Low back pain is the most common symptom that patients will report when evaluated in the Rothman Orthopaedic Institute clinic. It can be a significantly disabling condition and patients are rightfully concerned by their diagnosis, treatment options, and prognosis. Here are the five most frequently asked questions about low back pain that patients will ask in the office.
What are the most common causes of low back pain?
Low back pain affects nearly 80% of adults. For most adults, the most common structural cause of low back pain is muscle tightness or soreness known as myofascial pain. The next most common causes of low back pain involve the discs, facet joints, and nerves. The exact cause of low back pain can be determined with a detailed physical exam and imaging by a doctor.
What can I do to treat my back pain at home?
Most low back pain that is muscular will resolve with a short course of anti-inflammatory medications, stretching, and a combination of ice and heat. Stretches such as knee-chest, piriformis stretch, and pelvic tilts can help alleviate low back pain. Muscular back pain usually lasts for one to two weeks. If one suffers from persistent low back pain and has associated pain or numbness radiating down your leg, seek a consultation with your physician.
What treatment options are available besides spine surgery?
The good news for most patients that suffer from low back pain is that their pain will typically resolve with medications and structured physical therapy. Medications include anti-inflammatory, muscle relaxers, and steroids. Narcotics are rarely prescribed for treatment of low back pain.
Interventional pain management is another treatment option, which includes epidurals, facet ablations, and trigger point injections. Alternative non-operative treatment options such as acupuncture, massage, yoga, and chiropractic manipulation may also be considered. Experimental treatments such as platelet-rich plasma and stem cell injections are not currently recommended due to the lack of high quality evidence supporting its effectiveness.
What are the signs I need to see a spine surgeon for my low back pain?
There are certain symptoms that require an urgent consultation with a spine surgeon. These include progressive weakness in the lower extremities and bowel or bladder dysfunction. Fortunately, these symptoms occur very rarely. More commonly, patients will complain of persistent severe pain that is refractory to conservative treatments, including physical therapy, medications, and injections.
What advances have been made in spine surgery?
The goals of spine surgery have remained constant – decompress the nerve and stabilize the spine when necessary. There have been many advances that make spine surgery safer and more effective. Minimally invasive spine surgery allows us to effectively treat the pathology through smaller incisions, allowing faster recovery. Use of intraoperative navigation provides surgeons with the ability to place instrumentation with the highest precision. Advances in biomaterials and biologics allow us to achieve fusion much more reliably. We can now safely perform the majority of our spinal surgeries in an outpatient manner.
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