Low back pain is one of the most common complaints seen in pain management. Nearly 90% of people will have low back pain at some point in their life. Low back pain can be either acute (recent injury) or chronic (pain that has been present for some time, usually more than 3-6 months). The most common causes of low back pain include:

• Muscle strain or muscle pain

  • Most common cause of low back pain

• Ligament injury around the spine

• Degenerative disc disease

• Bones spurs

• Trauma

  • Car accident, contact sports​

• Facet joint arthritis​

• Bulging disc

• Pinched nerve (radiculopathy)

• Sacroiliac joint dysfunction

• Scoliosis

• Internal organs

  • Pancreatitis, aortic aneurysms, kidney stones, endometriosis can all mimic low back pain

• Compression fractures

  • Usually caused by osteoporosis​

• Inflammatory arthritis

  • Ankylosing spondylosis, Reactive arthritis​

• Cancer

  • Prostate cancer can spread to the bones (vertebrae) in the low back​

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What type of pain can you experience with low back pain?

Low back pain can be difficult to diagnose due to the large variation of symptoms that can occur. Our pain doctors have been specially trained to accurately diagnose and treat the true source of your low back pain. Depending on the cause, low back pain can either be solely isolated to the low back region or it can be associated with pain going down to the buttocks, thighs, calves and toes. Many common symptoms include: 

• Sharp stabbing pain

• Pain worse with walking and improved with rest

• Pain worse with walking upstairs than downstairs

• Electric pain

• Decreased range of motion of the low back

  • Pain with leaning forward or backwards, pain with twisting side to side​

• Muscle spasms

• Tightness of low back muscles 

• Sharp pain in the low back with coughing or sneezing

• Weakness in one or both legs

• Muscle wasting in one or both legs

• Stiffness

• Numbness and tingling

• Pins and needles

• Burning pain

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How can our St. Louis pain doctors help diagnose your low back pain?

• Thorough history and physical exam. This step is important in identifying the most likely cause of your low back pain. Other tests are used to help confirm what was found on the physical exam. 

• A neurological exam helps determine what nerves may be affected

• Imaging such as Xray, MRI and CT scan

• Bone scan

• A Nerve conduction study and EMG 

  • Vital in finding the location of the nerve damage and determining if the the low back pain is associated with a pinched nerve in the back. 

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What are your treatment options?

After the source of the low back pain has been identified, a treatment plan is created specifically to target that cause of pain. Depending on the diagnosis of your low back pain, a combination of treatment options below may be utilized.

• Non-steroidal anti-inflammatory medications (NSAIDS)

• Cold packs/heating pads

• Interlaminar epidural injections

• Transforaminal epidural injections

• Gabapentin (Neurontin) and Pregabalin (Lyrica)

  • Helps to decrease pain from a pinched nerve or bulging disc

• Trigger point injections

  • Help with muscle spasms or muscle pain​

• Facet joint injections​

  • Used to treat facet joint pain​

• Skin creams and patches​

  • Lidocaine cream, lidocaine patches, capsaicin cream​

• Anti-depressants​

  • Many of these medications have been shown to block pain signals in the spinal cord and brain

• Muscle relaxants​

• Acupuncture 

• TENS​

  • Also blocks pain signals from affected areas​

• Physical therapy

  • Ultrasound, myofascial release, Mckenzie back exercises, Williams flexion exercises

• Massage therapy

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What can you do to avoid or decrease low back pain?

• Exercise​

  • ​The stronger your muscles are, the less prone they are to injury​

 

• Avoid excessive bed rest​​​​

  • Studies shown that bed rest can make low back pain worse​

• Change your mattress

  • Some mattresses can be causing or making your low back pain worse especially if the mattress is too hard

• Strength training

  • Building strong muscles especially in the back and abdomen can significantly decrease spine fractures from osteoporosis

• Stretch low back muscles

• Weight loss

  • For every pound of excess weight that is lost, 7 pound of pressure are relieved from the back

• Reduce stress

  • Yoga, meditation, relaxation techniques

• Use proper technique when lifting or moving heavy objects

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For more information or to discuss an appropriate treatment plan for your low back pain with one of our specialized pain management physicians, call Saint Louis Spine and Joint Pain Specialists today.

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