The numbers are clear. Four out of five of us will, at some point in our lives, experience lower back pain
. At any given moment more than 30 million Americans are trying to figure out how to reduce their spinal suffering. The experts tell us that every back is different.
For back pain, the first step is figuring out what caused you to start feeling pain and when. Where you feel pain is also important.
“When you come see me, we’ll spend a lot of time talking about your pain,” says Wendy Chang, MD, a neurosurgeon at Rebound Orthopedics & Neurosurgery.
“I need to know how your pain began--after a fall or injury--or did it just come on with no trigger? We’ll discuss how long have you had pain, whether it is getting worse, and if it radiates into your legs. A few simple range-of-motion exercises will help determine how aggressive we need to be.”
Surgery shouldn't be first option
Dr. Chang says surgery should not be considered as the first option. "Many cases of back pain will improve over time with simple treatments like heat, ice, or massage." Certain kinds of exercises for low back pain can also be helpful.
Patients reporting radiating pain, such as pain in their legs or arms, are often dealing with compression of their spinal cord caused by narrowing of the spinal canal.
“Sometimes a disc in the spine will rupture, and its nucleus will erupt into the spinal canal,” notes Dr. Chang. “This can also be caused by bone spurs, or even a thickening of ligaments in the spine. We also see lower back pain caused by the simple wear and tear of the aging process.”
Various types of back surgery
There are a variety of surgical remedies
, and it’s important to discuss the benefits of each with your surgeon.
Many surgeons perform a procedure called laminectomy, involving the removal of a section of the vertebrae. The newly-created opening allows additional space for nerves to decompress. Dr. Chang says, while effective in reducing pain, a laminectomy also results in a slight loss of spinal stability. Some patients are excellent candidates for a “laminotomy” which results in the removal of a smaller section of vertebral structure.
“Rather than remove the entire back side of the vertebrae, I can instead create a small porthole in the vertebrae, allowing me to access the spinal canal to remove whatever is compressing the spine,” says Dr. Chang. “Laminotomy achieves the desired pain relief along with other benefits including a reduction in recovery time and a more structurally sound spine.”