Lower back pain can greatly affect patients’ physical, psychological, and social well-being, as well as their daily work and life. This time, Dr. Lee Yuk-ming, a specialist in pain medicine, will break down the common causes of lower back pain, related conservative treatments (such as medication and physiotherapy), and interventional treatment options, so that the public can better cope with the distress of lower back pain.
The Causes Behind Lower Back Pain
Dr. Lee Yuk-ming says that lower back pain refers to back pain below the ribs and buttock pain; sometimes the pain also extends to the thighs and calves. The causes of this condition are diverse, including degeneration or strain, trauma, inflammatory rheumatism, infection, fractures, and even possibly referred pain from internal organs or cancer.
When to Seek Medical Attention? Watch Out for Warning Signs!
Precisely because the causes behind the pain are complex, it is very important to to seek medical attention early if there is any doubt. Dr. Lee Yuk-ming reminds us that generally, if the pain persists for more than six weeks, or if it causes excessive restriction of activity or affects emotions, it is recommended to seek medical attention as early as possible.
Special attention should be paid to the following situations, which warrant immediate medical attention to avoid delaying treatment: loss of control of urine or stool, numbness of the perineum, weakness or numbness of both legs, a history of cancer, unexplained weight loss, nighttime pain, worsening pain, fever, or a high risk of fracture (such as long-term steroid use or significant trauma).
Comprehensive Diagnosis to Find the Underlying Cause and Treat Accordingly
After seeking medical attention, the doctor will conduct a comprehensive assessment of the patient, including understanding the impact of the pain on the patient and performing a clinical examination. When necessary, imaging tests (such as X-ray or MRI) will also be performed to understand the structural condition of the affected area and to rule out serious diseases (such as cancer or autoimmune diseases), thereby identifying the exact cause of the lower back pain and formulating an appropriate treatment plan.
Conservative and Interventional Treatment for Degenerative Lower Back Pain
Dr. Lee Yuk-ming points out that for degenerative lower back pain, conservative treatment is generally recommended first; if the effect is unsatisfactory, interventional treatment can be considered, in order to achieve better pain relief.
1. Conservative Treatment: Analgesics and Physiotherapy
The doctor will prescribe appropriate analgesics depending on the individual patient’s condition; commonly used ones include paracetamol, non-steroidal anti-inflammatory drugs, COX-2 inhibitors, and neuropathic pain medications. As for physiotherapy, it can generally be divided into two broad categories: active and passive. The former usually has more long-term benefit for the patient’s condition, while the latter is mostly used for short-term pain relief.
2. Interventional Treatment
Simply put, interventional treatment is minimally invasive surgery that does not require an incision; it is less invasive than open surgery, and its effect is usually better than conservative treatment. Some interventional treatment options are more commonly used to treat lower back pain, including:
- Regenerative therapy: such as platelet-rich plasma (PRP) and bone marrow aspirate concentrate (BMAC), which help promote tissue repair at the affected site and modulate the inflammatory response. Suitable for conditions such as sacroiliac joint pain and disc pain.
- Radiofrequency ablation (RFA): uses heat generated by radiofrequency to block the specific nerve signals causing the pain, thereby achieving pain relief. Suitable for conditions such as sacroiliac joint pain and facet joint pain.
- Spinal cord stimulator: the treatment course is usually performed by a pain medicine specialist. Its principle is to release a weak electrical current through a stimulator and wires to stimulate the spinal nerves, thereby achieving control of neuropathic pain. Suitable for cases such as long-term pain after lumbar surgery and sciatica.
Published in Health Power
