Low back pain is a result of the wear and aging of the spine during one’s lifetime. The spine consists of bones which become stiff and get thicker as the body grows older.
Symptoms
Low back pain is easily indicated by an aching, dull pain while standing or walking. It is most common in the lower back regions and can extend to the thigh area and the buttocks. It may also cause a sensation of numbness in the legs as well as pain. If the condition becomes severe, it can lead to the inability of a person to control bladder or defecation functions.
About this Condition
This condition is usually attributed to an aching pain in the lower back. It is often experienced while standing or walking. It is not limited to the lower back and may sometimes be felt in the thighs. Using a walker is one of the ways in which this pain can be reduced. Stopping to rest for a brief period also helps in reducing the pain. Low back pain can lead to difficulty in the ability to walk. This occurs slowly and gets worse over a period. Leaning forward can help improve this condition.
Low back pain usually occurs as an effect of the wear and aging of the spine as one grows older. The bones and the ligaments of joints tend to become stiff and thicken as the body ages. Another effect of aging is the compression of the nerve roots and spinal cord. This is caused by the narrowing of the spinal canal. This narrowing leads to an absence of space required for the proper functioning of the nerves.
Treatment
Conservative Treatments
Medication and Pain Management
Medication is given to the patient with the aim of reducing the discomfort and the pain experienced.
The medications may also be non-steroidal anti-inflammatory drugs (NSAIDs). Examples of drugs which fall under this category include ibuprofen, aspirin, and naproxen. They are very strong pain reducers, and they carry no risk of addiction for the patient. As a result, they can be prescribed for long-term use by the patient.
Another method is through opioid therapy. This approach is used as an alternative where the patient shows no positive response to other treatment. Drugs used in this treatment method can be toxic to the body and also cause addiction in the patient. The use of medications such as Topamax, Lyrica, and Neurontin which are anti-seizure pain medications and muscle relaxants is advisable.
Physical Therapy / Occupational Therapy
To hinder any risk of a repetitive injury, a therapist usually creates a rehabilitation program for a patient. This is usually after signs of improvement by the patient. Therapy is essential in making a complete recovery.
To heal wounds, increase strength and endurance as well as establish independence in carrying out different body functions, methods such as functional training, manual therapy, and therapeutic exercise are used. Adaptive equipment and assistive devices are also used. To decrease any swelling, hasten healing processes and reduce pain, programs such as heat therapy, electrotherapy, and cold therapy are incorporated.
Lumbar Artificial Disc Replacement Surgery
Injections
A corticosteroid injection may be administered by a doctor to reduce inflammation and alleviate the pain. The cortex of the adrenal glands is responsible for the production of the cortisone and hydrocortisone hormones. The effects produced by these hormones can be reproduced by corticosteroids. When corticosteroids are administered in doses higher than the natural level, it helps in alleviating pain as well as reducing inflammation. A major drawback to using corticosteroids are the side effects. For this reason, injections are restricted to a maximum of three in a year.
The nerve roots and spinal nerves are protected by a sheath-like membrane known as dura. The dura is located within the epidural space. If there is an irritated nerve within this space, a steroid is combined with an anesthetic and injected into this area. The steroid hinders any production of proteins which lead to inflammation. This reduces the irritation of the nerve. The anesthetic is responsible for reducing the pain by numbing the area.
To find out which nerve root is causing a problem, a doctor may administer an epidural spinal injection. This can be for therapy or diagnosis. When it is used for diagnosis, it is injected around a particular nerve root to determine if it is the cause of a problem. When used for therapy, it is administered to provide relief for a period. This can be anywhere from a week to months. Permanent relief can also be obtained in some special cases.
An epidural spinal injection is best administered as a means of easing pain and discomfort in patients preparing for surgical operations or going through therapy. It is not applied as a cure for low back pain.
Surgery
METRx Minimally Invasive Hemilaminectomy
When surgery is carried out on the spine to reduce excess pressure on the spinal nerve in the lower back by removing part of a laminae on a vertebra, this type of surgery is known as a hemilaminectomy. It is usually done to alleviate pains in the leg and the back. When the operation is performed using METRx technology, it is known as an METRx hemilaminectomy.
Open Laminectomy
Laminectomy is carried out to make extra free space in the region around the nerve roots by eliminating a portion of the bone around the root. This bone can be the bony rim which surrounds the spinal canal, known as the lamina. It is removed if it is responsible for the additional pressure on the nerve roots or the spinal cord.
