Lower Back Pain

Causes of Lower Back Pain

Mechanical problems: A mechanical problem is due to the way your spine moves or the way you feel when you move your spine in certain ways. Perhaps the most common mechanical cause of back pain is a condition called intervertebral disc degeneration, which simply means that the discs located between the vertebrae of the spine are breaking down with age. As they deteriorate, they lose their cushioning ability. This problem can lead to pain if the back is stressed. Another cause of back pain is the wearing down of the facet joints, which are the large joints that connect each vertebrae to another. Other mechanical causes of back pain include spasms, muscle tension, and ruptured discs, which are also called herniated discs.

Injuries: Spine injuries such as sprains and fractures can cause either short-lived or chronic back pain. Sprains are tears in the ligaments that support the spine, and they can occur from twisting or lifting improperly. Fractured vertebrae are often the result of osteoporosis, a condition that causes weak, porous bones. Less commonly, back pain may be caused by more severe injuries that result from accidents and falls.

Acquired conditions and diseases: Many medical problems can cause or contribute to back pain. They include scoliosis, which causes curvature of the spine and does not usually cause pain until mid-life; spondylolisthesis; various forms of arthritis, including osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis; and spinal stenosis, a narrowing of the spinal column that puts pressure on the spinal cord and nerves. While osteoporosis itself is not painful, it can lead to painful fractures of the vertebrae. Other causes of back pain include pregnancy; kidney stones or infections; endometriosis, which is the buildup of uterine tissue in places outside the uterus; and fibromyalgia, which causes fatigue and widespread muscle pain.

Infections and tumors: Although they are not common causes of back pain, infections can cause pain when they involve the vertebrae, a condition called osteomyelitis, or when they involve the discs that cushion the vertebrae, which is called discitis. Tumors, too, are relatively rare causes of back pain. Occasionally, tumors begin in the back, but more often they appear in the back as a result of cancer that has spread from elsewhere in the body.
Although the causes of back pain are usually physical, it is important to know that emotional stress can play a role in how severe pain is and how long it lasts. Stress can affect the body in many ways, including causing back muscles to become tense and painful. Untreated depression and anxiety can make back pain feel much worse. Likewise, insomnia, or the lack of sleep, can also contribute to back pain.

Symptoms of Lower Back Pain

• Persistent aching or stiffness anywhere along your spine, from the base of the neck to the tail bone
• Sharp, localized pain in the neck, upper back, or lower back — especially after lifting heavy objects or engaging in other strenuous activity
• Chronic ache in the middle or lower back, especially after sitting or standing for extended periods
• Back pain that radiates from the low back to the buttock, down the back of the thigh, and into the calf and toes
• Inability to stand straight without having pain or muscle spasms in the lower back

What is Sciatic Pain or Sciatica?

Sciatic pain or sciatica is the pain that occurs because a nerve coming from the spinal cord is pressed on (trapped) by a prolapsed disc, or is irritated by the inflammation caused by the prolapsed disc. Although the problem is in the back, you feel pain along the course of the nerve in addition to back pain. Therefore, you may feel pain down a leg to the calf or foot. Sciatic pain can range from mild to severe, but it is often worse than the back pain. With a prolapsed disc, the sciatic nerve is the most commonly affected nerve. The sciatic nerve is a large nerve that is made up from several smaller nerves that come out from the spinal cord in the lower back. It travels deep inside the buttock and down the back of the leg. There is a sciatic nerve for each leg.

Treatment of Lower Back Pain and Sciatic Pain

Spinal Injections: Injections like the Cervical, Thoracic and Lumbar Interlaminar Epidural Injections and Transforaminal injection are injections into the opening at the side of the spine where a nerve roots exits. These injections reduce the inflammation and swelling of spinal nerve roots and other tissues surrounding the spinal nerve root and reduces pain, tingling and numbness and other symptoms caused by such inflammation, irritation or swelling.
Spinal cord stimulation: Spinal cord stimulation is a procedure that delivers low-level electrical signals to the spinal cord or to specific nerves to block pain signals from reaching the brain. Spinal cord stimulation is recommended when other treatments have not been successful, when surgery is not likely to help, or when surgery has failed.

Radiofrequency Ablation: Radiofrequency ablation (or RFA) is a procedure used to reduce pain. An electrical current produced by a radio wave is used to heat up a small area of nerve tissue, thereby decreasing pain signals from that specific area. RFA can be used to help patients with chronic (long-lasting) low-back pain. RFA has proven to be a safe and effective way to treat some forms of pain. It also is generally well-tolerated, with very few associated complications.

Ozone Discectomy (Ozonucleolysis): Injection of Ozone-Oxygen mixture into the disc is a new alternative method of treating patients suffering from back and leg pain (sciatica) caused by disc prolapse. Large number of international studies confirms the efficacy of this treatment and superiority of this treatment over conventional disc surgery.

Surgery: Having back surgery can be a difficult choice. Typically, people consider surgery for back pain only after all other treatments have failed to provide relief. Even then, surgery does not provide significant improvement for everyone. And while the risks of back surgery are generally low, they can be serious in some people.

Lower Back Pain and Sciatic Pain treatment options available

• Ozone Discectomy (Ozonucleolysis)
• Percutaneous Hydrocision Discectomy
• Root Sleeve Epidural Injections/Transforaminal injections
• Cervical Epidural Injections
• Facet Blocks
• Spinal Cord Stimulation
• Radiofrequency Lesioning