Reviewed by Patrick Ahern, M.D.
In short, many cases of lower back pain can be treated effectively with minimally-invasive care that targets the source of the problem rather than relying on broad or aggressive interventions. At TSAOG, our spine specialists are here to help you better understand your symptoms and explore treatment options tailored to the underlying cause of pain.
Lower back pain is one of the most common reasons people seek medical care, but the cause is not always the same from one person to the next. Some cases stem from irritated nerves, while others involve joints, discs, or surrounding soft tissues. Because of this, treatment is not one-size-fits-all. The most effective approach begins with identifying what is actually causing the pain.
What Causes Lower Back Pain?
Lower back pain can develop from a variety of conditions affecting the spine and surrounding structures. In many cases, the issue involves spinal disc degeneration, facet joint arthritis, hip joint inflammation, spinal nerve irritation or muscular strain. At the core of the discomfort is inflammation of these areas. That inflammation is what causes significant and, often, chronic pain.
How Doctors Diagnose The Source Of Lower Back Pain
Accurate diagnosis is the foundation of effective care. Physicians begin by evaluating symptoms, movement patterns, and medical history to identify potential causes. Imaging studies such as X-rays or MRIs may be used to confirm structural issues, but they are often combined with clinical findings to avoid over-reliance on imaging alone.
In some cases, diagnostic injections are used to pinpoint the exact source of pain. By temporarily numbing a specific nerve or joint, providers can determine whether that structure is responsible for the patient’s symptoms. This step helps guide treatment decisions and ensures that any procedure is targeting the correct area.
Once the source of your pain is identified, we can then create a tailored plan to reduce your pain while allowing you to avoid back surgery.
Minimally Invasive Treatments Based On The Cause Of Back Pain
Most patients begin with conservative treatment approaches, including physical therapy, activity modification, medication management and guided care through TSAOG’s pain management services, before moving to more advanced interventions when needed. Research supports this stepwise approach, with nonpharmacologic therapies often forming the foundation of effective back pain treatment.
The majority of low back pain involves muscular tension, spinal nerve irritation, joint arthritis or spinal disc degeneration.
Muscular pain is caused by tight bands or “knots” in the muscles called trigger points. Irritated muscle can create persistent discomfort even when structural damage is minimal. This myofascial pain responds well to stretching, massaging, ergonomic changes, physical therapy, and trigger point injections that we perform in clinic.
Steroid injections are a common and effective way to treat nerve irritation from sciatica and piriformis syndrome in addition to pain from the sacroiliac joint – where your hips meet your spine. These pain generators affect the lower back, buttocks and can even spread to the legs. Performing a targeted steroid injection at the affected site is a quick, low-risk and effective way to reduce inflammation and provide long-lasting pain relief.
Low back pain stemming from joint arthritis and disc degeneration are causes of low back pain that are treated with a separate technique – nerve ablations.
Low back arthritis involves facet joints and is associated with stiffness and pain with twisting. A very specific nerve at these joints is responsible for transmitting the pain signal. Knowing this, we can ablate, or kill, the nerve just using a needle. These facet joint ablations provide pain relief for approximately 12 months and can be repeated if the pain ever returns.
Low back pain originating from disc degeneration has been historically difficult to treat. Fortunately, a relatively new procedure has been developed to target what is defined as vertebrogenic pain. The Intracept® ablation of the basivertebral nerves is minimally-invasive and provides many years of pain relief.
Lastly, spinal cord stimulation and peripheral nerve stimulation therapy are implant-based devices that work by blocking pain signals. Put simply, the device “turns down the volume” of low back pain. These are valuable treatment options in patients who may not be suitable candidates to undergo low back surgery.
Each of these approaches are performed with image-guidance to ensure precision. Because they are less invasive, recovery times are short and patients return to daily activities quicker compared to traditional surgical methods.
Schedule A Minimally Invasive Back Pain Evaluation at TSAOG Orthopaedics & Spine
If lower back pain is limiting your daily activities, a targeted evaluation can help identify the underlying cause and determine whether minimally invasive treatment is appropriate. TSAOG’s specialists provide comprehensive care, including advanced diagnostics, non-surgical treatment options, and surgical expertise when needed through their orthopaedic back and neck surgery team.
More importantly, treatment plans are built around the individual, not just the diagnosis. After identifying the source of pain, providers will discuss a spectrum of treatment options that begins with the least invasive and progresses further only if needed. This structured approach allows care to evolve based on the patient’s response, rather than moving directly to more aggressive treatment.
A personalized treatment plan can help address the source of pain while minimizing downtime and disruption. Contact TSAOG today to schedule an evaluation and take the next step toward lasting relief.
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Additional references:
- Latest Evidence-Based Application for Radiofrequency Neurotomy (LEARN): Best Practice Guidelines from the American Society of Pain and Neuroscience (ASPN) – PMC
- Long-term outcomes following intraosseous basivertebral nerve ablation for the treatment of chronic low back pain: 5-year treatment arm results from a prospective randomized double-blind sham-controlled multi-center study
- Trigger Point Injections – PMC
- Treating Low Back Pain in Failed Back Surgery Patients with Multicolumn-lead Spinal Cord Stimulation – PMC
- Percutaneous Peripheral Nerve Stimulation of the Medial Branch Nerves for the Treatment of Chronic Axial Back Pain in Patients After Radiofrequency Ablation – PMC
