Low Back Pain
50-70% of human beings will experience low back pain at least once in their lifetime while 13-15% sciatica.
Different age groups have different usual causes. For adults, the common causes of low back pain include spinal degeneration, intervertebral disc diseases, spondylolisthesis, spinal stenosis, trauma like fracture, tumour metastasis and infection.
However, one must not forget the possibility of referred pain which is not caused by spinal causes, e.g. abdominal aorta anerysm.
Patients with low back pain should seek orthopaedic care.
The orthopaedic surgeon will take history and perform examination for the patient. Depending on indications, further investigations include:
- CT scan and/or myelogram or with/ without contrast
- Facet/nerve root injection
- Bone scan
- Electrophysiological studies, etc
Treatment modalities for spinal back pain are:
- Taking a brief period of rest
- Orthosis e.g. corset
- Occupational therapy
- Back exercises
Surgery is indicated in case:
- Severe back pain or sciatica that cannot be relieved by non-surgical means
- Rapidly deteriorating neurology or troublesome neurologic claudication
- Spinal instability which is causing problem Some cases of fractures
- Some cases of fractures
- Spinal decompression for neural compression, e.g. discectomy, laminotomy, laminectomy
- Sometimes spinal fusion is needed if the spine is unstable or discogenic pain. It can be anterior or posterior or combined spinal fusion
- Disc replacement surgery is another option for disc diseases
- Facet joint/ nerve root injection can relieve facet joint pain/ radiculopathy
- Depending on the fracture pattern, spinal fracture may require vertebroplasty, kyphoplasty, spinal instrumentation with or without fusion, corpectomy + anterior spinal fusion, etc
- Of course, some surgery can be done with minimal invasive technique
The information on this website is for general educational purpose only.
Readers should consult their physician before considering treatment, and should not interpret their condition solely based on the information above.