What Are The Most Common Lower Back Surgery Procedures
Spine surgery is not necessary for most people who have lower back pain. If you do need it, your doctor will recommend an appropriate procedure to address your specific symptoms and medical situation. Common spine surgeries include:
Spinal Fusion. Two or more vertebrae are permanently fused together to limit excess spinal motion. Your surgeon will use a combination of bone, bonelike material, screws, plates and rods to hold the vertebrae together so they can heal into a single unit. Spinal fusion may be done to correct spinal deformities or to increase the spines stability in severe cases of spinal osteoarthritis or herniated discs.
Laminectomy and laminotomy. Laminectomy is a surgery in which your surgeon removes the back portion of one or more vertebrae to create more space for the spinal cord or other nerves. In people with severe arthritis, bone spurs within the spinal canal can grow large enough to press on the spinal cord, causing pain and limiting mobility. In a similar surgery known as laminotomy, your surgeon will remove a small piece of bone called the lamina from the back of the vertebra.
What To Do If You Have Symptoms Of Cervical Cancer
All of the symptoms we talk about on this page often happen for a reason other than cervical cancer. But if you have any of these symptoms or are worried about anything else, it is best to contact your GP as soon as possible.
Coronavirus and cervical cancer symptoms
We know it can be worrying when you notice unusual symptoms and you may feel especially concerned at the moment. If you have symptoms, you should ring your GP surgery and ask for an appointment. Your GP may want to assess you over the phone to help decide the next steps:
- Medical history. Your GP should ask about your medical history to try and understand what may be causing the symptoms. They may also ask about your last cervical screening result.
- Sexual history. Your GP may ask about the possibility of you having a sexually transmitted infection , which may be causing the symptoms. They may also ask if you are taking any contraception.
- Pregnancy. Your GP may ask about the possibility of you being pregnant and ask you to take a pregnancy test.
Once they know more about your individual situation, they will decide on the next steps. This may be seeing you at a face-to-face appointment to do a further examination.
Your GP may decide that you do not need an urgent face-to-face appointment. You can ask them why they think it is safe for you to wait, as their answer might reassure you. It is important to remember that cervical cancer is rare, so the likelihood that your symptoms are caused by cervical cancer is low.
What Are The Symptoms Of Low Back Pain
Low back pain is classified as acute and chronic. Acute low back pain lasts from a few days to a few weeks. Most acute low back pain will resolve on its own. Chronic low back pain lasts for more than 3 months and often gets worse. The cause of chronic low back pain can be hard to find. These are the most common symptoms of low back pain. Symptoms may include discomfort or pain in the lower back that is:
- Aching
- Protruding or herniated disk
- Disease
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Arthritis Of The Spine
Arthritis of the spine the slow degeneration of the spinal joints is the most frequent cause of lower back pain. All of us experience wear and tear as we age, and it is normal for your lower back to start acting up as you get older. As the cartilage breaks down between the spinal joints, surrounding tissues may become inflamed. The inflammation and the thinning of cartilage increase friction in the joints, which may cause pain in the lower back.
When To Call A Doctor
Consult your doctor if you have back pain thats intense, worrisome, or that doesnt go away with self-care measures. Its also important to call your doctor if your lower back pain is making it hard for you to go about your daily activities.
Most cases of lower back pain on the right side are not medical emergencies. However, dont hesitate to get immediate medical help if you experience back pain thats accompanied by any of the following symptoms:
- loss of bladder or bowel function
- sudden, severe pain
- weakness or loss of sensation in your lower body
- pain accompanied by fever, clammy skin, a rapid heart rate, nausea, vomiting, or any other concerning symptoms
The appropriate treatment for lower back pain emergencies depends on the cause. If the source of the pain isnt obvious, you may need one or more of the following screenings to determine the right course of action:
- an MRI to check your spinal cord, nerve roots, and other soft tissue
- an X-ray to look at your spine and other joints for signs of fracture or other concerns
- blood tests to check for markers of inflammation
If nerve or muscle problems are the cause of lower back on the right, epidural injections of corticosteroids may be necessary if the pain and loss of mobility and function are severe.
If appendicitis is diagnosed and it cant be managed by antibiotics, then emergency surgery to remove the appendix may be necessary.
- nerve compression in your spine
- disc degeneration
- an abdominal aortic aneurysm
- appendicitis
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What Pain Can Tight Hamstrings Cause
Tight hamstrings can cause the hips and pelvis to rotate back flattening the lower back and causing back pain, knee pain or foot pain. Tight hamstrings can also be responsible for postural problems and other back problems such as sacroiliac joint pain, as they will tend to pull the pelvis out of normal position.
