One of the most common medical complaints that patients seek care for is back pain. Pain involving the low back can present as dull aching pain across the low back with or without sharp shooting pain radiating down the leg. Obesity, cigarette smoking, genetic factors are among the several risk factors that predispose an individual to this type of pain.
There are several causes of for this such as nerve root compression caused by disc herniations and degenerative disc disease, or facet joint pain caused by arthritis. Spondylosis or degenerative changes in the discs and joints is one of the more common causes of back pain. Certain autoimmune conditions, cancers, or osteoporosis can also lead to pain in the back. In some cases, patients experience persistent back or leg pain after spinal surgery even after normal healing has occurred. The diagnosis of the underlying cause of back pain is made by taking an accurate history and performing a physical examination. In some cases, lab tests and imaging such as an X-ray, MRI or CT scan may be indicated.
Most cases of back pain resolve on their own with conservative management. These options may involve a home exercise program, physical therapy and anti-inflammatory medications. In certain cases, based on the cause, patients may require minimally invasive procedures such as epidural steroid injections or radiofrequency ablations. In some cases, such as persistent pain after back surgery, patients may be good candidates for spinal cord stimulation therapy.