Low Back Pain

Overview

Low back pain is the most common condition affecting the lumbar spine, producing discomfort in over six to twelve million Americans per year. The etiology of back pain is complex and commonly occurs after work, home, and auto related accidents, as well as spontaneous occurrences. Pain generators in the lumbar spine are limited to muscle, joint, and nerve.

The most common cause of low back pain in the younger population is muscular, due to a specific movement. A pain response occurs, subsides over time, and usually resolves. As the population ages, patients become more susceptible to joint pain or arthritis, referred to as degenerative joint disease or degenerative disc disease. These can be multifactorial, including physical and psychological factors.

A complete evaluation requires a thorough history of the patient, family history, and imaging. Although MRI is the gold standard, patients should have x rays of the lumbar spine with static as well as flexion and extension views. While an MRI may show degeneration, surgeons treat according to symptoms. In most cases, patients have a transient episode of back pain. If symptoms have improved, the best course of treatment is conservative care.

Surgical treatment for low back pain is reserved for patients who are unable to perform their activities of daily living, have exhausted all conservative measures, and have an abnormality on imaging. Some patients present with significant pain, but if the MRI does not indicate a pain generator, surgery will usually not help.

Symptoms

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Causes

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When to see a specialist

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Non surgical treatment options

We offer comprehensive non surgical treatment plans tailored to each patient's condition, focused on pain relief, mobility improvement, and overall spinal health. While we do not perform these treatments in house, we collaborate with trusted local specialists to ensure you receive the highest level of care.

Physical therapy

We develop personalized physical therapy prescriptions based on your specific needs and refer you to experienced local providers. These programs are designed to improve strength, flexibility, and posture, helping to reduce pain and enhance mobility while promoting long term spinal health.

Epidural injections

For patients who may benefit from epidural steroid injections, we provide expert evaluations and referrals to trusted local physicians who specialize in pain management. These injections can reduce inflammation and nerve related pain caused by conditions such as herniated discs and spinal stenosis, offering significant relief with minimal downtime.

Chiropractic care and acupuncture

Chiropractic care can help patients with leg pain as a component of their condition. Acupuncture works best in the presence of severe muscle spasms. Both are considered alongside physical therapy and medication as part of a comprehensive conservative plan.

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Common treatments include non steroidal anti inflammatory agents, physical therapy, and epidural injections. Acupuncture and chiropractic care can help as well.

Surgical options

Patients are initially evaluated by a physiatrist to ensure all non surgical options, including physical therapy and non narcotic pain management, are exhausted before considering a surgical solution.

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To treat low back pain alone without leg pain, most patients require at least a single level fusion with pedicle screws and an interbody cage.

Recovery

Content pending medical review.