From strained muscles and pinched nerves to slipped or damaged discs, back pain has many causes. Depending on what triggers it, back pain can be sharp and sudden, or feel more like a dull ache that doesn’t go away. Fortunately, most types of back pain can be treated, and patients can successfully return to work, school and other activities.
Scripps orthopedic spine surgeon Maneesh Bawa, MD, answers common questions about back pain and discusses how minimally invasive surgery may be used as a treatment.
Eight out of ten people will experience back pain at some point in their lifetime. Pain can be caused by a number of factors, including overuse, trauma and illness. Lower back pain, or pain that radiates down into the leg, often may be due to a muscle or nerve injury.
“Acute back pain comes on suddenly and usually lasts from a few days to a few weeks,” says Dr. Bawa. “If it lasts longer than three months, we consider it a chronic condition, but with the right treatment it doesn’t have to be permanent or debilitating.”
Treatments vary widely depending on the cause of the pain. “Generally, mild injuries such as strained muscles respond well to at-home treatment with rest, ice and over-the-counter anti-inflammatory medications such as ibuprofen,” says Dr. Bawa. Massage, acupuncture, and chiropractic treatments may help relieve pain and promote healing, while physical therapy can help restore strength and flexibility to injured muscles.
Most people will improve with non-operative treatments, but some will require surgery.
“Surgery is always a last resort, but may be necessary for specific conditions such as a collapsed or slipped disc, herniated disc, compressed nerve, compression fracture, spinal instability, or narrowing of the spinal canal,” says Dr. Bawa. “Many of these conditions can now be treated with minimally invasive surgical techniques.”
In standard open surgery, the orthopedic surgeon makes one large incision along the back. In minimally invasive orthopedic surgery, the surgeon makes one or more small incisions around the area to be worked on, and inserts a tube with a tiny camera attached through the small incision. The camera projects images of the surgical field onto a video screen; using these images, the surgeon performs the procedure with specially designed instruments that fit through the incisions. In some cases, the surgeon may use a robotic surgery system, which allows for enhanced dexterity as well as a 3-D view of the surgical site.
According to Dr. Bawa, minimally invasive orthopedic surgery is often used to repair pressure on spinal nerves, remove a damaged disc or replace it with an artificial one, fuse vertebrae to stabilize the spine, or repair a compression fracture.
Compared to standard open surgeries, minimally invasive procedures have been shown to cause less blood loss, less pain and reduced scarring due to the smaller incisions, says Dr. Bawa. Also, patients often are able to go home sooner than after an open surgery, and recovery time and return to work and other activities also tends to be faster.
If you have back pain that comes on suddenly for no apparent reason, or doesn’t improve over time, call your primary care doctor or make an appointment with an orthopedic specialist. Depending on your symptoms, medical history and tests such as X-rays and MRIs, your physicians will determine the best treatment option.