Lower Back Pain
Persistent or unusual back pain, especially if accompanied by buttock or leg pain, could signify an underlying health problem. If you have had lower back pain for longer than 6 weeks, or if you have experienced a traumatic event or injury to your back, you should come in for spinal imaging and evaluation. Proper identification of the source of your lower back pain will indicate which treatment could best alleviate your symptoms.
- Pain, potentially significant or debilitating, in the lower back
- Pain may radiate down into the buttocks and/or legs (“sciatica”)
- Pain may be dull or sharp
- Pain that is so intense that older patients must lean over a shopping cart, walker, or another assistive device to experience relief (“shopping cart sign”)
- Stiffness or muscle tightness in the lower back, buttocks, or hamstrings
- Burning, tingling, numbness, cramping, or weakness in the legs
- Symptoms may worsen slowly, go through cycles of remaining stable or rapidly worsening, and flare during certain activities or physical movements
- Symptoms may progress and cause permanent numbness, weakness, incontinence, balance problems, or even paralysis
Frequently Asked Questions
The key to determining whether you will need back surgery is to identify the cause of the pain. The first indicators are lower back pain that persists for longer than 6 weeks or if you have experienced a traumatic injury to your back. If you have these symptoms, and especially if your pain radiates down your buttocks or legs, you should come in for spinal imaging and evaluation so that a proper diagnosis and treatment plan can be determined.
If surgery is necessary to resolve your lower back pain, the recommended procedure will be based on the cause of your pain as well as various other factors. For example, if you have lumbar spinal stenosis, your doctor may recommend one of a number of procedures to address this particular problem. If the pain is caused by a slipped disc, lumbar disc replacement may be recommended. Conservative treatment will usually be recommended first, and surgery will be recommended if nonsurgical treatments have not substantially improved your pain levels, if your symptoms are severe or debilitating, or if the spinal nerves are being compressed.
To get a proper diagnosis for your lower back pain, it is best to meet with an orthopedic spine surgeon; as an expert in this area, your surgeon will know what to look for and how to reach a conclusive diagnosis for your lower back pain. A combination of a detailed medical history, physical examination, MRI, CT scan, X-rays, reflex testing, and other evaluation methods may be used to diagnose your condition and ensure that you get the treatment you need.
All surgeries carry some risks. These include but are not limited to reactions to anesthesia, nerve injury, reduced movement, discomfort, failure to alleviate symptoms, and others. The risks of nerve injury are incredibly low due to modern techniques and careful monitoring of the patient during the procedure. All potential risks and the potential benefits will be discussed with you in detail when you are evaluated in clinic.
The details of surgical recovery will vary depending on the surgical technique chosen. In most cases, patients can return home on the day of the surgery or within 1 to 2 days. A back brace may be placed to support the spine as it heals; this may need to be worn for up to several weeks depending on the procedure. Typically, some pain and stiffness are common during recovery but will subside as the tissues heal. More details will be provided for you based on your surgical plan.
In many cases, conservative treatments can provide sufficient relief so that you will not need to undergo surgery. However, it should be noted that some conditions that cause lower back pain can worsen over time. A degenerative or slipped lumbar disc may not cause serious symptoms now but may require operation in the future if your pain worsens or your mobility is greatly reduced. Some causes of lower back pain may even lead to permanent numbness, weakness, incontinence, balance problems, or paralysis. With a proper diagnosis, your surgeon will be able to help you determine whether or not you should undergo surgery to improve your health and quality of life.