Back pain is a common medical complaint that patients seek care for. It can present as dull aching pain across the low back with or without sharp shooting pain radiating down the leg. Risk factors for back pain include obesity, smoking, and genetics. Causes of back pain include nerve root compression, degenerative disc disease, facet joint pain, spondylosis, autoimmune conditions, cancers, and osteoporosis. Other causes could include a bad personal injury or car accident. In some cases, patients may experience persistent pain after spinal surgery.
The diagnosis of the underlying cause of back pain is made by taking an accurate history and performing a physical examination. In some cases, lab tests and imaging such as an X-ray, MRI or CT scan may be indicated.
Most cases of back pain resolve on their own with conservative management. These options may involve a home exercise program, physical therapy and anti-inflammatory medications. In certain cases, based on the cause, patients may require minimally invasive procedures such as epidural steroid injections or radiofrequency ablations. In some cases, such as persistent pain after back surgery, patients may be good candidates for spinal cord stimulation therapy.