What Are Some Complementary Alternative And Emerging Treatments For Lower Back Pain
In some cases, doctors suggest therapies that are not considered standard of care. They probably wont be covered by insurance, but they may be worth considering. Examples include:
Platelet-rich plasma . PRP treatments use a small sample of your own blood that has concentrated amounts of blood building blocks known as platelets. Your doctor then injects the PRP directly into a damaged disc. The theory is that PRP injections use your own healing system to accelerate improvement of injured tendons, ligaments, muscles, and joints. PRP treatment has a longer track record in knee osteoarthritis, but a recent review article in the Journal of Spine Surgery suggests it may have a useful role for back pain, too. PRP needs a lot more research before it can be considered a proven technique.
Stem cells. In this emerging treatment, your doctor injects stem cells harvested from your hip into the intervertebral disc or discs causing your pain. Doing so may lessen pain and the degenerative effects of aging, though, like PRP, more research is needed before stem cells for lower back pain could eventually become the standard of care.
Acupuncture. Your doctor probably doesnt perform acupuncture , but may support you trying it as a complementary therapy. Acupuncture involves careful insertion of fine, sterile needles into specific points on your body. This may stimulate the release of your natural pain-killing chemicals.
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Can Lower Back Pain Be Related To Weather
If you feel like your lower back pain worsens on days when its cold or the weather is changing, you are not imagining things. Back pain can indeed be related to barometric pressure and outdoor temperature. Changes in pressure can sometimes cause pain in arthritic joints, including the spine. Muscles and joints in general react to the environment, which can make them stiffer and more likely to suffer an injury.
What Can I Do For Low Back Pain At Home
If your lower back pain has just started, the best thing you can do is start a log. Record your symptoms, times, dates and which activities trigger the pain or make it worse or better. Take this information to your family physician if the pain doesnt resolve on its own. It will make diagnosing the cause much easier.
Once you know which motion or position causes your lower back pain, try to avoid it and see if you get better. Icing the painful spot can also help. And so can over-the-counter pain relievers that help reduce inflammation. Just remember that pain killers treat only the symptom pain and not its cause.
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More Advanced Care Options
Surgery When other therapies fail, surgery may be considered to relieve pain caused by worsening nerve damage, serious musculoskeletal injuries, or nerve compression. Specific surgeries are selected for specific conditions/indications. However, surgery is not always successful. It may be months following surgery before the person is fully healed and there may be permanent loss of flexibility. Surgical options include:
Implanted nerve stimulators
- Spinal cord stimulation uses low-voltage electrical impulses from a small implanted device that is connected to a wire that runs along the spinal cord. The impulses are designed to block pain signals that are normally sent to the brain.
- Dorsal root ganglion stimulation also involves electrical signals sent along a wire connected to a small device that is implanted into the lower back. It specifically targets the nerve fibers that transmit pain signals. The impulses are designed to replace pain signals with a less painful numbing or tingling sensation.
- Peripheral nerve stimulation also uses a small implanted device and an electrode to generate and send electrical pulses that create a tingling sensation to provide pain relief.
What Causes Low Back Pain
It might develop suddenly, like after you lift something heavy. Or it might come on slowly.
As you get older, the structure of your back begins to show wear and tear. Doctors call it âspondylosis,â which means your spineâs joints, disks, and vertebrae get worse over time. This slow decline can lead to many problems, like the following:
- Strains. This means you overstretch or tear your tendons or muscle. You can do this by twisting, lifting something thatâs too heavy, or lifting something the wrong way.
- Degenerated disks. When these are healthy, they cushion your back as you bend, flex, and twist. As disks begin to wear out, they no longer absorb the shock of these movements well.
- Herniated or ruptured disks. Normal disks are rubbery. When they become squeezed, a portion bulges out between your vertebrae.
- Radiculopathy. A spinal nerve can become pinched or inflamed. This can cause low back pain to travel down your legs. It can also cause numbness or tingling.
- Sciatica. This is the type of radiculopathy that affects the sciatic nerve, which runs from your butt down the backs of your legs. When itâs inflamed, you may feel burning or pain like an electrical shock that may go all the way down to your feet.
- Spondylolisthesis. In this condition, a vertebra slips out of place and pinches spinal nerves.
- Spinal stenosis. Your spinal column may narrow over time, putting pressure on your nerves. Your legs may feel numb and grow weaker.
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How Is Back Pain Diagnosed
Your health professional will first assess your back pain. They may ask questions including:
- When did your back pain begin?
- What activities were you doing differently to normal before your back pain started?
- How would you describe the pain? Is there tingling or numbness?
- What makes the pain better or worse?
If your pain doesnt settle after a few weeks or starts getting worse, ask your doctor or other health care professional about other management options. You may be referred for tests if there is reason to suspect a more serious cause for your back pain.
In most situations, imaging such as X-ray, CT or MRI scans are not helpful unless there is an obvious injury or strain.
Unnecessary tests can be expensive, and many investigations will show changes in your spine that reflect the normal passage of time, rather than damage to your spine.
Following Up With Your Doctor
After making treatment recommendations, a doctor will typically ask to see you again in 6 to 12 weeks. In the interim, if your chronic back pain symptoms do not improve or even get worse with treatment, you can contact your doctors office and ask about adjusting the treatment plan.
