Low back pain is something that every human being will have to deal with in some capacity in his/her lifetime. We have all “pulled” our backs but as we age and the spine ages, other problems begin to arise; the chronic causes of back pain per se. The modality in which this occurs is quite variable.
While there are acute causes of it, the aspects that, most often, bring patients into the clinic occur due to chronic changes. This includes changes to degenerative disc/joint disease, arthritis, etc. The pathophysiology (the process by which these changes occur) indicates the treatment plan. We can, for the sake of this article divide three regions: lumbar spine, sacroiliac (SI) joint, and neuropathic pain.
In the case of the lumbar spine, disc, joint, ligament changes typically put pressure on the exiting nerve roots which leads to back and leg pain. With the SI joint, its most often caused by friction in a non-mobile joint. Lastly, over time patients can develop chronic nerve damage or a chronic pain syndrome. Each of these is treated differently.
The treatment for back pain usually begins with conservative treatment methods such as physical therapy to strengthen the supporting musculature with the aid of medications to treat any pain, muscle spasms, and/or nerve pain. When these conservative treatment modalities fail to adequately treat symptoms, surgical intervention is warranted.
For the lumbar spine, we can employ a variety of techniques such as decompression procedures, artificial disc replacement, or fusion procedures. For the SI joint, after a comprehensive work up a minimally invasive SI joint fixation has a high success rate in treating symptoms. Lastly for neuropathic pain, we can use neurostimulator therapy in the form of spinal cord stimulators, or peripheral nerve stimulators.
At SCCNS, Dr. Mesiwala regularly treats and operates on patients who have varying issues with low back pain. Over the years his clinical experience ensures that he can employ a multitude of techniques to address the patients’ needs effectively and efficiently.