Low back pain is one of the most common problems. It affects more than 80% of adults at some point in their lives. The causes of lower back pain are sometimes viewed as being mechanical, organic or idiopathic. Many of these are treatable in various ways .
1.Lumbar pain
Mechanical lower back pain is often triggered by spinal movement and involves spinal structures, such as the facet joints, intervertebral discs, vertebral bodies (vertebrae), ligaments, muscles or soft tissues. It is usually treated with medications and physiotherapy.
Degenerative: disc disease. As age progresses or due to obesity, discs become thinner and flatter due to wear and tear. That leaves them less able to cushion the vertebrae. These can lead ot disc herniation or facetal arthritis.
Herniated disc: A disc that bulges or slips out of place is known as a herniated disc, bulging disc, or slipped disc. The herniation may press on nerve roots, leading to symptoms such as pain, tingling, numbness or even weakness in the area that the nerve serves
Sciatica: Pain that results from a pinched or irritated sciatic nerve. This nerve runs down in the lower back through your hips and buttocks and down each leg. Sciatica is the common term usually used for radiating pain or the pain that travels down the leg from the lower back.
Facet Joint Arthroplasty: It happens due to the degeneration, inflammation and injury to the facet joints. Poor back musculature tone along with obesity adds on to the cause. Pain is always in the back which gets aggravated on movement of the spine.
Failed back surgery syndrome: Many a times pain reccurs after surgery due to different causes. It may be due to adhesions or development of pain in a different level other than operatated area.
Interventional therapy:
After initial medications and physiotherapy if there is no relief then Fluoroscopic guided interventions are proceeded depending on the cause. Injections are given to relieve the cause of pain like nerve compression due to herniated disc, facetal blocks for the inflamed facet joints and release of adhesions in case of failed back surgery. Many a times RFA( Radiofrequency ablation) is also given for a lasting relief in chronic cases.
2.Sacroilliac joint pains
Various causes are attributed to the Sacro iliac joint pain which leads to pain around the low back and buttocks but does not radiate below the knees. Arthritis is usually cause. It is also seen after spine surgery.
Interventional therapy:
After initial medications and physiotherapy if there is no relief USG guided interventions are proceeded into the joint.RFA may be considered in resistant cases.
3.Coccydynia
It is charecterized by the pain localized to tail bone. It usually happens after a fall, many a times after difficult childbirth.
Interventional therapy:
After initial medications if there is no relief then USG/ fluoroscopic guided interventions are given. RFA may be needed and provide long lasting relief in selective patients.
4.Piriformis syndrome
It is characterized by pain and tingling sensation in the buttocks. The usual cause is due to the trauma to the gluteal region leading to inflammation of sciatic nerve caused by abnormal condition of piriformis muscle.
Interventional therapy:
After initial medications if there is no relief then USG/ fluoroscopic guided anti-inflammatory medications are given. RFA may be needed and provide long lasting relief in selective patients.
