Back Conditions
Minimally Invasive Techniques Used

Nitin Khanna, MD

Overview

Back (Lumbar) pain can be very difficult to treat. Successful treatment depends on early and accurate diagnosis. The first step for many patients is over-the-counter medications and some basic stretching exercises. If those fail, a doctor may order an MRI to obtain a look at the condition of the discs and spinal facet joints.

Unfortunately, many patients still suffer from back pain with an essentially normal MRI. Clinicians and patients alike can be very frustrated by this diagnostic dilemma. Recommendations for pain medications and non-specific injections will lead to unsatisfying results and continued pain.

And, lumbar pain is a common ailment that affects a growing number of Americans on a yearly basis. Many symptoms will improve over time and not require any type of medical intervention. The question is: When is back pain severe enough to need to be evaluated by a medical professional?

Patients with a long history of back pain may be suffering from degenerative conditions of the spine such as arthritis and degenerative disc disease. But, when other treatment methods have been utilized without effect, it may be time to investigate other symptoms and treatment methods. This is true especially symptoms are severe and are associated with radiation of pain in the arms or legs and/or if weakness is present in the arms or leg, it is time for a full evaluation. Often this is a sign of injury to a disc which may be compressing a nerve. In these situations, an expeditious evaluation can significantly improve results.

Our understandings about surgical treatments and pain injections have also progressed over the years. Injections can be very helpful for the treatment of acute injuries, such as a disc herniation, but their long-term effectiveness and use in treating chronic conditions have been called into question. There is an increasing body of evidence supporting minimally invasive spine surgery leading to decreased recovery times for patients. These advanced techniques are based on decreasing the muscle dissection and blood loss associated with open procedures. Surgical procedures on the back can now be done on an outpatient basis with little down time for the patient.