Lower Back Pain Treatments

Physical Therapy

Medications

• Nonsteroidal anti-inflammatory drugs (NSAIDs): Over-the-counter options like ibuprofen or prescription NSAIDs can help reduce inflammation and alleviate pain.
• Acetaminophen: A milder option for pain relief.
• Muscle relaxants: These may help relieve muscle spasms that often accompany back pain.
• –Opioids: In some cases, stronger pain relievers like opioids may be prescribed, though they are typically used for short periods due to the risk of dependency.

Chiropractic Care

Cognitive Behavioral Therapy (CBT)

• Chronic pain can take a mental toll, and CBT helps individuals manage pain by changing negative thought patterns and developing coping strategies.

Heat and Cold Therapy

Injections

• Epidural steroid injections: These can reduce inflammation in the affected area and provide pain relief, often for several weeks or months. 

Facet joint injections: These may help if the pain is coming from the joints in the spine.

• Deep Trigger Point Injections: In Many cases the pain is Not originating from the herniated disc or other MRI finding. Instead, the pain is originating from Deep trigger Points within certain muscles. Trigger Points can mimic pain from Sciatica, pinched nerve, radiculopathy, and can be the cause of headaches, neck pain, back pain.
• Deep trigger points are areas of tight, hyperirritable muscle fibers that form within a muscle and cause pain in the local area or sometimes in another part of the body. These points are often deeper within the muscle tissue and are typically more difficult to reach than superficial trigger points. Trigger points are often associated with myofascial pain syndrome and can result from muscle overuse, poor posture, stress, injury, or other factors.
• When pressure is applied to a deep trigger point, it may cause localized tenderness or a referred pain sensation in another area. This referred pain is one of the hallmark characteristics of trigger points, where pain is felt at a site distant from the trigger point itself. For example, a trigger point in the neck might cause pain, tingling, numbness in the head, shoulder, arm, or hand.  Lower back trigger points can cause pain, tingling, and numbness that radiates down the leg, potentially mimicking sciatica/radiculopathy/ pinched nerve.

Percutaneous Endoscopic Discectomy

Percutaneous Endoscopic Discectomy is a minimally invasive surgical procedure used to treat certain types of herniated discs in the spine. It is designed to remove or reduce the part of the disc that is pressing on the surrounding nerves, which is often the cause of pain, numbness, or weakness in the back, neck, or limbs.

How it Works:

• Diagnosis and Preparation:
  • A diagnostic evaluation is done to determine if a herniated disc is the cause of the patient’s symptoms. This may include imaging tests like MRI or CT scans.
  • The patient is typically given a local anesthetic to numb the treatment area and may receive sedation for comfort.
• Procedure:
  • The procedure is performed through a small incision, usually less than a centimeter in length. A needle or catheter is inserted through the skin and guided to the site of the herniated disc using fluoroscopy (real-time X-ray imaging).
  • Once the needle or catheter is in place, laser or radiofrequency energy is often used to vaporize or remove the portion of the disc that is protruding and causing pressure on the nerves. In some cases, a small mechanical device might be used to remove the disc material.
• Effect: The goal is to remove enough of the disc material to relieve pressure on the affected nerve, which can significantly reduce or eliminate pain, numbness, or weakness caused by the herniated disc.

Benefits of Percutaneous Discectomy:

• Minimally Invasive: Unlike traditional open surgery, percutaneous discectomy requires only a small incision, leading to less tissue disruption, smaller scars, and quicker recovery.
• Outpatient Procedure: It is typically performed on an outpatient basis, meaning you can go home the same day.
• Faster Recovery: Most patients experience a quicker recovery compared to traditional discectomy (open surgery), with many returning to normal activities within a few weeks.
• Reduced Risk of Complications: Because the procedure is minimally invasive, the risk of infection, bleeding, and other complications is generally lower than with traditional surgery.

Ideal Candidates:
Percutaneous discectomy is typically recommended for patients who have a herniated disc in the lumbar (lower back) or cervical (neck) spine and have not found relief through non-surgical treatments (such as physical therapy, medications, or epidural steroid injections). It is most effective for smaller herniations that are causing nerve compression and symptoms like sciatica (pain radiating down the leg) or radiculopathy (nerve root pain).