Lower Back Pain

Many cases of lower back pain are linked to muscle or ligament strain or tension and often heal with assistance from at-home remedies or nonsurgical treatment options. At other times pain in the lower back may require lumbar spine surgery.

If you have signs of lower back pain, seek treatment immediately, including advice from a specialist.

Treating Lower Back Pain at Home

Many cases of lower back pain due to muscle or ligament strain or tension will get better on their own with self-care and home remedies, guided by your physician. These treatments for lower back pain relief include:

• Healthy habits, including achieving and maintaining a healthy weight through diet and physical activity, practicing good posture, and learning to lift properly
• Hot or cold compresses, which can bring relief to achy muscles and joints
• Modified activity and rest to allow injuries to heal
• Over-the-counter pain relievers such as ibuprofen, acetaminophen, and naproxen
• Specific back exercises and/or stretching routines, as directed by your healthcare provider
• Mind-body activities such as yoga and meditation

Nonsurgical Lower Back Pain Treatment Options

Our lumbar spine specialists first consider nonsurgical treatment for lower back pain. You may receive:

• Prescription medications when over-the-counter medicines are not sufficient, such as anti-inflammatories, muscle relaxants, or medications like gabapentin that act directly on nerve pain
• Physical therapy is a vital part of your recovery if you have lower back pain. Physical therapists help patients learn about proper alignment of the spine and approaches to move safely while teaching ways to improve strength, posture, and flexibility. Components of physical therapy for lower back pain may include:
• Exercises you learn with your therapist and do at home to stretch and strengthen your lower back muscles and hips
• Manual therapy to facilitate optimal mobility and alignment
• “Palliative” techniques during a physical therapy session or at home, such as applying heat or ice, massage, and electrotherapy (applying tiny electrical currents to affected muscles)
• Steroid spine injections can provide short-term relief from lower back pain and can allow you to engage more fully in physical therapy. Pain relief may be immediate or gradual and can last up to several months.
• Nerve blocks, sometimes called medial branch blocks, are a form of regional anesthesia. With this treatment, the nerve supply to the area of discomfort in the lower back can be temporarily blocked with a local anesthetic (numbing medication). Steroids may be used during the procedure to provide longer-term relief.
• Radiofrequency ablation (RFA) is a same-day procedure performed under light sedation or an anesthetic. The doctor first performs a nerve block to determine the exact source of the pain. A needle is then inserted to target the nerve causing the pain and heat is applied. This heat creates a lesion that blocks pain signals arising from your spine that travels along the affected nerve to the brain.
• Neuromodulation is the use of spinal cord stimulation, peripheral nerve stimulation or multifidus muscle stimulation. This can provide not only pain relief but also a restorative function of muscles that have atrophied.

Lumbar Spine Surgery

You may need lower back surgery if your pain persists despite nonsurgical treatments. Our lumbar spine surgeons use minimally invasive approaches whenever appropriate, operating through tiny incisions or taking a muscle-splitting approach. They use augmented reality technology and computer-guided navigation to complete these procedures precisely and safely.

You may have outpatient surgery, which allows you to avoid an overnight hospital stay and return to the comfort of your home the same day as the procedure. The operation performed depends on the cause of your lower back pain.

• Microdiscectomy. During this procedure, the surgeon repairs or removes a small piece of your lumbar disc, causing lower back pain and nerve compression.
• Discectomy with spinal fusion. Some patients needing more stability have the nearby vertebrae joined together (fused) with plates or screws when the disc is removed. This procedure is commonly used to treat spondylolisthesis and certain spinal fractures.
• Laminectomy. This technique is used to decompress the nerves in your spine. Compression may occur as a result of spinal stenosis and other degenerative changes. The surgeon enters through the back of the spine and removes part of the lamina (the section of bone that covers the spinal canal) to relieve pressure on the spinal cord and nerves.
• Treatment of vertebral compression fractures. During vertebroplasty, the surgeon injects artificial bone cement into a fractured vertebra. The cement stabilizes the bone and prevents further damage from occurring. With another treatment—balloon kyphoplasty—a tiny balloon is first inflated inside the fractured vertebra to restore its height. The cement is then injected into the expanded space to ensure the bone does not collapse again. Both procedures are performed under X-ray guidance.
• Correction of lumbar spine deformities. Abnormal or excessive curvature of the spine may be corrected with spinal fusion using specialized instruments. Och Spine has helped people with spine deformities from across the nation and worldwide. People come to us after surgeries elsewhere have failed.