About Lower Back Pain
Lower back pain can be a sharp, throbbing sensation that is isolated in the lower spine area. Our spinal cord and nerves are complex systems that consist of bones, discs, tendons, and muscles that can be damaged by many factors. If you are experiencing discomfort in your lower back, the first step in identifying the underlying source of your pain is considering the type and severity of your symptoms. As a general rule, any back pain that goes away within a few days with or without medication is classified as acute. If the pain persists for more than a few months, it is considered chronic and it should be thoroughly investigated in order to determine its cause. This is not an easy process and should be performed by a licensed healthcare professional, like our doctors at Tricity Pain Associates. We have offices all over the state of Texas and invite you to contact us to discover the location nearest to you so we can help alleviate your pain.
Acute Back Pain
The most common and best understood type of pain is acute pain. Acute pain will result when tissue is injured by trauma, surgery, illness, or infection. This type of pain is generally understood and expected. It is typically sharp, shooting, aching, or burning, and it decreases as the tissue heals and the body recovers. This is pain that is "talking to you" and telling you that something is wrong.
The sudden onset of pain in the back can occur after an injury or may appear without a known problem. If the pain is only in the tissues around the spine and does not radiate into the shoulders, arms, or hand, it is less likely to involve pressure on the nerve roots. If the pain is radiating into the limb, then this is more likely to involve pressure on the nerve. The etiology could be strain or tearing of the supporting tissues with intense muscle spasm, a herniation of the disc between the vertebrae, or a fracture of the bony structure of the spine. Initial care will include rest, pain medications, muscle relaxants, and possible epidural steroid injections, with trigger point injections for muscle spasms. The early use of physical therapy is important in many cases.
Chronic Back Pain
When a particular pain outlasts the normal healing process, it is categorized as chronic pain. Chronic pain symptoms can be caused by a variety of abnormalities in the nervous system. It can be complex, and it is often disabling. Chronic pain can greatly affect a person’s work, personal relationships and self-esteem. The determination of a specific and accurate diagnosis is mandatory for proper treatment.
Chronic back pain is pain experienced longer than 3 – 6 months and might result from the same sources as noted in acute back pain. However, many times the pain may originate from injury to the nerve tissues from chronic degeneration of the spine, or may continue after surgery. Appropriate evaluation might reveal the pain source, and allow specific treatment. The anatomical reasons for pain need to be differentiated from the pain caused by nerve injury which is also known as neuropathic pain.
Lower Back Pain Reviews
"I would recommend. I suffer with chronic lower back pain and nerve pain in my legs due to degenerative diseases of my lumbar spine and a lumbar fusion surgery that did not alleviate my pain. Dr. Bengali is probably the best pain management physician in San Antonio. I have seen a lot of doctors. Hands down, he is one of the best out there."- M.B. / Google / Dec 04, 2018
"I would recommend. I suffer with chronic lower back pain and nerve pain in my legs due to degenerative diseases of my lumbar spine and a lumbar fusion surgery that did not alleviate my pain. Dr. Bengali is probably the best pain management physician in San Antonio. I have seen a lot of doctors. Hands down, he is one of the best out there."- M.B. / Google / Aug 29, 2019
"The staff is amazing, Dr. Kim , all I can say is bless him. He has helped reduce my lower back pain. I recommend Tri City Pain to anyone with injuries. I can't say thank you enough."- B.C. / Google / Nov 09, 2020
"Dr Kim was great. Pain relief after first treatment for lower back pain that I have experienced for over 30 years."- D.B. / Google / Nov 21, 2020
Symptoms of Lower Back Pain
Below are the following complications or conditions associated with lower back pain:
- Muscle spasms
- Back feels sore when touched
- Dull pain or numbness
- Stiffness/difficult mobility
- Trouble sleeping
- Tingling or "pins and needles" sensation
Causes of Lower Back Pain
Lower back pain can be caused by muscle strain, a slipped disc, a pinched nerve, a sedentary lifestyle, arthritis, a curved spine (scoliosis), or bone fracture. These conditions can arise from poor weight lifting techniques, bad posture, advanced age, excessive weight gain, a sports injury, or trauma. To help prevent injury and lower back pain when doing heavy lifting or working out, it's important to lift with your legs instead of your back. Steady, low impact exercises, such as walking and swimming, can also help strengthen the back without putting unnecessary stress on the spine. Incorporating routine stretching, daily exercise, and maintaining a healthy weight are essential for maintaining optimal back function.
