Minimally Invasive Treatments Can Help Relieve Back Pain

By Maneesh Bawa, M.D.

“Oh, my aching back!”

It’s a complaint many of us will have at some point in our lives. Back pain is one of the most common medical problems, affecting eight out of 10 people. Here’s a look at types of back pain and treatments available to relieve it.

Back pain can be acute or chronic.
Back pain can range from a constant dull ache to a sudden, sharp pain. Acute back pain comes on suddenly and usually lasts from a few days to a few weeks. We consider back pain chronic if it lasts for more than three months.

A number of factors can contribute to back pain, including overuse, injuries, trauma and illness. Lower back pain, or pain that radiates down into the leg, often may be due to a muscle or nerve injury. If you have pain that comes on suddenly for no apparent reason or doesn’t improve over time, call your primary care doctor or make an appointment with an orthopedic specialist.

Treatments depend on the cause and severity of back pain.
In general, you can treat mild injuries, especially minor muscle strains, with rest and over-the-counter anti-inflammatory medications such as ibuprofen. Massage, acupuncture, and chiropractic treatments may help relieve pain and promote healing. Physical therapy and muscle strengthening exercises can help restore strength and flexibility to injured muscles. If pain is severe, trigger point or epidural injections may help calm muscle spasms or block nerve pain while the body heals.

Surgery is always a last resort, but may be necessary for specific conditions such as a collapsed or slipped disc, herniated disc, compressed nerve, compression fracture, spinal instability, or spinal stenosis (narrowing of the spinal canal).

Minimally invasive surgery may be an option for many conditions.
Orthopedic surgeons may treat many of these conditions with minimally invasive surgery. Symptoms, medical history and the results of pre-surgical tests such as X-rays and MRIs help us determine the best option for each patient.

Whereas standard open surgery is performed through a large incision, minimally invasive surgery involves one or more small incisions. The orthopedic surgeon inserts a tube with a tiny camera through one of the incisions and, guided by images on a video screen, performs the procedure using very slim surgical instruments inserted through the incisions. In some cases, the surgeon may use a robotic surgery system, which offers the surgeon enhanced dexterity as well as a 3-D view of the surgical site.

The following orthopedic surgery procedures are often done using minimally invasive techniques:

• Laminectomy – Removal of the lamina, a bone at the back of the vertebra, to relieve pressure on spinal nerves
• Discectomy – Removal of all or part of a damaged spinal disc
• Kyphoplasty -- Inserting a balloon and cement into the bone to repair compression fractures.
• Disc replacement – Replacing a damaged disc with an artificial one
• Spinal fusion – Removing a damaged disc, and fusing vertebrae for stability.

Minimally invasive orthopedic surgery may offer several advantages.
Compared to standard open surgeries, multiple studies have shown that minimally invasive procedures may result in less blood loss, less pain after surgery due to smaller incisions, and reduced scarring.

In addition, minimally invasive surgery generally requires a shorter hospital stay. Depending on the type of minimally invasive surgery, the patient may go home the same day or within a few days.

While recovery time tends to be faster than open surgery, it varies with the specific type of procedure. How soon patients are given the green light to return to work depends on how quickly they heal and their occupation.

For a relatively simple surgery such as a laminectomy, patients may go back to desk work in a couple of weeks, while more physically demanding occupations could require six weeks of recovery. Physical therapy may be recommended to help patients safely gain strength to resume activities after surgery.

Although back pain is common, in many cases it doesn’t have to be a permanent and debilitating condition. With any type of treatment, our goal is to return patients to an active and fulfilling lifestyle.

Maneesh Bawa, M.D. is an orthopedic spine surgeon with Scripps Health. “To Your Health” is brought to you by the physicians and staff of Scripps. For more information, please visit www.scripps.org/Patch or call (858) 914-4275.