If your days are challenged by lower back pain, you are not alone. An estimated 75 to 85 percent of Americans experience back pain at some point in their lives.
Frequently, low back pain results from an injury, such as a muscle sprain or strain caused by sudden movements, playing sports, or poor body mechanics while shoveling snow or lifting heavy objects.
However, age-related conditions such as degenerative disc disease and arthritis are also leading causes of lower back pain. These often cause stiffness, reduced flexibility, and chronic pain, which may worsen with activity or prolonged sitting.
Degenerative disc disease is extremely common, with 30% of people showing signs of it by age 35, 90% by age 60, and 96% of those in their 80s. Also, 53% of those over 75 years old suffer from doctor-diagnosed arthritis.
While lower back pain is inevitable for most of us, in many cases, you don’t have to let it impact the quality of your life. This article explores practical steps to help you regain control over your life and embrace an active lifestyle despite the limitations imposed by lower back pain.
Understanding Arthritis and Degenerative Disc Disease
Arthritis is an inflammatory condition that affects the joints, leading to pain, swelling, and stiffness. In the lower back, osteoarthritis, the most common form, occurs when cartilage breaks down, causing pain, stiffness, and reduced mobility. It is primarily caused by the gradual wear and tear of joint cushioning, which is worsened by factors such as age, obesity, joint injuries, and genetics.
Degenerative Disc Disease is a condition in which spinal discs wear down due to aging, daily activities, or injury, causing chronic pain in the neck or lower back. These discs act as cushions between the vertebrae in your spine. It is a natural, progressive degeneration that may cause pain, numbness, or tingling if the discs tear or dry out.
When Should You Seek Medical Advice for Low Back Pain?
There are certainly steps you can take on your own to deal with low back pain. In fact, most lower back pain will go away on its own within a few days to six weeks with self-care. Staying active, using heat and ice packs, and over-the-counter pain relievers are all common remedies.
However, if your lower back pain is severe, lasts longer than a few weeks, or is a result of a major injury, you should visit a medical provider for evaluation.
A board-certified Physical Medicine and Rehabilitation doctor is a reliable expert to start your journey to reclaim an active lifestyle. They will be key to a comprehensive evaluation and diagnosis of the causes of your back pain, which may result from a single condition or multiple conditions. You’ll then be able to develop an action plan with your doctor to manage them.
What Treatment Options Will a Doctor Normally Recommend for Low Back Pain Caused by Arthritis or Degenerative Disc Disease?
If your doctor determines that your low back pain is caused by arthritis, degenerative disc disease, or both, they’ll start with basic treatment options before considering more involved alternatives. These may include:
- Physical Activity and Weight Control: Your doctor may recommend that you regularly engage in appropriate physical activity and focus on maintaining a healthy weight. For adults with osteoarthritis, any amount of regular physical activity may reduce pain and improve function and general quality of life. This may also benefit sleep, mood, bone and brain health, and weight control. However, when engaging in any physical activity, it’s important to take precautions to protect your joints and avoid further aggravating your condition.
- Physical Therapy: A doctor may prescribe physical therapy to help you strengthen your muscles by supporting your back, improve flexibility, and teach you proper body mechanics to reduce strain on your spine. For some people with low back pain, strengthening back muscles helps support the spine, reducing pressure on degenerating discs and enhancing overall function.
- Injections: Your doctor may administer lower back pain injections, most commonly epidural steroid injections, which deliver anti-inflammatory medication directly into the epidural space of the spine to relieve pain caused by arthritis and degenerative disc disease. These outpatient, fluoroscopy-guided procedures offer temporary to long-term pain relief.
If Basic Treatment Options Don’t Pan Out, What Alternatives Are There for Low Back Pain Caused by Arthritis or Degenerative Disc Disease?
The good news is that with the advent of new imaging and surgical technologies, spine surgeries can now be performed minimally invasively. This results in smaller incisions, less blood loss, a quicker return to daily activities, and improved visualization for your doctor when performing the procedures.
Thus, if basic treatment options aren’t effective, there are an increasing number of alternative, minimally invasive treatments available. These options include:
- Radiofrequency Ablations: In this minimally invasive, outpatient procedure, a doctor uses a local anesthetic to numb the area where the procedure will be performed. A specialized needle is then guided over the affected nerves. Radiofrequency energy is then sent through the needle. The heat from this energy disrupts the nerves responsible for transmitting pain signals.
- MILD® (Minimally Invasive Lumbar Decompression): This procedure is performed by a doctor using a single, tiny incision that is even smaller than a baby aspirin (measuring 5.1 mm) in size. Doctors use special instruments under fluoroscopic guidance to remove small pieces of bone and excess, thickened ligament tissue. This process restores space in the spinal canal and reduces pressure on the spinal nerves.
- Intracept® (Basivertibral Nerve Ablation): This is a minimally invasive outpatient procedure for patients with vertebrogenic pain. A doctor uses fluoroscopic guidance to target a radiofrequency probe. The probe heats the basivertebral nerve, stopping it from sending pain signals to the brain.
- Neuromodulation Pain Relief Therapies (Spinal Cord Stimulation, Dorsal Root Ganglion Stimulation, Peripheral Nerve Stimulation): Neuromodulation uses electrical impulses to interrupt or alter pain signals, offering non-opioid relief for chronic pain. Main types include implanted spinal cord stimulators (SCS) and dorsal root ganglion stimulators (DRG) for nerve pain, and peripheral nerve stimulators (PNS) for localized pain.
- Advanced Interventional Spine Procedures: This covers additional spine procedures that are minimally invasive, image-guided techniques designed to diagnose and treat chronic back and neck pain, reducing reliance on opioids and avoiding open surgery.
Summing It Up
Reclaiming an active lifestyle from arthritic and degenerative disc lower back pain is a journey that requires patience, persistence, and a proactive approach. By understanding your condition, seeking appropriate medical advice, embracing physical activity, making lifestyle modifications, and implementing self-care strategies, you can significantly improve your quality of life. Remember, the path to recovery may be gradual, but with dedication and the right support, you can overcome the limitations imposed by pain and enjoy a fulfilling, active life once again.