Treatment Options

The best lower back pain treatments range from non-invasive lifestyle changes to more interventional treatments. Many are done in combination with other therapies.

1. Rest

For acute injuries where there is active inflammation or painful spasms, rest. Taking a few days off to allow inflammation to subside or your muscles to relax is a great first step.

2. Heat and cold therapy

While you rest, hot and cold therapy may be appropriate. In general, heat relaxes and releases, and cold reduces inflammation. Ask your doctor which therapy is best for you.

3. Exercise and physical therapy

Exercise, especially low-impact, full-body exercise combined with targeted strengthening moves, can help you heal lower back pain for long-term pain relief.

Suffering from more advanced or chronic pain? Physical therapists provide regimens of strengthening exercises to restore core stability, along with stretching routines to restore range of motion.

4. Massage

Muscle tightness and soreness can be relieved by massage. It can also help encourage blood flow to injured areas to speed healing.

5. Medications

Sometimes all you need is a few days of ibuprofen, taken as directed by your doctor, to relieve pain and inflammation.

If spasms continue, your doctor might turn to prescription medications such as muscle relaxers to help you find relief. For chronic pain, antidepressants can reduce symptoms.

6. Injections

There are a variety of injections that can help treat chronic lower back pain. A lumbar epidural steroid injection, a medial branch block, and sacroiliac joint injections are three options that treat various types of lower back pain.

These injections can also be used as diagnostic tools.

7. Lumbar medial branch radiofrequency ablation

Lumbar medial branch radiofrequency ablation (RFA) is a procedure that follows a successful medial branch block. RFA uses heat to damage the nerves that send pain signals to our brain.

This approach can lead to long-term pain relief, especially when combined with physical therapy and restorative exercise

8. Spinal cord stimulation

This minimally invasive device replaces chronic pain signals with a mild electrical current. The current produces a slight tingling sensation on the skin, replacing the feelings of pain.

For many patients, this represents a great option to avoid more invasive surgery.

9. Surgery

Surgery is a treatment of last resort for unresponsive back pain.

Surgery is used to repair damage and restore your back’s structural integrity to prevent further injury. Always talk candidly with your doctor about less invasive options to attempt before surgery.

Symptoms

Lower back pain symptoms are familiar to anyone who suffers but can vary from person to person.

Depending on what causes your pain, you may experience some or all of the following lower back pain symptoms:

• Pain in the lower back
• Inability to point big toe upwards
• Numbness in leg
• Pain radiating down your leg
• Pain that worsens with inactivity or activity
• Weakness in legs

Loss of bowel or bladder control is a rare symptom of a dangerous condition that requires emergency medical care. If you experience this system, head to the nearest emergency medical provider.

Diagnosis/Tests

A full medical history is the first step towards an accurate diagnosis. This helps your doctor determine the best course of treatment and to see if there are underlying issues to address.

Your doctor will also conduct a physical examination to test your range of motion and pain levels. If the medical history and physical exam do not provide enough information, they may order diagnostic testing.

Possible diagnostic tests for lower back pain include:

• Blood tests
• Bone scans
• CT scans
• Discography
• Electrodiagnostic tests
• MRIs
• Myelograms
• Ultrasound imaging
• X-rays

Diagnosis also depends on the location of pain, the history of the injury, and the determination if there has been a prior injury.

Types

Lower back pain can be divided into three distinct types, each with their own characteristics.

1. Axial pain: This is mechanical pain that occurs due to strain placed on the muscles that run along the sides of your spine
2. Radicular pain: Also referred to as radiating pain, this is sharp, shooting pain that radiates outward
3. Referred pain: Referred pain comes from another part of the body and is usually dull and achy

Causes

For as strong and beautifully constructed as the back is, there are many different ways it can lead to pain.

The most common lower back pain cause is pulled or torn muscles or ligaments. Anyone who has spent a long day weeding a garden or working at a construction site knows what this feels like!

Other lower back pain causes include:

• Bone and joint conditions
• Compression fractures
• Degenerative disc disease
• Herniated discs
• Lumbar strain
• Mechanical issues
• Osteoarthritis
• Soft-tissue injuries
• Trauma
• Tumors

Pregnancy often causes lower back pain that resolves after birth. Additionally, issues with the organs (e.g., kidneys and ovaries) can cause lower back pain that is unrelated to any of the above conditions.

Facts

Lower back pain is one of the leading causes of disability worldwide. It costs the U.S. an estimated $50 to $80 billion dollars in direct medical costs annually, and another $15 to $20 billion in other costs (e.g., lost productivity and wages). In the U.S, we miss almost 187 million days of work due to lower back pain; it’s one of the most common reasons people call in sick.

Across the globe, women are more affected by lower back pain than men.