Chronic Low Back Pain

Dealing with any sort of back pain can put up major obstacles for you trying to live life on a daily basis. When your back pain becomes chronic — lasting more than three months — we understand the sheer exhaustion that comes with this condition. If you’ve had chronic back pain for weeks, months or even years, our experts at Ohio State Spine Care are ready to help.

There may be an ongoing cause of the pain, such as arthritis or cancer. Unfortunately, in some cases, there’s no clear cause. Our experts know certain problems can lead to chronic back pain, including:

• Arthritis of the spine
• Spinal stenosis
• Herniated disc, or other spinal disc problems
• Degenerative disc disease
• Spondylolisthesis
• Facet joint pain
• Sacroiliitis
• Vertebrogenic low back pain

Chronic pain usually can’t be cured, but treatments can help alleviate symptoms. At Ohio State Spine Care, we always start with the least invasive treatment before considering surgical options.

Our experts are trained in orthopedic, neurological and physical therapy specialties, meaning we look at every factor that could be causing your chronic back pain.

Symptoms of chronic back pain

The symptoms of acute and chronic back pain are very similar, but different in their duration. Chronic back pain symptoms may come on slowly and can last for more than six weeks. Chronic back pain symptoms may also go away then return later. Acute back pain, however, comes on rapidly and is likely to go away within two to six weeks.

Symptoms include:

• Mild to severe pain that doesn’t go away
• Shooting, burning or aching pain
• Regular tightness or stiffness after lying down, sitting or standing for long periods of time
• Difficulty sleeping
• Pain radiating to the legs, feet or hips
• Pain that worsens with activity, especially bending, lifting, standing or walking
• Pain that lessens when reclining

Diagnosing chronic back pain

Many factors can contribute to your chronic back pain. Your initial visit to Ohio State Spine Care may be with a spine surgeon, orthopedic physician, physical medicine and rehabilitation specialist or nurse practitioner. We’ll listen to you carefully and perform a thorough examination to assess your range of motion and areas of pain.

Our team will work to determine if your pain is from affected muscles, ligaments, nerves, organs or something else. If you’ve been experiencing back pain for more than three to six months, it would be classified as chronic back pain.

To further confirm your diagnosis, we offer:

• X-rays of the spine
• Computed tomography (CT) scans
• Magnetic resonance imaging (MRI) scans
• Electromyography (EMG) studies, tests that measure the electrical activity of muscles and nerves

Nonsurgical treatments

Chronic back pain doesn’t automatically mean that surgery is your only choice. At Ohio State Spine Care, we exhaust all nonsurgical options first before recommending a more invasive procedure.

Our physicians recognize and understand the pain characteristics of back conditions. This helps us develop an effective, personalized treatment plan for you. Your treatment plan most likely will include several options, and you’ll be the primary decision-maker.

Physical therapy

Our physical therapy program includes therapists who specialize in complex spine conditions. They’re ready to create a customized plan for you, based on your needs and current range of motion. Usually, you’ll meet one-on-one with a physical therapist on pain-relieving movement exercises and ways to enhance strength and flexibility.

Radiofrequency ablation

Radiofrequency ablation (also called rhizotomy) helps with chronic pain that can't be resolved with the short-term relief provided by nerve blocks and spinal injections.

Prior to the procedure, your doctor will assess if you’re likely to have success with the ablation procedure. Doctors will use nerve blocks to determine which joints are causing the pain. If the nerve blocks give you substantial (greater than 80% pain relief) but only for a short time (1 to 8 hours) then you may be a candidate for radiofrequency ablation.

During an ablation procedure, our spine specialists burn the nerves, which effective stops the nerves from working and sensing pain.

Since your body’s nerves will heal, this procedure is rarely permanent. However, many patients can experience pain relief for 6 months to 1 year.

Additional nonsurgical treatments

• Learning ways to adapt daily tasks to be easier on your back
• Real-time ultrasound imaging (RUSI) of movement in the spine area to retrain and stabilize your spine
• Anti-inflammatory medications
• Guidance on maintaining a healthy weight to ease pressure on your back
• Pilates, yoga and aquatic therapy to strengthen back muscles
• Acupuncture or dry needling for pain control
• Spinal injections, such as epidurals or nerve blocks, to relieve pain
• Spine orthobiologics help your body repair damaged cells
• Spinal cord stimulation in the Center for Neuromodulation provides an option when surgery isn't an option or your preference. A device similar to a pacemaker, usually implanted under the skin in your abdomen or upper buttock, sends mild electrical impulses. You use a transmitter that controls the signal, which changes pain messages before they reach the brain. Instead of pain, you feel a soothing, tingling sensation.

Surgical treatments

When other treatment options have failed, surgery can benefit you under certain circumstances:

• Decompression surgery (laminectomy): If a particular nerve is causing pain, a spine surgeon can remove the pressure being placed on the nerve by moving, widening or removing bone causing the pressure.
• Spinal fusion surgery: When vertebrae (bones of the spine) are out of alignment and causing instability in the back, a spinal fusion surgery can be performed to permanently join two vertebrae together.
• Spinal canal surgery: Surgery around the spinal canal (the opening in the vertebrae through which the spinal cord passes) can be performed to repair a damaged disc.

Why choose Ohio State for treatment of chronic back pain?

Comprehensive care: The Ohio State University Wexner Medical Center has multiple options in one location to treat chronic back pain. Our experts will diagnose the severity of your condition and know which approach will restore you to the highest level of function possible with the least invasive treatment.

Team approach: At Ohio State, your care is not limited to just one physician’s perspective. We have a clinical team made up of neurological specialists, orthopedic physicians, physical therapy experts, pain specialists, spine surgeons and more, available to determine the source of your pain and make the most accurate diagnosis for you.

Physical therapy expertise: Our physical therapists specialize in spine conditions, working with you one-on-one to alleviate pain and improve strength and coordination.

Surgical expertise: For the majority of people with chronic back pain, surgery isn’t necessary. But if your quality of life is compromised, our fellowship-trained spine surgeons can address the most challenging surgical cases, helping people who haven’t found help elsewhere. We perform more complex spine surgeries than any other medical center in central Ohio.

Research: You’ll benefit from our involvement in national and international trials that provide you with the most current methods for chronic back pain treatment.

New technology: We rely on new technology to deliver better care for our patients. Recent additions include an implanted nerve stimulator that won’t interfere with an MRI scan. We also recently acquired a device to perform radiofrequency ablation, which uses radio waves to provide long-acting pain relief in the joint above the tailbone.

Research

Ohio State Spine Care conducts innovative research and participates in clinical trials that may be open to you as part of your treatment choices.

Areas of focus include:

Biomechanical testing: A specialized vest helps us understand your spinal movement and measure the effectiveness of surgery. This biomechanical testing ultimately may provide valuable information about which treatment methods will best increase mobility and function of the spine.

Back pain consortium: We are members of the International Consortium for Health Outcomes Measurement (ICHOM). Membership in this elite organization allows us to engage with other top U.S. medical centers in global research studies on back pain. As we measure our results against established international standards, we share best practices and elevate our standard of care.

Enroll in a clinical trial