Lower back pain treatments options: non-surgical and surgical

Lower back pain

If you’ve been suffering from back pain for more than three months, you’re in the phase of chronic disease. Often, temporary relief from taking medications turns into disappointment: their purpose is to alleviate the patient’s suffering through analgesia, reduce inflammation, and relax muscles. But what about the long-term effect and treatment of spinal deformity? 

Chronic back pain can occur at any age but is often associated with degenerative bone and cartilage tissue processes. Arthritis, spinal stenosis, myofascial pain syndrome, and disc problems (such as a herniated or bulging disc) are also reasons to consider when undergoing a major medical procedure. 

By working with your doctor to reduce flare-ups and relieve pain, you can miss the disease phases that signal the need for surgery. Therefore, if you feel that your rheumatologist has exhausted his diagnostic capabilities, you’d find an alternative opinion. In this case, an intervention may be the only correct solution. Lower back surgery – better recovery, return to regular activity and sports, improved quality of life.

Non-surgical treatments for chronic back pain

Meditation 

Therapy involves working on the psychological aspects of pain that fatigue the patient’s body physically and emotionally. They become apathetic, inactive, and irritable. A rehabilitation psychologist may recommend meditation, yoga, tai chi, and other mental relaxation strategies to keep the patient focused on the pain.

Physiotherapy

The base of treatment and even postoperative rehabilitation is physical activity maintenance.

Under the guidance of physiotherapists, the patients must perform a daily set of exercises adapted to their health conditions and diagnoses:

  • Posture training;
  • Checking the limits of pain tolerance;
  • Stretching and flexibility exercises;
  • Aerobic workouts;
  • Cardio.

Homework is also an integral part of success. 

Nutrition 

Diets high in trans fats, refined sugar, and salt cause inflammation. So if you’re a fan of semi-finished pizza with brown sauce and cola, then most likely, you’ll have to give up these foods in the name of maintaining your health. 

You can keep the strength of the spine’s bones by consuming adequate amounts of calcium and vitamin D. Learn to eat more greens and dairy products; supplement your diet with fatty fish, egg yolks, beef liver. Consult with your doctor about supplementation. 

Lifestyle modification

Do you remember the central postulate of meditation – “listen to your body”? That also applies to lifestyle: avoid anything that aggravates your pain, get rid of bad habits. 

As you know, smokers are more likely to experience back pain than non-smokers. The fact is that nicotine restricts blood flow to the spinal discs, which leads to their drying out and even rupture. It also reduces the amount of oxygen in the blood, which leads to muscle and tendon hypoxia.

Sometimes it’s worth changing your shoes to reduce the strain on your back. A small heel less than 1 inch is a great choice. You can also use a pillow under your knees while sleeping.

Injection procedures

When the exact source of the pain is known, but non-surgical treatments don’t work, the following therapy is used:

  • Epidural steroid injections

Steroids injected into the outside of the dural sac temporarily relieve pain by reducing inflammation around the compressed nerve root. Injections can be used in conjunction with physical therapy to achieve rapid progress.

  • Narcotic pain relievers

Opioids alter the perception of pain by attenuating signals sent to the brain. They’re used for short-term relief of intense pain syndrome. 

Remember, narcotic drugs are addictive and have a ton of side effects. Talk to your doctor about alternatives.

  • Muscle relaxants 

They act as CNS depressants by increasing tense muscle mobility and relieve spasms but don’t treat pain. The injections stop pain for some time and cannot be used continuously.

Alternative methods 

Acupuncture, massage, biofeedback therapy, laser therapy, electrical nerve stimulation can also help relieve pain. Talk with your doctor if you need them.

Surgical treatments for back pain

Vertebroplasty and kyphoplasty

An injection of glue-like cement is used to repair the vertebrae’s compression fractures, which hardens and strengthens the bone. The principal procedure risks are the migration of bone or cement fragments into the spinal canal. Cases of pulmonary embolism caused by leakage of implanted material into the venous circulation were reported.

Spinal laminectomy/decompression

To relieve pressure on the nerves, the surgeon removes the bony walls of the vertebrae. A complex operation can be fatal for the patient because there’s a high risk of damage to the nervous tissue and dura mater, cauda equina syndrome. 

Diskectomy

In the case of a hernia or high pressure on the nerve roots, the disc is removed. The development of infection, bleeding, and even leakage of cerebrospinal fluid are possible consequences of surgery. 

Foraminotomy

Enlarging the vertebrae aperture at the exit site of the nerve root is used to prevent pressure on the nerve. The risks of foraminotomy include infection of the wound and vertebral bones, damage to the spinal nerves.

Nucleoplasty 

That’s an operation to relieve pressure on the nerves performed in a minimally invasive way: a laser device located at the tip of a needle vaporizes fluid in the disc tissue, reducing its size and relieving pressure on the nerves. The consequences of the operation are similar to a discectomy, but a re-hernia may occur.

Spinal fusion

The surgeon connects two or more vertebrae using bone implants – metal structures fixed with screws. It leads to a loss of flexibility in the spine and a lengthy recovery period. After the intervention, blood clots and bleeding, trauma to blood vessels, nerves, and even the spine may occur. Patients have pain at the implant site.

TOPS System implant

The procedure is considered an alternative to the above as it’s minimally invasive and has low negative consequences. It consists of introducing a mechanical implant that will replace the bone and soft tissue removed during decompression. The implant consists of two plates and a mechanical device in the middle. It provides a wide range of movements while preventing spine immobilization, such as the fusion procedure. In 86% of cases, the system proved to be excellent: a case of uncomplicated leakage of the hard spinal cord as well as a focus of progressive degenerative changes in the vertebral column above the implant was reported; 6 months after the operation, one patient had an asymptomatic screw halo. There’s also a rapid postoperative recovery and return to normal activities, including sports. 

Conclusion

Non-surgical therapy is effective for certain diseases and can show impressive results if you follow the doctor’s instructions. In the event of chronic severe forms of the disease, surgery is indispensable. Of course, among the list of services of the medical center, you can choose the cheapest one. Still, it’d help if you considered the occurrence of negative consequences and a significant decrease in the quality of life. If you look to maintain your health and return to regular activity, you’d consider the alternative surgery methods described in this article.