Low Back Pain

Herniated/Protruded/Bulging Disc

A herniated disc is the result of a weakened disc which can lead to pain or numbness in the back, arm, neck, or leg. This occurs when the outer part of the disc, called the annulus, is weakened over time from wear and tear or a previous injury. Once it’s weakened to a certain state, the inner part of the disc, called the nucleus, may experience a hernia or rupture in the outer fibers. This results in direct pressure being applied onto spinal nerves which is what leads to the aforementioned pain or numbness. The herniated disc can only be identified via an MRI or a CT scan but thankfully; there exists some non-surgical methods of treatment such as epidural steroid or stem cell injection, intradiscal steroid injections, and physical therapy.

Low Back Pain

One of the most common reasons for patients going to visit their doctors is because of low back or lumbar pain. It is second only to visits related to the common cold worldwide. This is because the issues and pain associated with these problems isn’t necessarily related to a specific event or injury. Over time, a person’s disc, facet joints, and supporting musculoskeletal system changes. This means that simple things such as a person’s posture, their weight, repetitive movements, even their genetics, all of these things and much more can all contribute to low back or lumbar pain. Common causes in the past for low back pain are herniated disc, joint inflammation, arthritis, muscle strain or spasm, sacroiliac joint pain, and stenosis.

The associated pain can be difficult to identify and considering that the spine is a series of thousands of nerves, it can also be the most painful ailments a person can suffer with. It can be located in one or multiple parts of the back and even radiate down to the buttocks, hip, and groin. Some have even claimed that the pain spreads as far down to their legs while others have experienced tingling and spells of weakness. It’s also not uncommon for the pain to become worse after walking because of the connection between the nerves of the spine and the legs.

As identifying the source of low back pain is tricky, one might need to conduct an MRI scan, a CT scan, an ultrasound, or an NCS/EMG to help. Following that, non-surgical treatment options can be carried out, which includes physical therapy, customized home exercise programs, topical treatments, neuromodulation such as TENS, interferential stimulation, trigger point injections, sacroiliac joint stimulation, protein-rich plasma (PrP), among many other options.

Piriformis Syndrome/Buttock Pain

The piriformis muscle is an under-diagnosed muscle which can often be the source of pain in the buttocks for many. The muscle is also known to sciatic nerve as well, meaning that pain connected to it can also be tied to a person’s leg as this nerve is pivotal to the connection between the leg and hip. In these cases, the nerve may exit through the muscle and cause immense pain in the leg. It should also be said that there are also cases where the sacroiliac joint is instead the cause of pain in the buttocks instead. An x-ray scan, MRI scan, or ultrasound is occasionally used to identify the source of pain in the buttocks. Afterwards, one can use ultrasound-guided injections into the piriformis muscle with steroids as a non-surgical treatment option. Other options include regenerative medicine treatments, sacroiliac joint injections, and physical therapy.

Sacroiliac Joint Pain

The sacroiliac joint is a large joint that can be found in the region of the buttocks and connects the pelvis to the sacrum. It can be aggravated from trauma from falls, altered gait, or even naturally over time through wear and tear and inflammation. It’s also very common for patients to suffer from sacroiliac joint pain alongside a low back issue but thankfully; there are many methods of treatment available: diagnostic injections, corticosteroid injections for acute inflammation, and stem cell/growth factor/protein-rich plasma (PrP) injections for regenerative changes.

Degenerative Disc Disease

As one becomes older, their spinal disc undergoes changes. Degenerative disc disease is a term used to describe this and isn’t an actual disease. The spine is made up of interlocking bones that are separated by soft compressible discs; spinal discs. In this way, these discs act as shock absorbers for the many motions of the spine and are what allow the spine to twist, flex, and bend. With that in mind, it’s more typical for degenerative disc disease to be located around more active parts of the joint such as the lower back (lumbar region) and the neck (cervical region). It should also be noted that degenerative disc disease can also lead to:

  • Osteoarthritis, the breakdown of the tissue cartilage that protects and cushions joints
  • A herniated disc, an abnormal bulge or breaking open of a spinal disc
  • Spinal stenosis, the narrowing of the spinal canal, the open space in the spine that holds the spinal cord

Failed Back Syndrome

It is not uncommon for patients who have already undergone surgery for a spinal issue to still suffer pain in their back afterwards. These cases are often related to chronic nerve inflammation, facet joint inflammation, scar tissue from the surgery, degenerative disc disease, or stenosis. This can also be described as failed back syndrome as it is multiple spinal issues plaguing the patient where at least one has not been properly identified and ignored after surgery. In these scenarios, an MRI scan, CT scan, or NCS/EMG may be necessary to identify the secondary cause of back pain. Following that, one can seek non-surgical treatment options which include selective nerve blocks, facet injections, intradiscal steroid injections, and spinal cord stimulation. Regenerative medicine in particular does wonders for patients of this ailment as stem cell/growth factor injections can offer them significant relief.