Back pain, especially lower back pain (also known as lumbago), is one of the most common pain conditions. Four out of five Americans will experience back pain at some point in their lives. Back pain is the most common cause of job-related disability and one of the most common reasons for missed work days. If you have back pain, you’re not the only one.
Back pain is common in part because it has many potential causes. The cause of your back pain will indicate what treatments you need. In many cases, back pain goes away spontaneously after about two weeks. However, if your pain has lasted longer than that, you may need treatment.
Common Causes of Back Pain
Many health conditions can cause back pain. At Edison Spine Center, we are most concerned with musculoskeletal causes. These can include:
- Coccydynia, pain at the base of the spine
- Compression fractures
- Degenerative disc disease
- Muscle and tendon strains
- Herniated discs
- Spinal stenosis, which is a narrowing of the spinal canal that can put pressure on nerve roots
It is important to note that two of the most common spine conditions—herniated disc and spinal stenosis—may not always cause back pain. Back pain is a possible symptom, but these conditions are more likely to cause radiculopathy, which is pain that radiates to the arms or legs. Where the pain manifests depends on which nerve roots are being compressed.
Diagnosing Back Pain
Back pain can be difficult to diagnose. Many times, patients will make an appointment only to have their back pain resolve before they see a doctor. This is the best outcome, but it doesn’t always happen.
If you have chronic back pain (back pain that doesn’t go away), a spine expert may use a number of diagnostic techniques to get to the root of your problem. Most start with a physical exam and medical history.
The exam will determine your ability to sit, stand, move and lift your arms and legs, and your pain level. During the medical history, the healthcare practitioner will want to know of any recent injuries, any past surgeries and any family history of disease, among other items.
If an orthopedic spine specialist cannot determine the cause of back pain through physical exam and medical history alone, he or she may order imaging tests. These tests can include:
- X-ray: Often the first test to be ordered, X-rays can detect or rule out vertebral fractures, bone spurs (osteophytes) from arthritis and other bone conditions. Soft tissue such as muscles, ligaments and intervertebral discs do not show up on X-rays.
- MRI scans: Magnetic resonance imaging (MRI) scans use powerful magnets and radio waves to depict structures inside the body. Unlike X-rays, MRI scans can show soft tissue.
- CT scans: Computed tomography (CT) scans are a composite image made of many cross-sectioned X-rays put together by a computer. These are better than X-rays at showing soft tissue.
Possible Back Pain Treatments
Treatment for back pain will depend on cause. Most treatment plans begin with conservative, nonoperative treatment. This can include:
- Physical therapy
- Corticosteroid injections
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Muscle relaxants
These treatments are also common for idiopathic back pain—back pain where the cause cannot be determined.
If a cause can be pinpointed and conservative treatments have not relieved the pain, likely surgical treatments for back pain include:
- Laser disc decompression: A treatment for herniated disc, this minimally invasive procedure uses heat energy from a laser to heat the disc, which changes the pressure inside the disc and causes the herniation to withdraw, relieving pressure on the spinal cord or nerve roots.
- Microdiscectomy: This procedure is similar to laser disc decompression, except the herniated part of the disc is physically removed.
- Spinal fusion: This procedure uses a bone graft to encourage vertebrae to grow together, thus eliminating painful movement.
- Kyphoplasty or vertebroplasty: These procedures treat vertebral compression fractures. They use bone cement to reinforce fractured vertebrae and restore their height.
- Laminectomy: This is an excellent choice both for stenosis and herniated discs. It removes the rear part of a vertebra to make more room in the spinal canal and eliminate compression of nerve roots or the spinal cord.
If you are bothered by back pain that has lasted longer than two weeks, request an appointment at Edison Spine Center. Our spine and pain management experts will try to uncover the root cause of your back pain and recommend a treatment plan that will work for you.