Overview
Lower back pain (LBP) is one of the most prevalent musculoskeletal complaints, affecting nearly 80% of adults at some point in their lives. It can range from a dull, persistent ache to sharp, disabling discomfort and may be acute (lasting less than 6 weeks), subacute (6–12 weeks), or chronic (more than 12 weeks).
Common Causes
Lower back pain may arise from a variety of structural, degenerative, inflammatory, or mechanical sources. Key causes include:
Muscle strain or ligament sprain – Often due to heavy lifting, poor posture, or sudden movements.
Herniated or bulging discs – Displacement of intervertebral disc material that can compress nearby nerves.
Degenerative disc disease – Breakdown of intervertebral discs over time, reducing cushioning between vertebrae.
Facet joint arthritis – Degeneration or inflammation of the small joints at the back of the spine.
Spinal stenosis – Narrowing of the spinal canal, often resulting in nerve compression.
Sacroiliac joint dysfunction – Inflammation or dysfunction at the junction between the spine and pelvis.
Vertebrogenic pain – Pain originating from vertebral endplates, often underdiagnosed.
Myofascial pain – Trigger points and muscle tightness contributing to pain referral patterns.
Treatment Options
Conservative Approaches
Physical therapy
Core strengthening, stretching, and stabilization exercises.
Chiropractic care
Spinal manipulation for select cases.
Medications
NSAIDs, muscle relaxants, or short-term opioids.
Activity modification
Ergonomic corrections and graded return to activity.
Interventional Pain Management
When conservative treatment fails or pain persists, interventional techniques may be considered:
Medial Branch Blocks & Radiofrequency Ablation (RFA)
Used to diagnose and treat pain from arthritic facet joints by ablating sensory nerves.
Epidural Steroid Injections
Sacroiliac Joint Injections
Targeted injections to reduce inflammation and pain in the SI joint.
Intracept® Procedure
Minimally invasive ablation of the basivertebral nerve for vertebrogenic pain due to Modic changes.
Endoscopic Discectomy or Rhizotomy
Minimally invasive surgical procedures to treat herniated discs or ablate pain-generating nerves with direct visualization.
Spinal Cord Stimulation (SCS)
For refractory cases, neuromodulation may provide relief by interrupting pain signaling at the spinal cord level.
Conclusion
Lower back pain can stem from a variety of causes and significantly affect quality of life. A multidisciplinary approach—including lifestyle modification, physical rehabilitation, and interventional pain management—is often most effective in achieving long-term relief and functional improvement. Proper diagnosis and targeted treatment selection are key to successful outcomes.