Treatment Options for Lower Back Pain

When people suffer from back pain, it usually occurs in the lower back, known as the lumbar region. This area tends to bear the brunt of our daily twisting and turning, bending and lifting. It is also where the weight of the upper body comes to rest when we are seated.

Given the amount of action it sees, it is no wonder that more than a quarter of all Americans will deal with lower back pain during their lifetimes.[1] Much of that has to do with the fact that as we get older, we may lose bone strength, muscle elasticity and the spinal discs which provide cushioning between the spinal bones (vertebrae) begin to degenerate. The odds of developing back pain are even greater for those who smoke, are overweight or are sedentary.

Common Causes of Lower Back Pain

• Compression fractures occur when vertebrae lose strength, collapse and press on nearby nerves. 
• Degenerative disc disease develops when the fluid in the discs between the vertebrae dries out and weakens. This causes the discs to bulge out (herniate) and narrows the spinal column (stenosis). This puts pressure on spinal nerves, including the sciatic nerve (sciatica).
• Facet or Sacroiliac joint dysfunction results when these joints within the lumbar spine become inflamed and irritate neighboring nerves.
• Spondylolisthesis occurs when one vertebra slips over an adjacent one and compresses nearby nerves.
• Osteoarthritis (also known as spondylosis or degenerative joint disease) is the result of wear and tear on spinal discs and joints, usually as part of the aging process.
• Trauma such as fractures or dislocations of the spine. 

Will the Pain Last?

Acute back pain, that which often occurs suddenly and can be resolved in a short period of time, is often the result of overuse or poor lifting techniques that cause muscle strains and spasms. Even pain that results from trauma such as a car accident or fall can resolve itself as the body heals.

But for many people, including some of those who initially suffer acute pain, their lower back pain becomes chronic, meaning it does not get better after several months. Chronic back pain is often the result of arthritis, disc erosion and general degeneration that leads to compression and inflammation that irritates spinal nerves.

The good news for patients with lower back pain is that advances in minimally invasive treatments are providing long-term relief and allowing them to enjoy life fully again.

They include:

• Lumbar Steroid Injections: Corticosteroid medication to reduce inflammation is injected into the area surrounding the spinal nerve root that is irritated and causing pain.
• Facet Joint Injections: Corticosteroid medication is delivered directly to worn or inflamed cartilage inside the joints of the lower spine (facets) that control our ability to bend and twist. 
• Spinal Cord Stimulation (and peripheral nerve stimulation) : A small device implanted under the skin delivers precise electrical pulses that interrupt pain signals before they reach the brain.
•  Vertiflex : A small h-shaped spacer is fed through a tube and placed between the vertebrae to expand the space and relieve the pressure on affected nerves caused by spinal stenosis.
• Sacroiliac Joint Fusion: Sacroiliac joint injections and can be used to diagnose and treat SI join Pain

All of these treatments are performed using fluoroscopic (x-ray) guidance to ensure targeted delivery of the pain-relieving therapies. They are performed on an out-patient basis and patients are often able to resume their normal activity level within days.

Dr. Skaribas has been performing some of the most advanced minimally invasive interventions to treat lower back pain for more than 25 years. Fellowship-trained and double board certified in Anesthesiology and Pain Medicine, Dr. Skaribas is nationally recognized for his expertise in diagnosing and treating difficult cases of unrelenting chronic pain. 

Resources:

[1] https://www.statista.com/statistics/188852/adults-in-the-us-with-low-back-pain-since-1997/

https://www.ninds.nih.gov/DISORDERS/PATIENT-CAREGIVER-EDUCATION/FACT-SHEETS/LOW-BACK-PAIN-FACT-SHEET#3102_4