Back pain is a common ailment, ranking among the top reasons people visit their doctor. Often, the cause is soft tissue inflammation, muscle spasms, or degenerative arthritis. These conditions typically respond well to conservative treatments like anti-inflammatory medications, stretching exercises, and osteopathic manipulative therapy. Additional helpful options include physical modalities such as heat or cold therapy, massage, and acupuncture.
However, certain symptoms warrant immediate attention. Any loss of bowel or bladder control requires prompt medical evaluation. In such cases, surgery may be necessary to relieve pressure on the nerves, often restoring full function.
The longer bladder or bowel control loss persists without treatment, the greater the risk of permanent damage. This also applies to muscle weakness in the legs or feet, where timely intervention can reduce the risk of falls and fractures.
Despite common misconceptions, a comprehensive medical history, neurological and structural examinations, and basic spinal X-rays can accurately diagnose the problem in 80-90% of cases. While expensive MRI studies can provide detailed cross-sectional views of the spine, discs, and spinal cord, they often don’t alter the course of conservative treatment.
Consider an MRI if surgery is a likely option, especially if symptoms fail to improve after several weeks or if pain worsens.
Beyond muscle spasms, degenerative discs, and osteoarthritis, chronic structural imbalances significantly contribute to lower back pain. The cumulative effects of old traumas, sports injuries, and obesity can cause spinal discs to lose their cushioning ability, potentially leading to bulging or protrusion.
It’s important to note that almost everyone over 50 experiences changes in their spinal discs, including height loss and bone spur formation. However, not everyone experiences pain. Surgery is typically only beneficial when a nerve root or the spinal cord itself is compressed. Even radiating leg pain (sciatica) accompanied by numbness and tingling can often resolve with appropriate treatment, including osteopathic manipulation therapy.
Studies indicate that, after five years, back pain sufferers who undergo surgery experience no better pain relief or functional improvement than those who pursue non-surgical options. Therefore, seeking a second opinion before opting for surgery is advisable.