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Treatment Options for Lumbar Back Pain

Did you know that lumbar back pain is the leading cause of disability worldwide? There’s no denying the impact this common condition can have on your everyday life. If you’ve been dealing with lumbar back pain for an extended period of time, you are probably searching for a way to relieve it. 

There may be a bright light at the end of this often-frustrating tunnel. Many advances have been made in treating lumbar back pain. According to DISC Sports & Spine Center surgeon Dr. Robert S. Bray, Jr., in more than half of the cases he sees, pain can be successfully managed without the need for surgery. And for those who do require a surgical solution, minimally invasive spine surgery may be the ideal option.

Ensuring You’ve Received a Proper Diagnosis

Not all lumbar back pain is the same, and getting the right diagnosis is key to finding the right treatment. A thorough work-up is necessary to determine whether your pain is coming from a strained muscle, a herniated disc, osteoarthritis, or something else.

Your doctor should get your full medical history, ask for a description of your symptoms, and perform a complete physical exam. Additional tests, including X-rays, CT scans, or MRIs, may also be needed. Your doctor will combine all of this information to arrive at a diagnosis. 

If you don’t believe you’ve received a complete work-up or aren’t confident in the diagnosis you’ve been given, don’t hesitate to get a second opinion. 

Exploring Your Treatment Options

With only rare exceptions, lumbar back pain should first be treated with conservative measures. Conservative treatments include:

  • Over-the-counter pain medications, such as nonsteroidal anti-inflammatory drugs
  • Short-term rest
  • Physical therapy
  • Hot and cold therapy
  • Soft tissue work
  • Prescription medications, such as muscle relaxants and medications that treat nerve pain

Minimally invasive pain-controlling procedures may also be attempted. Some examples are: 

  • Epidural steroid injections
  • Facet joint injections
  • Nerve blocks
  • Infusion systems that deliver pain medication directly to the spine

Surgery should be suggested only if previous treatments have been unsuccessful at relieving your pain and there is an identified structural problem with your spine that can be corrected. 

Sometimes, because of compression on your spinal cord or spinal nerves, you may develop other symptoms in addition to pain. You may experience things such as numbness or weakness in your extremities or problems with mobility. If these symptoms don’t improve with non-operative treatments, this may be another indication for spine surgery. 

In general, it’s always a good idea to ask your doctor, “What’s the least invasive treatment option that will give me my desired outcome?”

Recognizing the Benefits of Minimally Invasive Spine Surgery

Are there times when a large, complex spine surgery may be the best solution? Yes. But often, a minimally invasive procedure may provide an equal or better outcome. Minimally invasive spine surgery utilizes small incisions and special medical equipment to perform the procedure with less trauma to muscles and tissues in the area. Benefits of minimally invasive spine surgery include:

  • Less bleeding
  • Quicker recovery
  • Fewer infections
  • Minimal scarring
  • Shorter hospitalizations

In fact, many types of minimally invasive spine surgery can even be performed in an outpatient setting.

Understanding Common Lumbar Spine Surgeries

Lumbar spine surgery may be used to fix areas of your spine where movement causes pain and/or to relieve pressure on your spinal cord and spinal nerves. Two main categories of lumbar surgery include:

  • Lumbar spinal fusion: For this procedure, a bone graft is used to join two adjacent vertebrae in your back into one solid bone. This stops movement in that area of your spine, often relieving uncomfortable symptoms.
  • Lumbar decompression: A number of  procedures fall into this group, including microdiscectomy and laminectomy. A microdiscectomy removes a portion of a spinal disc that’s protruding into your spinal canal and putting pressure on your spinal nerves. A laminectomy removes part of the bony covering of your spine, called the lamina, enlarging your spinal canal to make more room for your spinal cord and nerves. 

Knowing What to Look for in a Spine Surgeon

Who you choose to treat your back pain may be just as important as what you do to treat it. Take your time when meeting with a potential surgeon. Keep these questions in mind during your meeting:

  • Do you understand your diagnosis?
  • Have you been given a range of treatment options?
  • Are there minimally invasive alternatives?
  • Did you get a second opinion?
  • Is the surgeon experienced in different types of spine surgery?
  • How are the facilities? 

You should feel fully informed and comfortable with your decision.

When it comes to treating your lumbar back pain, there’s a lot to consider. To address this topic in more detail, our team at DISC Sports & Spine Center has created an e-book that can be downloaded at your convenience. At DISC, we believe that understanding your treatment options is the only way to make the best decision for you, and we hope our book will help you in your process. 

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Robert S. Bray, Jr., M.D.

About the author

Robert S. Bray, Jr., M.D. Nicknamed “Dr. Fix-It” by The Red Bulletin, Robert S. Bray, Jr., M.D. makes an art of helping the world’s most elite athletes return to push the boundaries of performance. The neurological spine surgeon, recognized globally for his thorough diagnoses and pioneering minimally invasive approach, is quickly redefining sports medicine, one champion at a time. Dr. Bray founded the state-of-the-art, multi-disciplinary DISC Sports & Spine Center (DISC) in 2006 located in Los Angeles, CA. Read more articles by Robert S. Bray, Jr., M.D..