and mass that is often associated with aging
  • scoliosis—irregular curvature of the spine
  • sacroiliac (SI) problems—pain in the joint between the sacrum (lower back) and the ilium (hips)
  • stenosis—narrowing of the spinal canal which can cause compression of spinal nerves
  • spondylitis—inflammation of the vertebrae
  • spondylolisthesis—spinal instability due to a vertebrae slipping out of place and thus out of proper alignment

Regardless of what triggers your lower back pain, you should not ignore it. Getting help can allow you to resume playing sports, traveling, and enjoying all the activities you love when you seek relief through a spine specialist, pain management procedures, minimally invasive procedures and other effective treatments.

Minimally Invasive Procedures

When back pain does not improve after six to 12 weeks of nonsurgical treatments, medical intervention is necessary.  Pain management intervention or minimally invasive procedures can provide significant relief. Minimally invasive spine procedures are usually short outpatient procedures entailing small incisions that are just a few millimeters in length.  These procedures can address back pain more quickly—and often more effectively—than other forms of intervention.  Minimally invasive procedures allow patients to recover more quickly than traditional open back surgery.

Minimally invasive procedures used to treat lower back pain can include:

Lumbar laminectomy/discectomy

Removes tissue, bone or disc material causing nerve compression and pain.

Intralaminar lumbar microendoscopic discectomy

Removes the herniated portion of the disc that is causing painful symptoms through a small incision.

Transforaminal lumbar interbody fusion (TLIF)

Removes the degenerated disc that is causing painful symptoms along with any bone spurs in the affected area before inserting a spacer to restore the disc to its natural height and alignment.

No matter which minimally invasive procedure your doctor determines to be appropriate for you, rest assured that compared to conventional surgeries, these procedures are usually outpatient procedures and rarely entail any hospital stay.  They also allow for shorter recovery times, minimal scarring and muscle damage, and a reduced risk of infections or complications.

Non-Surgical Techniques

Sometimes offered in tandem with minimally invasive procedures, non-surgical techniques can also prove effective in treating back pain. Such treatments include:

Medical therapy

Relieves pain with over-the-counter remedies or prescription drugs such as muscle relaxants, steroids, anti-inflammatory medications or short-term painkillers.

Physical therapy

Builds support for spinal structures including the ligaments, tendons, and muscles through the use of techniques such as strengthening and muscle building exercises.

Radiofrequency ablation (also called rhizotomy)

A short outpatient procedure that uses an electrical current produced by a radio wave to heat a specific nerve, eliminating pain signals from that area.

Sacroiliac joint injection

Alleviates pain in the SI joint which links the iliac bone (in the pelvis) to the sacrum (in the lowest part of the spine, just above the tailbone).

Trigger point injections

Locates a trigger point (generally a knot or tension point within a lower back muscle), and injects a numbing medication or saline into the area, alleviating pain.

Other treatments

Include therapeutic massage and three treatments that can also double as diagnostic tools: medial branch block (anesthetic injected into nerves affecting the facet joint); facet injection (administered directly into the facet joint); and selective nerve root block (targeting the specific nerves that cause pain).

Every year, Americans spend an estimated $50 billion on lower back pain. Talk to your doctor to determine if you are a candidate for non-surgical intervention or a minimally invasive procedure.

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