BACK AND LEG PAIN

WHAT IS IT?

Low back pain is the second most common reason for a patient to seek medical attention. It can range in intensity from a dull, constant ache to a sudden, sharp or shooting pain. It can begin suddenly as a result of an accident or by lifting something heavy, or can develop over time as we age.1 What’s more, pain that starts in your back often spreads to other areas, such as your buttocks, pelvis and legs.

Most low back pain is acute and can be resolved between a few weeks with no residual loss of function. However, approximately 20% of people affected by acute low back pain develop chronic low back pain with persistent symptoms.

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BACK AND LEG PAIN

WHAT CAUSES IT?

Most acute low back pain is due to a disruption in the way the components of the back (spine, muscle, intervertebral discs, and nerves) fit together and move. Some examples of include:

  • Skeletal irregularities, such as scoliosis, lordosis and kyphosis
  • Spina bifida
  • Sprains (overstretched or torn ligaments), strains (tears in tendons or muscle) and spasms
  • Traumatic injury, which could be caused by playing sports, car accidents, or a fall
  • Intervertebral disc degeneration, which occurs when the rubbery discs in the spine are worn down
  • Spondylosis, which refers to the general degeneration of the spine
  • Arthritis
  • Spinal nerve compression
  • Sciatica, caused by something pressing on the sciatic nerve that travels through the buttocks and extends down the back of the leg
  • Herniated or ruptured discs
  • Infections
  • Cauda equina syndrome, which occurs when a ruptured disc pushes into the spinal canal and presses on the bundle of lumbar and sacral nerve roots
  • Osteoporosis

Tests to diagnose and determine the cause of low back and leg pain include: bone scans, discography, electromyography, CT scan, MRI scan and X-ray imaging.

BACK AND LEG PAIN

TREATMENT OPTIONS

Acute back pain usually gets better on its own and can be treated with medications designed to relieve pain and inflammation, heat or ice packs, and gentle stretching upon advice by your healthcare professional.

The treatment of chronic low back and leg pain often requires a step-by-step approach from a multidisciplinary team, moving from minimally invasive to more invasive treatment options.

  • Medications, such as analgesics and NSAIDS
  • Physical therapy programs to strengthen core muscles that support the low back, improve mobility and flexibility, and promote proper positioning

The next step of the treatment journey may involve spinal injections, which cover:

  • Epidural steroid injections into the lumbar area of the back
  • Radiofrequency ablation, which involves inserting a fine needle into the area causing the pain through which an electrode is passed and heated to ablate the nerve fibres that carry pain signals to the brain. The procedure can relieve pain for several months

More advanced care options include:

  • Neuromodulation or Spinal Cord Stimulation (SCS), which works to reduce pain by altering the pain signals as they travel up the spinal cord to the brain. A generator, similar to a cardiac pacemaker sends electrical pulses to a thin wire called a lead. The lead is placed in the epidural space and delivers pulses to nerves along the spinal cord. The pulses modify the pain signals as they travel to different types in the brain

Surgical options such as vertebroplasty and kyphoplasty, spinal laminectomy, discectomy and microdiscectomy, foraminotomy, artificial disc replacement and spinal fusion

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