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Acute and chronic low back pain is a very common condition affecting up to 80 percent of the population in the United States. Fortunately the majority of patients suffering from lower back pain will resolve their symptoms with simple treatments such as physical therapy, exercises, healthy living and sometimes anti-inflammatory medications. Certain conditions affecting the lumbar spine may cause low back pain that fails non-operative treatments. There are conditions, such as degenerative disc disease, spondylolysis, spondylolisthesis, stenosis, arthritis and internal disc derangement that may require more intensive treatments for low back pain relief. Certain modalities, such as interventional pain management may offer temporary or permanent alleviation of pain by integrating different modalities. Interventional pain management may utilize epidural steroid injections, facet injections, rhizotomies, sacroiliac injections and other modalities that will decrease the inflammatory reaction from the pain generator in the lumbar spine. Patients that do not respond to any of the modalities that are available today for lower back pain relief may be candidates for spine surgery.
Spinal surgery for low back pain, for the most part is elective (i.e. not life threatening). There are very few acute and chronic conditions that cause lower back pain that mandate surgery (lumbar epidural abscess, cauda equina syndrome, tumor conditions of the lumbar spine and certain fractures to name a few). There are many different surgical options that are available. It is important for patients with low back pain that requires surgical intervention to seek care from a physician that specializes in spine surgery only. Different surgical techniques, such as minimally invasive spine surgery, artificial disc replacement, and lumbar fusion have evolved to offer patients a safe and reliable surgical option for their specific condition when applied correctly.
There are other conditions in the lower back that may manifest themselves as buttock or thigh pain, sciatica or pinched nerve and leg cramps. Lumbar herniated disc (slipped disc, disc bulging, pinched nerve) may be as a result of degenerative disc disease or an isolated process as a result of a twisting injury. Herniated discs usually manifest as radiculopathy, pain and numbness or weakness along a specific nerve root that is being affected by the herniation. Lumbar stenosis, a narrowing of the spinal canal that usually causes neurogenic claudication, or pain radiating to the legs when standing or walking. These conditions also usually respond to non-operative treatments and surgical intervention is usually reserved for those with continued symptoms despite extensive attempt at non-operative modalities. |