For example, if you have been diagnosed with chronic lower back pain caused by degenerative disc disease, you may be prescribed a muscle relaxant or advised to take an over-the-counter pain reliever. If you find the recommended medication causes side effects that you cant tolerate, your doctor can recommend alternatives.
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Vaginal Bleeding That Is Unusual For You
If you have regular periods, unusual vaginal bleeding happens any time outside of your regular period. It may happen:
- between periods
- during or after sex
- after the menopause.
Although this may be worrying, remember there are many different reasons for unusual bleeding that may not be related to cervical cancer. These include hormonal contraception and cervical ectropion. Whatever type of unusual vaginal bleeding you have, it is important to contact your GP. They can examine you and make sure everything is okay.
When To Get Medical Help And Advice
Nine out of 10 people find their lower back pain improves within four to six weeks. You may find that you feel better sooner than this, in a few weeks. But contact your GP if the pain is severe, getting worse over time or isnt improving after four to six weeks. Also, contact your GP urgently if you feel unwell or have a high temperature. And if you have had cancer or osteoporosis, your GP may want to check that there isnt a more serious cause.
Seek medical attention right away if you:
- have numbness or tingling around your bottom or genitals
- cant control when you pee or cant go at all
- lose control of your bowels
- are unsteady when you walk, your legs feel weak or your foot is dropping or dragging
These may be signs that the nerves at the bottom of your spine are being squashed. This is called cauda equina syndrome and needs urgent treatment.
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Prevention Of Lower Back Pain
If you know how to look after your back, you can greatly reduce your risk of getting back pain. It can help to do the following.
- Exercise regularly walking, swimming or using an exercise bike are all things you can do even if your back feels a bit sore. Take time to build up your fitness if youre trying new activities.
- Use your legs to lift objects by bending your knees and hips, not your back.
- Keep a good posture if you work at a desk, make sure your chair, desk and computer screen are set up correctly. It will help if your employer assesses your work station.
- Move regularly dont sit in the same position for long periods of time.
Diagnosing Lower Back Pain
To diagnose lower back pain, a doctor will first do a physical exam. Theyll look at how well you move and if your back has any visible issues.
Then theyll take a medical history. This will cover your symptoms, any recent injuries, previous back issues, and the severity of your pain.
A physical exam and medical history are often enough for a doctor to determine the cause of your pain. However, they may also need to do an imaging test. Potential tests include:
- X-ray, which can find broken or misaligned bones.
- CT scan, which shows soft tissues such as the discs between vertebrae and potential tumors
- myelogram, which uses dye to enhance the contrast in a CT scan or X-ray to help a doctor identify nerve or spinal cord compression
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Surgery For Lower Back Pain
Because the vast majority of patients recover from their low back pain with little help from a doctor, the rationale behind choosing surgery must be convincing. Eighty percent of patients with sciatica recover eventually without surgery.
Severe progressive nerve problems, bowel or bladder dysfunction and the cauda equina syndrome make up the most clear-cut indications for back surgery. Back surgery will also be considered if the patients signs and symptoms correlate well with studies such as MRI or electromyogram .
In the most serious cases, when the condition does not respond to other therapies, surgery may well be necessary to relieve pain caused by back problems. Some common procedures include:
- Discectomy, such as a or removal of a portion of a
- a bone graft that promotes the vertebrae to fuse together
- removal of the lamina to create more space and reduce irritation and inflammation
References and useful links
- 1, 2. Excerpted from Low Back Pain Fact Sheet, National Institute of Neurological Disorders and Stroke, National Institutes of Health
- Low Back Pain Fact Sheet, National Institute of Neurological Disorders and Stroke, National Institutes of Health. Reviewed, July 26, 2003.
- Deyo RA, Weinstein JN, Low Back Pain, N Engl J Med, Vol 344, No. 5, Feb 1, 2001, pp 363-370.
Home Remedies For Lower Back Pain When Sitting
In addition to improving your posture when sitting, try these at-home remedies for lower back pain:
- Change your position. Consider a standing desk or one thats ergonomically designed to help you maintain good posture by allowing you to adjust the height of your monitor.
- Apply ice.Cold helps reduce inflammation that may be affecting your back. Leave the ice pack on for about 20 minutes, and then remove it. You can do this every hour or so.
- Use a heating pad. After any inflammation is under control , many people find heat soothing. It also promotes healing by bringing blood to your back.
- Take over-the-counter medication.Pain relievers like nonsteroidal anti-inflammatory drugs can reduce discomfort and swelling.
- Use a support. Placing a rolled-up towel or special lumbar pillow at the base of your spine while sitting will help you remember to sit up straight and provide you with some stability.
- Get a massage. This can help loosen and relax tight muscles.
- Consider yoga.Yoga is known for its ability to stretch and strengthen the body. Many programs allow for modification of the poses as needed.
There are several exercises that will help strengthen your lower back. Try these three stretching exercises to help make your back stronger and better toned:
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