Where does low back pain originate?
All structures of the spine can contribute to low back pain, including muscles, ligaments, joints, discs and also the nerves within the spine. However, the vast majority of patients have low back pain due to one of the following situations. Firstly due to muscle contracture. The great majority of patients, especially young people and in sports, have low back pain due to musculo-skeletal injury, in most cases due to overload or repeated microtrauma. Secondly, the most frequent injuries are those of the intervertebral discs, which first dehydrate as a form of natural aging of the disc. This makes them very fragile and then they break and can become displaced. Thirdly, there are lesions of the nerves inside the vertebrae, generally due to a disc lesion or a herniated disc that compresses these nerves, or due to osteoarthritis that causes a narrowing of the channels through which these nerves pass.
What is the treatment for low back pain?
Most patients with acute low back pain improve with treatment based on anti-inflammatory drugs, muscle relaxants, local heat or ultrasound in a few days. Absolute rest should be limited to a maximum of 1 or 2 days or until the muscle contracture subsides. In the case of long-standing low back pain, it is advisable to eliminate excess weight. Gymnastics can be useful, especially with a program of exercises aimed at flexing and strengthening the trunk musculature. In the case of osteoarthritis of the posterior elements of the lumbar vertebrae, rhizolysis may be indicated, which is a non-invasive technique with local anesthesia, in which a radiofrequency current is sent through special needles to the joints that are damaged, thus eliminating the painful sensation of the spine.
Which cases are candidates for surgical intervention?
Firstly, those who have a ruptured or herniated disc, i.e. displaced, that is compressing the nerves, that is causing pain in the legs or sciatica and that has not improved with conservative treatment. Secondly, patients, generally older, who have a stenosis or narrowing of the channels through which the nerves pass. This narrowing is caused by bone production in a situation of vertebral osteoarthritis, production that blocks and closes these channels. The intervention consists of widening these channels in order to leave a good passage to the nerves. If there is also a herniated disc, it is removed from the inside of the canal.
What is the postoperative period like?
The vast majority of these spinal interventions have a short stay in the clinic, only 2 or 3 days, after which patients can walk, so that the return home is done in their own car. Afterwards, they have to rest and avoid exertion for about 8 weeks, during which time they wear a light corset made of elastic material with rods. Recovery in most cases is very rapid and the pain usually disappears during the stay in the clinic.