Treatments for Lower Back Pain
Acute lower back pain generally improves overtime with at-home remedies, like over-the-counter pain medication and the use of cold and hot compresses. The longevity and severity of lower back pain will vary from patient to patient, and if it can't be eased with nonprescription medication, then it may be time to see a medical professional about your symptoms. At Tricity Pain Associates, we offer several options for lower back pain, including anti-inflammatory medication, prescription pain relievers, steroid injections, and nerve blocks. When you visit one of our Texas locations, we will carefully evaluate your condition to determine the best treatment option for you.
Types of Back Pain
Lumbar radiculopathy occurs when a nerve root is irritated in the back and radiates pain into the buttock(s) and or leg(s). When the sciatic nerve is involved it is termed Sciatica. Two nerve roots, one on the right and one on the left, exit in between each bone in the spine (vertebrae) and supply sensation, motor ability, and position sense to a specific area in the body. The nerve roots can become irritated if pressed upon such as when there is a bulging disc pushing against a nerve, narrowing in the spinal cord, or narrowing in the space where the nerve roots exit through the vertebrae. Symptoms typically include back pain that radiates into the leg(s). Pain is described as "pins and needles," burning, or aching pain that is typically worse when walking. Patients may also complain of numbness or weakness in the legs. Treatment options include physical therapy, non-steroidal anti-inflammatories (NSAIDs), exercise, weight loss, ice, traction, epidural steroid injections, and surgery.
Lumbar Spondylosis is a degenerative condition that occurs with aging and affects the vertebrae and discs. It is a type of arthritis in the back that causes inflammation in the small joints on the side of the vertebrae (called facet joints). When the joints become inflamed or bone spurs (osteophytes) develop, narrowing can occur where the nerve roots exit and pinch the nerves. Symptoms can include back pain that may radiate into the buttock, hip, or leg, and weakness or numbness. Treatment options include traction, physical therapy, traction, massage, epidural steroid injections, facet joint injections, medial branch blocks, radiofrequency denervation, and surgery.
The coccyx is also known as the tailbone that is between the buttocks and the very bottom part of the spine. Pain in this area (Coccydynia) is most often due to inflammation from injury, giving birth, or occurs randomly without any known cause. Symptoms include buttock pain that is worse when sitting and tenderness to the touch. Treatment options include use of a seat cushion when seated, pain medications, non-steroidal anti-inflammatories (NSAIDs), chiropractic adjustments, stretching, physical therapy, and caudal steroid injections.
The piriformis is a muscle in the buttocks that helps with balance, walking, and movement of the hips. Occasionally, the muscle traps the sciatic nerve as it passes through the muscle and down the leg. This typically occurs when the piriformis is frequently stressed which is most common in athletes, specifically runners. Symptoms of this syndrome include pain, "pins and needles," and/or numbness in the buttocks that may go down the backside of the thigh, typically not extending past the knee. The pain typically worsens with extended periods of sitting as well as with hip flexion when walking up the stairs. Conservative treatments consist of ice, stretching, anti-inflammatory medications, muscle relaxants, and physical therapy. Steroid injections into the muscle may also provide relief.
Post Laminectomy Syndrome Spinal Stenosis
Post laminectomy syndrome (also known as Failed Back syndrome) is continued neck and or arm pain even after surgery. The cause for the continued pain is varied and could be due to injury to the nerve root during surgery, scar formation after the surgery, changes above or below the fusion, and delayed surgery causing significant damage to the nerve root before surgery. Symptoms include neck pain with or without associated arm pain. Treatment options include physical therapy, pain medications, tricyclic anti-depressants, anti-seizure medications, epidural steroid injections, and spinal cord stimulation.
