What Lower Back Pain Might Mean

There is a reason that upwards of 80 percent of all adults will experience lower back pain at some point in their lives.[i] Much of it has to do with the anatomy of the lower (lumbar) spine.

This area bears much of the weight of the upper body before transferring it to the pelvis. This includes the weight of all of the upper body’s bones (including the skull) as well as the organs (lungs, heart, kidney, liver, etc…)

Also, the lumbar facet joints, the small, cartilage-lined points of contact where each individual backbone (vertebra) meets the one above and below it, are vertical and not designed to bear load.[ii]

When the Pain Doesn’t Stop

Acute cases of lower back pain are often caused by muscle or ligament strains from repeated heavy lifting or awkward movements. They come on suddenly and often resolve themselves with basic care such as over-the-counter anti-inflammatories, continued movement to avoid stiffness, and heat or ice therapy.

But chronic lower back pain, that which last for several months and does not resolve with basic treatment, might be caused by a number of conditions, including:

• Bulging (herniated) or ruptured disks occur when the jelly-like center of lumbar discs begin to push against the spinal cord or one of the spinal nerve roots. When this occurs in the lumbar region of the spine, it can cause the spinal column to narrow (spinal stenosis) and often leads to pressure on the sciatic nerve (sciatica.)
• Osteoarthritis occurs when the cushioning cartilage between the vertebrae begins to break down and bones begin to rub against each other.
• Osteoporosis causes the bones to become brittle, which in the case of the vertebrae means they may lose some of their height and become compressed and irritate spinal nerves
• The facet joints mentioned above as well as sacroiliac joints that connect the pelvis to the lower spine can degenerate and cause pain.
• Spondylolisthesis develops when a vertebra slides forward over the bone below it. This usually happens in the lower spine.

Minimally Invasive Treatments to Relieve Low Back Pain

There are several treatments available to help patients who suffer from chronic lower back pain. These include:

• Lumbar Epidural Steroid Injections: This treatment has been used for nearly 70 years with great success. Highly anti-inflammatory corticosteroid medication is injected in the lumbar epidural space under fluoroscopic guidance to reduce swelling of irritated nerves in the lower spine.
• Vertiflex: This innovative new technique uses x-ray guidance to lead a small h-shaped spacer through a tube to be placed between the vertebrae to expand the space and relieve the pressure on affected nerves.
• Facet Joint Injections: These targeted x-ray guided injections deliver anti-inflammatory steroids to reduce painful swelling and inflammation in the area where cartilage between the facet joints has worn down.

These treatments are performed under local anesthetic and do not require hospitalization or lengthy rehabilitation time. Many patients experience pain relief very quickly. These interventions should be performed by a qualified pain management specialist who understands the best course of treatment based on the specific cause of the patient’s pain and the degree of pain they are in.

Dr. Skaribas is double board certified in Pain Medicine and Anesthesiology and has more than 25 years of experience performing minimally invasive treatments to address chronic pain. He was one of the first physicians in the United States to perform Vertiflex. Having performed more Vertiflex procedures than anyone else in the Houston area, he now instructs other physicians on how to perform the treatment.

Resources:

[i] American Chiropractic Association: Back Pain Facts and Statistics

[ii] Physiotherapy Clinic: Spinal Anatomy