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Treatment Options for Back Pain

Doctor Q&A

Anyone who has ever experienced back pain knows that it can interfere with one’s work and personal life. Up to 80 percent of adults will experience back pain at least once in their lives. Back pain can be a muscular issue or, more seriously, a spinal issue. Dr. Paul O’Boynick, MD, neurosurgeon at AdventHealth Shawnee Mission, answers common questions about available options for treating back pain.

When is back surgery the right choice?

Surgery is almost never the first choice, unless there is a traumatic injury requiring immediate correction. In general, back surgery should be considered when the patient has tried and failed all conservative treatments and continues to suffer from a pain syndrome that is treatable with surgery. Careful radiologic imaging including MRI should be part of the decision-making process.

How many types of back surgery are there?

There are numerous procedures. The simplest is lumbar discectomy, in which a small window of access is opened and, under microscopic vision, the fragment of disc and degenerative disc material are removed. Lumbar laminectomy refers to the process of bone removal to gain access to the spinal canal in procedures requiring access to the spinal canal and more widespread decompression of compressed nerve roots. Lumbar fusion procedures usually involve a combination of titanium hardware to stabilize the spine along with bone grafting at the appropriate location for ultimate fusion and long-term stability.

What are nonsurgical options to relieve back pain?

Nonsurgical options include physical therapy and various injections including trigger point, epidural and joint injections. Heat and ice are often used. Medications including over-the-counter anti-inflammatories such as ibuprofen are often helpful in the acute phase. Muscle relaxants can relieve lumbar muscle spasm. In addition, some patients obtain relief from decompression devices or chiropractic treatment.

What causes compressed nerves in the spine?

When a lumbar disc herniates, it may compress one or more of the lumbar nerve roots causing leg pain, commonly referred to as “sciatica” by patients. Another common cause is lumbar stenosis. In this situation, the spinal canal harboring the spinal cord or nerve roots is narrowed by a degenerative process. Once the spinal canal is critically compromised, leg pain may occur. This classically is exacerbated by exercise. There may be associated numbness and tingling.

Your pain condition or injury should first be brought to the attention of your primary care doctor, who can determine if you should be referred to the Pain Specialists at AdventHealth Shawnee Mission or a surgeon. If you’re in need of a primary care doctor, MyHealthKC can help you find the perfect match. Take the quiz on our Find a Doctor tool to discover a list of local primary care providers selected just for you.

Cervical Discectomy,
a surgery to treat spinal cord compression, takes place in this section of the spine.

Lumbar Discectomy,
a surgery to remove abnormal disc material, takes place in this section of the spine.

Cartilage makes up 25 percent of the spine’s overall length. Gravity compresses the cartilage over time. After the age of 40, the average person shrinks as much as 1/3 of an inch every 10 years.

Cervical Spine

Back pain is the single leading cause of disability and the most common reason for missing work in the United States.

Thoracic Spine

Your spine protects your spinal cord, which delivers messages throughout your body. There are 13.5 million neurons in the spinal cord, and it weighs approximately 35 grams.

Lumbar Spine

Low-back pain costs Americans at least $50 billion in health care costs each year.

Sacrum & Coccyx