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Treating Lower Back Pain

Pain in the lower back can be caused by a variety of conditions. A review of anatomy will help to understand the potential sources of pain. We’re here to help walk you through the major causes of discomfort and strategies to offer relief.

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Understanding the Source of Low Back Pain

Photo Credit: AA0S

There are different types of vertebrae (bones) in the spine: seven vertebrae that make up the cervical vertebrae in the neck, twelve thoracic vertebrae, five lumbar vertebrae, and five fused sacral vertebrae. Vertebrae are separated from one another by intervertebral discs. These discs have a tough cartilage exterior called the annulus fibrosis and a jelly like center called the nucleus pulposus. The soft center allows the intervertebral discs to absorb impact in the spine and permit a range of mobility. The annulus encases the nucleus, providing a solid support network for the nucleus to move in.

Vertebrae articulate with one another through facet joints. This minimizes rubbing against one another, and helps to maintain the relative position of vertebrae. Between the area where the intervertebral disc sits (the vertebral body) and facet joints, there is an opening called the vertebral foramen. The spinal cord passes through the vertebral foramen, branching spinal nerves that extend out at locations between the vertebrae (varies at different sections of the spine).

Lower back pain correlates to the lumbar section of the spine. These five vertebrae are often seen abbreviated as L1 (lumbar vertebrae #1) with a number of 1-5.

[box]Dr. Hamid Mir Explains the Source of Bain Pain

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Call 310-574-0400 to schedule an appointment with a board-certified specialist.

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Causes of lower back pain

Lower back pain is a common complaint that can become symptomatic as early as one’s 20’s or 30’s. Pain may stem from a variety of tissues, including muscles of the lower back, nervous issues, or pain resulting from issues with the intervertebral disc. It is important to consider that pain may be the result of a combination of problems in the lower back. Additionally, lower back pain is often categorized as either acute lower back pain, or chronic lower back pain.

Muscular problems in the lower back are often quite painful, but subside after a few days of inactivity. Incorrect technique while lifting heavy objects can often lead to lower back pain. Adequate rest and corrected technique will help to avoid future injury. The ligaments of the lower spine may also be affected by a more traumatic event. Similarly this type of injury will heal with adequate rest.

Pain may be the result of compression of the spinal cord and/or the spinal nerve roots at a particular area of the back. Sciatica is a common example of this, where pain felt in the lower back radiates down the buttocks and leg. Compression of nerves may be caused by degenerative disc disease and the resulting complications, a herniated or bulging disc, or a type of spinal stenosis. Less frequently, compression is due to an inappropriate mass of tissue, such as a cyst or tumor.

In some situations, vertebral bodies will fracture, altering the alignment of the spine and putting pressure on surrounding nerves. This is more common in patients who suffer from osteoporosis, or post-menopausal women.

Fibromyalgia, which affects the joints and causes diffuse muscular pain, is an additional possibility to describe lower back pain. Infection may also be present, as in the case of spondylitis, osteomyelitis, or sacroiliitis. Arthritis of the facet joints (osteoarthritis) may also cause discomfort. Rubbing of the joints due to arthritis can create reactive bone spurs that frequently crowd the exiting spinal nerves.

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What can the physician tell me?

If you are suffering from chronic lower back pain, consider contacting a physician at DISC.

Administration of a physical examination, in conjunction with X-Ray, MRI, or potentially a CAT scan will show definitively the source of lower back pain. In some circumstances, injection of a small amount of dye around the spine (a myelogram) will be used to visualize the source of nerve constriction. All imaging at DISC is performed in house, providing patients a fast, accurate diagnosis, without the need for multiple office visits.

What can be done?

Many types of lower back pain are manageable through physical therapy, anti-inflammatory regiment, and appropriate rest. In specific circumstances, alternative methods of healing such as acupuncture, or chiropractic treatment, may be helpful in alleviating symptoms. The majority of DISC patients do not require surgery for their low back pain. A coordinated team of physicians across a broad range of specialties work together to design the most appropriate treatment plan for each individual patient. Many patients achieve lasting relief through a combination of physical therapy, soft tissue treatment, targeted strengthening using Med-X conditioning, and other conservative modalities. Some patients find relief through targeted pain management injections. Pain management procedures are performed in DISC's ultra-clean, state of the art surgery center. These relatively painless procedures relieve pain and help patients to increase mobility and range of motion and aid in the natural healing of the body. Surgery is only considered when a patient's condition presents a significant risk to the patient's health and well being, or is causing a debilitating hindrance to the patient's ability to function or quality of life. Performed on an outpatient basis, with most patients returning home the same day, minimally invasive spine surgery offers patients lasting relief from pain associated with conditions of the lower back. Patients experience a rapid recovery and return to a dynamic and active lifestyle.

As can be seen in the origins of lower back pain, the solutions are highly dependent on the root cause of discomfort. By consulting a physician and establishing the source of pain, a plan of action can be formulated.

If non-surgical methods are unsuccessful, surgical options offer a high success rate. Problems associated with stenosis or intervertebral discs may be treated by minimally invasive surgeries, such as microdiscectomy, foraminectomy, or vertebral fusions. In some cases a disc replacement may be used, to preserve the mobility between two vertebrae. Minimally invasive outpatient surgery at DISC has provided over 7,000 patients with relief, minimizing microdiscectomy risks and other dangers in the process. Maintaing a 97% excellent patient satisfaction rating and zero MRSA surgical infections, the DISC team of physicians and staff are committed to providing effective, reliable compassionate patient care.

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For more information about low back pain visit American Academy of Orthopedic Surgeons-AAOS