Chronic Back Pain: Your Treatment Options
Back pain is a very common experience, affecting 1 in 6 Australians or about 4 million people per year. Many of us have experienced some form of back pain at some point.
What are the most common causes of chronic back pain?
Chronic back pain becomes more likely with age. It’s also more common if you’ve had a previous back injury.
Several health conditions can lead to lower back pain, including:
- Osteoarthritis in your spine, which leads to loss of the spongy discs between your vertebrae or facet joint arthritis, causing pain, and stiffness as the bones rub against each other.
- Spinal stenosis, a narrowing of your spinal canal, which can lead to back pain due to compressed nerves.
- A bulging or herniated disc
- Malalignment problems such as spondylolisthesis , kyphosis or scoliosis
- Fractures – particularly osteoporotic insufficiency fracture
- Myofascial pain syndrome, a chronic pain disorder.
It can be quite hard to find the source of some chronic back pain. Your spine is a complex structure of nerves, discs, vertebrae and joints, supported by various muscles and tendons. You may have had frustrating experiences already with different healthcare professionals giving diverging opinions about your condition.
Management and treatment of chronic back pain
In most cases, we recommend trying conservative treatments first. For chronic back pain, initial management may include:
- Physiotherapy to strengthen your core muscles, improve your posture and help with pain tolerance
- Psychological therapy to help you manage the added burden and frustration of living with persistent pain
- Lifestyle changes such as avoiding foods that promote inflammation, monitoring your activity levels and, if necessary, losing weight and stopping smoking
- Judicial use of steroid injections to help identify the source of pain and to reduce its severity
- Medications to reduce pain and strengthen the bone.
When do you need surgery for chronic back pain?
Back surgery must be carefully considered but it is sometimes the way forward with certain types of chronic back pain. Surgery may be worth considering if your back pain has a clear cause (confirmed by imaging tests) and hasn’t responded to other treatments.
Some symptoms are immediate indications for surgery. Severe back and (often) leg pain accompanied by weakness, numbness around your bottom and private parts and bladder or bowel incontinence are red flags for a condition called cauda equina syndrome which is a surgical emergency.
Back surgery is not an instant quick fix but it can help to stabilise your spine or relieve pressure on your discs or nerves.
At the Victorian Orthopaedic Spine Service, we perform many different types of back surgery including:
Radiofrequency neurotomy for facet joint syndrome
- Spinal decompression – microdiscectomy, laminectomy, laminoplasty
- Spinal fusion for degenerative disease and deformity using OLIF, ALIF or PLIF
- Robotic guidance and CT-navigated placement of spinal screws
- Spinal fracture fixation and reconstruction
- Spinal tumour biopsy, resection and reconstruction
- Spinal infection – drainage and reconstruction
- Adult scoliosis and kyphosis correction
- Cervical spine – ACDF, posterior instrumented fusion, corpectomy
You can read more about these operations on our back surgery page.
How can the Victorian Orthopaedic Spine Service help?
If you’ve been dealing with a bad back for more than 3 months, please contact us. We’ll listen to your symptoms, examine you thoroughly and order any tests necessary to identify the true source of your chronic back pain.
Then we’ll discuss your treatment options, starting with conservative methods such as medication, physiotherapy or injections. Our care pathway is designed to ensure you only progress to back surgery if you really need it.
If you do really need surgery, we’ll outline your options, help you understand the risks, benefits and costs and then perform it to high quality standards.
Book your appointment today.
* To receive Medicare rebates for your appointment costs, you will need an up-to-date referral from either a GP (usually valid for 12 months) or from another specialist (only valid for 3 months).
All information is general in nature. Patients should consider their own personal circumstances and seek a second opinion. Any surgical or invasive procedure carries risks.
About Dr David Edis
Dr David Edis is an Orthopaedic and Spine Surgeon. David’s areas of special interest include the management of adult spinal conditions as well as hip and knee replacements. He has extensive experience in all facets of spine surgery from simple to complex, covering cervical to lumbo-pelvic conditions. He is an active researcher and medical educator and believes in lifelong learning. He is constantly updating his skills and helping other surgeons.