Most adults dealing with their first bout of back pain will heal and get back to their daily life. But if you’re one of the 20% whose first episode turns into chronic back pain, you understand why back pain is the leading cause of disability.
Chronic back pain is one of the most challenging conditions faced by my patients, which is why at my practice, Richard B. Kim, MD, I recommend seeking treatment as early as possible. The sooner you get help with your back pain, the better your chances of finding relief and restoring your quality of life.
Typically, you begin with the most conservative treatment that’s appropriate for the cause of your back pain and severity of your symptoms. When these treatments don’t help, you may consider the next step, interventional pain management. If your pain still persists after all nonsurgical therapies, it’s time to talk about minimally invasive surgery.
Here’s a rundown of the possible back pain treatments at each level of care, and I explain the types of surgery in more detail.
Conservative treatments include medications, ice and heat, and exercise or physical therapy.
Applying ice and heat helps to reduce inflammation and ease your pain. Medication typically begins with over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs). Depending on the severity of your pain, you may need prescription medication. The most common prescription medications include muscle relaxants, antidepressants, and narcotics.
Exercise promotes long-term pain relief by strengthening the core muscles that support your lower back. However, you should only exercise after a thorough examination.
It’s important to have your back checked out first to be sure you don’t have a condition that might get worse with activity. Many patients need physical therapy because it includes a range of gentle passive treatments, massage, and therapeutic exercises.
The next step for easing back pain involves interventional pain management. These treatments target the nerves causing your pain. Some provide temporary relief; others have longer-lasting results.
A few examples of interventional treatments include epidural steroid injections, radiofrequency ablation, spinal cord stimulation, and selective nerve root blocks. Epidural steroid injections ease your pain by reducing spinal nerve inflammation.
The other procedures use different techniques to block the nerves sending pain signals to your brain. These treatments work because your brain must get the nerve signal and perceive the pain before you feel it.
Though interventional treatments may effectively relieve your pain, they don’t treat the underlying source of the problem. If your chronic back pain is caused by a spinal condition, it’s only natural to wonder about spine surgery to repair the problem, because it’s the best way to get long-term pain relief.
If you’re concerned about the prospect of spine surgery, you need to know that I specialize in minimally invasive surgery, and I have extensive experience helping patients overcome their back pain.
Minimally invasive surgery causes significantly less trauma compared to open surgery. The incision is smaller and, in many cases, I can avoid cutting the surrounding muscles.
As a result, you have less postop pain, a low risk of problems, and a faster recovery. Some minimally invasive spinal surgeries are done on an outpatient basis, so you go home the same day.
These are a few of the minimally invasive surgeries I often recommend for back pain:
A discectomy treats herniated and degenerated discs by removing the damaged disc.
A microdiscectomy repairs a herniated disc by removing the protruding portion of the disc that’s pressing against the nerves. During a microdiscectomy, I only remove the damaged part of the disc.
Several minimally invasive procedures treat pinched nerves by removing a small part of a vertebra. This enlarges the space, takes pressure off the nerve, and alleviates your pain. Several types of decompression procedures — laminectomy, laminotomy, foraminotomy, and laminoplasty — target different areas of the vertebra.
If you need to have a disc removed, I may replace it with an artificial disc. The new disc stabilizes the spine while preserving normal movement.
A lumbar fusion permanently connects two adjacent vertebrae in your lower back. After removing a disc or performing a decompression procedure, a fusion restores spinal strength and stability.
If you need help with back pain, call one of my offices in Newport Beach and Orange, California, or request an appointment online today.