Sacroiliac (SI) Joint Pain
The SI joints are where the bottom portion of the spine, the sacrum, connects to two of the bones that make up the pelvis and iliac bones, which lie on each side of the spine. The SI joints are relatively immobile being held in place by ligaments and support the majority of the weight of the spine so they are frequently stressed. Chronic stress can lead to arthritis of the SI joints which in turn, causes pain. The SI joints can also be painful during pregnancy when added stress is applied to them due to the relaxation of the ligaments that help hold the SI joints stable as the body prepares for childbirth as well as the added weight incurred during pregnancy. Unequal leg lengths may also place added stress on the SI joints causing pain. Symptoms typically include low back pain that is worsened with standing or walking and may or may not include pain into the thighs or groin. Treatment includes NSAIDs, physical therapy, chiropractic adjustments, exercise such as yoga or Pilates, and steroid injections into the joint.
Sacroiliitis is inflammation of either one or both SI joints. The inflammation can occur due to injury, infection, pregnancy, or arthritis. The most common cause is arthritis. Symptoms include low back pain that may radiate into the buttocks, groin, or thigh. The pain is typically worse after extended periods of standing or going up the stairs. Treatments include ice/heat, pain medication, NSAIDs, muscle relaxants, physical therapy, steroid injections into the SI joint(s), as well as radiofrequency denervation.
Cervical Spinal Stenosis
Spinal stenosis is narrowing in the spine that can be in the central canal, where the spinal cord is located, or where the nerve roots exit from the spinal cord, the neuroforamen. This is most commonly due to degenerative changes such as disc bulges or enlargement of the facet joints from arthritis, bone spurs, thickened ligamentum flavum (ligament that runs in between the vertebrae and spinal cord providing strength to the spine). Symptoms can include pain and/or numbness in the neck with possible radiation into the arms, weakness, numbness, and if severe enough, can cause bladder and bowel difficulty. The pain is worse with activity such as working with the upper extremities, driving, or working over a desk or computer. Treatment options include oral steroids, anti-inflammatory medications like Ibuprofen or Naproxen, anti-seizure medications, pain medications, physical therapy, and epidural steroid injections. In some patients, surgery to open the space is necessary or indicated.
Spondylolisthesis is when one vertebra is not in correct alignment with the vertebrae either above or below it. When the vertebra is moved forward, it is called anterolisthesis, and retrolisthesis is when the vertebrae move backward in comparison to the other vertebrae. This can occur due to injury, a defect in the bone that can be due to a tumor or a disorder you are born with but is most typically caused by arthritis. Symptoms of spondylolisthesis include low back pain, stiffness of the low back, and possible numbness or weakness in the legs if it causes spinal stenosis. Treatments include non-steroidal anti-inflammatory drugs (NSAIDs), physical therapy, epidural steroid injection if it causes spinal stenosis, and possible surgery.
Lower Back Pain FAQ
Is my lower back pain serious?
In many cases, lower back pain is simply uncomfortable. However, if you find it to be debilitating, it is important to see a medical professional as soon as possible to diagnose the issue and begin treatment. Additionally, you should schedule an appointment if you notice any of the following symptoms:
- Sudden spike in pain, discomfort, weakness, or numbness
- Loss of bladder function
- High fever
- Severe stomach pain
- Unexplainable weight loss
- Pain resulting from a fall or a blow to your back
Are my muscles or spine causing my lower back pain?
Pain in the muscles usually feels like a constant burn or shock and is usually felt constantly. However, spinal-related pain typically extends down your legs. The best way to know for sure is to schedule a consultation with a member of our team so we can perform an in-depth analysis.
How long does lower back pain last?
The answer to this question depends on the type of back pain the patient is suffering from. Most mild cases of acute lower back pain last anywhere from several days up to four weeks. More severe cases of acute lower back pain could last even longer, however, with many lasting up to 12 months. Anything lasting longer than 12 weeks is considered chronic lower back pain and will require medical intervention to resolve.
Ease Your discomfort
Getting help from a skilled physician can help bring insight into the underlying cause of your pain and why it’s not going away despite countless over-the-counter medications. Let our doctors at Tricity Pain Associates give you the right treatment and diagnosis for your chronic back pain. We have a diversely trained and knowledgeable pain management team that can help alleviate your discomfort so you can regain mobility and optimal back function.