What Are the Pain Management Options For Treating Chronic Low Back Pain?

Over 80% of Americans will suffer from back pain at some point in their lives. Within 3 months of onset over 90% of back pain goes away on its own or with conservative treatment, however, the other 5-10% will be left with chronic back pain.

Once back pain becomes chronic, patients have several options.

1) Living with the pain as it is - It's not mandatory to undergo treatment if it's endurable. Chronic back pain can act as a "pebble in one's shoe" and affect capacity to work, concentration, social life, and lead to depression.

2) Traditional medical treatment - This includes physical therapy with lumbar stabilization, core strengthening, and other therapeutic measures.

3) Medication management - The basics of medication include Tylenol, non-steroidal anti-inflammatories (Ibuprofen, Advil, Naproxen, etc), muscle relievers (Valium), and narcotics (Percocet, Oxycontin, etc). One needs to be careful of the doseage to prevent side effects (such as liver or kidney issues) along with addiction to narcotics.

4) Interventional pain management - Pain injections can help with pain relief dramatically and also decrease the need for pain medication. If a patient has a radicular component to the back pain (sciatica), then an epidural injection can be of benefit. If there is arthritis or inflammation in the facet joints, then facet injections can help. Medial Branch Blocks and Radiofrequency Ablation can help as well. As a last resort, a spinal cord stimulator can be considered, but this falls into the surgical intervention category.

5) Alternative treatments - More and more these types of treatments are becoming mainstream. Chiropractic manipulation is very common these days and there is some literature showing effectiveness for chronic back pain. Acupuncture and massage therapy can be helpful for pain relief as well. Spinal Decompression Therapy, which is intermittent spinal traction, has been shown in numerous studies to be effective too.

6) Surgical Intervention - If conservative treatments fail, surgery can enter the picture as an option. Surgical options can range from spinal fusion to artificial disc replacement. Results are variable, and compilations of spine surgery results show effectiveness to average right around 60%.