Low back pain can make it difficult to sit, stand, walk, sleep, work, or complete everyday activities comfortably. Some patients experience aching or stiffness across the lower back, while others develop sharp, burning, or electric-like pain that travels into the buttock, hip, leg, or foot.
Low back pain can come from irritated nerves, spinal discs, arthritic joints, narrowing around the spinal nerves, muscle tension, or changes that develop after spine surgery. Because several lumbar conditions can cause similar symptoms, the right treatment begins with a careful evaluation.
We commonly help patients experiencing:
Lumbar radiculopathy occurs when a nerve in the lower back becomes irritated or compressed. Sciatica commonly refers to pain that begins in the lower back or buttocks and travels into the leg along the path of the sciatic nerve.
Patients may describe the pain as sharp, burning, shooting, or electric-like. Some also experience numbness, tingling, weakness, or changes in sensation in the leg or foot. Symptoms may worsen with sitting, standing, bending, walking, coughing, or certain movements.
Treatment options may include:
The goal is to determine which nerve may be affected and whether inflammation around that nerve is contributing to your symptoms. Your provider may review prior imaging or recommend additional diagnostic steps when needed.
The lumbar facet joints are small joints located along the back of the spine. They support movement and stability but can become painful due to arthritis, age-related changes, injury, or ongoing mechanical stress.
Lumbar facet pain often causes an aching sensation across the lower back. It may spread into the buttocks or upper thighs and may worsen when standing, twisting, bending backward, or remaining in one position for an extended period.
Treatment options may include:
Medial branch blocks may be used as part of the diagnostic pathway for suspected lumbar facet-mediated pain. Radiofrequency ablation may be considered after completion of the required confirmatory medial branch block pathway under the applicable clinical and payer criteria.
Vertebrogenic low back pain is associated with pain signals coming from the vertebral endplates, which are located where the spinal bones meet the discs. In some patients, MRI findings known as Modic changes may indicate inflammation or damage in this area.
This type of pain is often felt in the center of the lower back and may worsen with sitting, bending forward, lifting, or prolonged activity. It may be persistent and may not respond fully to treatments aimed at the facet joints or spinal nerves.
Treatment options may include:
Basivertebral nerve ablation may be considered for appropriately selected patients with chronic axial vertebrogenic low back pain and Modic type 1 or type 2 changes from L3 through S1. The treatment pathway also requires failure of appropriate conservative care and assessment for other competing pain generators. The presence of a Modic change alone does not establish candidacy for the procedure.
Lumbar spinal stenosis occurs when the spaces around the nerves in the lower back become narrowed. This narrowing can place pressure on the spinal nerves and contribute to pain, numbness, tingling, heaviness, or weakness in the legs.
Neurogenic claudication refers to symptoms that commonly worsen while standing or walking and improve when sitting, resting, or leaning forward. Some patients find that they can walk farther when leaning over a shopping cart or similar support.
Treatment options may include:
The recommended approach depends on the severity of the narrowing, your symptoms, how far you can comfortably walk, and whether weakness or other neurological changes are present.
Patients may experience:
Treatment options may include:
Patients may experience:
Treatment options may include:
Some patients continue to experience back or leg pain after lumbar spine surgery. This may be described as persistent spinal pain after surgery or failed back surgery syndrome.
Ongoing symptoms can be related to nerve irritation, scar tissue, adjacent joint pain, sacroiliac joint dysfunction, recurrent disc problems, or other changes in the spine. Pain may remain in the lower back, travel into the legs, or involve both areas.
Treatment options may include:
Because persistent pain after surgery can have more than one source, treatment begins with a detailed review of your symptoms, prior procedures, imaging, and response to previous care.
If lower back pain, sciatica, leg symptoms, or difficulty standing and walking are interfering with your daily life, our team can evaluate your condition and discuss available treatment options.
Your evaluation may include a physical exam, a review of your symptoms and medical history, and a discussion of whether imaging, prior records, or additional diagnostic steps are needed to better understand your condition and recommend appropriate next steps.
We may ask about:
Not all lower back pain comes from the same source. An irritated nerve, herniated disc, arthritic facet joint, spinal stenosis, vertebral endplate pain, or muscle spasm may require a different treatment strategy.
Our approach focuses on:
