In our previous blog we discussed conservative approaches to the treatment of chronic low back pain.  This blog will discuss more invasive procedures.  If conservative approaches do not work, many physicians refer their patients for more invasive procedures—typically injections or surgery.

Injections:  A neurologist injects anesthetics, steroids, or narcotics into the soft tissues and joints around your spine to reduce inflammation and relieve pain.  One of the most commonly injected medications is a synthetic version of cortisone, which is a natural steroid released by the adrenal glands when your body is under stress.  However, a review of studies found insufficient evidence that injection therapy is more effective than other treatments.

Surgery:  The most invasive approach “is the last resort—even for surgeons,” says James Weinstein, D.O., chair of the Orthopaedic Surgery Medical School and Dartmouth Medical School and Dartmouth-Hitchcock Medical Center.  Three of the most common operations include:

1.    Discectomy, or surgical removal of part of the damaged disc, is most often performed on herniated discs.  A 2006 study, though, found that lumbar discectomy offered only modest short-term benefits. 

2.    Laminectomy is the removal of part of a vertebra, and is used in certain cases of spinal stenosis or spondylolisthesis to decompress the nerve.

3.    Spinal fusion is the fusing together of vertebrae using bone grafts and metal rods.  In a 2001 study of patients with severe long-term back pain, pain was reduced by 33 percent after two years of those who had spinal fusion, compared with 7 percent for those who received more conservative treatment. 

Adapted from an article by Perry Garfinkel in the AARP Magazine

If you sustain an injury, consult with an experienced injury attorney.  Buckland & Schumm offers free initial consultations by telephone or in person.

Next Month—The Major Causes of Low Back Pain