Your back plays a vital role in nearly every movement — walking, bending, lifting, and even sitting. When pain strikes, it can make these everyday activities difficult. Back problems are common and can affect anyone, regardless of age, lifestyle, or job. While most conditions are treatable, the key to recovery is identifying the root cause of pain.
Back Anatomy – The Foundation of Support
The spine is designed to be both strong and flexible, supporting the body in movement and protecting the spinal cord. When one part is injured or misaligned, it can lead to widespread pain and mobility issues.
The back is made up of:
- Bones (Vertebrae): 33 stacked bones protecting the spinal cord
- Discs: Soft, cushion-like pads that act as shock absorbers between vertebrae
Common Back Issues
Here are five of the most frequent causes of back pain, their symptoms, and treatment approaches:
- Back Injuries (Muscle, Ligament, or Joint Strain)
Sudden twists, heavy lifting, or awkward movements can strain muscles, ligaments, or joints. These injuries are painful but often heal with conservative care.
Symptoms:
- Dull, achy pain or soreness in the lower back
- Tenderness to touch
- Muscle spasms or stiffness
- Pain worse with movement, improved with rest
Treatment:
- Short periods of rest (avoid prolonged bed rest)
- Ice/heat therapy
- Over-the-counter anti-inflammatory medication (NSAIDs)
- Gentle stretching or physical therapy
💡 Opioids are not typically recommended for muscle or ligament injuries, as most people improve with conservative measures.
- Sciatica (Lumbar Radiculopathy)
Commonly called sciatica, lumbar radiculopathy occurs when one of the spinal nerve roots in the lower back — often L4, L5, or S1 — becomes irritated or compressed. This irritation produces pain that follows the path of the sciatic nerve, running from the lower back through the buttock and down the leg.
Symptoms:
- Pain radiating from the lower back to the buttock, thigh, or foot
- Burning, shooting, or tingling sensation
- Weakness or numbness in one leg
- Pain that worsens with prolonged standing or walking and improves with sitting
Treatment:
- Heat and cold therapy
- Anti-inflammatory medications (NSAIDs)
- Nerve pain medications (neuropathic agents such as gabapentin or pregabalin, when symptoms involve burning or tingling)
- Gentle stretching or physical therapy
- Epidural steroid injections for persistent inflammation
- Surgery is considered only if symptoms are severe or do not improve with conservative care
💡 Opioids are not recommended for chronic back or nerve pain, as they do not address the underlying problem and carry higher risks of side effects and dependence.
- Wear and Tear (Degenerative Disc Disease, Osteoarthritis, Spinal Stenosis)
As we age, spinal structures naturally break down. Discs may lose height, joints may develop arthritis, and the spinal canal can narrow, putting pressure on nerves. These changes can cause stiffness, activity-related pain, or persistent discomfort.
Symptoms:
- Chronic back pain that flares with activity
- Stiffness and reduced flexibility
- Pain with prolonged sitting or standing
- Sometimes leg pain or weakness if nerves are compressed
Treatment:
- Low-impact exercises (walking, swimming, cycling)
- Physical therapy to strengthen supporting muscles
- Medications (NSAIDs, or nerve pain agents for neuropathic symptoms)
- Lifestyle adjustments (posture, ergonomic changes, weight management)
- Injections (such as epidural steroids or facet joint injections) to reduce inflammation and pain
- Advanced minimally invasive procedures when conservative care is not enough:
- Basivertebral nerve radiofrequency ablation (BVN RFA): For chronic low back pain caused by vertebral endplate nerve irritation
- Facet joint radiofrequency ablation (Facet RFA): Uses targeted heat to block pain signals from arthritic facet joints
- Spinal cord stimulation (SCS): An implanted device that modifies pain signals, useful for chronic back and leg pain not responsive to other therapies
- Minimally invasive lumbar fusion (arthrodesis): Stabilizes the spine when instability or advanced degeneration is the main cause of pain
- Kyphoplasty: A minimally invasive procedure performed at OSMI to stabilize and restore height to fractured vertebrae caused by osteoporosis or trauma
💡 Opioids are generally discouraged for long-term management of degenerative spine conditions, as safer and more effective alternatives are available.
- Slipped Disc / Spondylolisthesis
When a disc herniates or a vertebra slips forward, it can compress nearby nerves. This is often related to injury or repetitive strain.
Symptoms:
- Localized or radiating back pain
- Sciatica-like pain in one or both legs
- Tight hamstrings and leg weakness
- Pain relief when sitting
Treatment:
- Activity modification
- Heat/cold therapy
- Physical therapy (including water-based exercise)
- Anti-inflammatory medications
- Surgery if pain is disabling or if nerve damage occurs
💡 Opioids may be considered only in short-term, severe cases, but safer alternatives are usually preferred.
- Scoliosis
Scoliosis is an abnormal sideways curve of the spine, most often identified in children and adolescents.
Symptoms:
- Uneven shoulders or hips
- One shoulder blade protrudes more than the other
- Leaning to one side
- Mild scoliosis usually does not cause pain
Treatment:
- Observation for mild cases
- Bracing in growing children and adolescents to prevent worsening
- Surgery for severe curves
- Exercise for flexibility (though it does not correct the curve)
💡 Opioids play no role in scoliosis management; treatment focuses on posture, bracing, and, in some cases, surgery.
When to See a Doctor
Occasional backaches are common, but warning signs should not be ignored. Seek medical attention if you experience:
- Pain lasting more than a few weeks
- Pain radiating down the legs
- Weakness, numbness, or tingling
- Loss of bladder or bowel control (emergency)
- Severe pain following an injury or trauma
Non-Surgical Treatment Options
Most back conditions improve without surgery. Conservative care focuses on pain relief, reducing inflammation, and restoring mobility.
Options include:
- Rest & activity modification (stay gently active, avoid painful movements)
- Physical therapy to strengthen muscles and improve flexibility
- Heat & cold therapy
- Medications (NSAIDs, muscle relaxants, or nerve pain medication)
- Injections (corticosteroids for inflammation)
- Lifestyle changes (weight management, posture correction, ergonomic adjustments)
Surgical and Advanced Treatment Options
Surgery is considered only when conservative measures fail or when there is a risk of permanent nerve damage. Advances in minimally invasive techniques and interventional procedures mean many patients now have options that are safer, less invasive, and allow quicker recovery.
Common surgical procedures (typically performed by spine surgeons) include:
- Discectomy: Removing part of a herniated disc to relieve nerve pressure
- Laminectomy: Removing part of the vertebra to create space and reduce nerve compression
- Spinal Fusion (Arthrodesis): Joining vertebrae to stabilize the spine in cases of severe degeneration or instability
Minimally invasive and interventional options available at OSMI include:
- Basivertebral nerve radiofrequency ablation (BVN RFA)
- Facet joint radiofrequency ablation (Facet RFA)
- Spinal cord stimulation (SCS)
- Kyphoplasty: Performed at OSMI to stabilize spinal fractures and restore vertebral height
- Select cases of minimally invasive lumbar fusion (arthrodesis): Offered in a multidisciplinary setting for carefully chosen patients, with referral to spine surgery colleagues when more extensive reconstruction is required
💡 Opioids are generally not a long-term solution for spinal pain. At OSMI, we focus on safer, more effective treatments that target the true source of pain.
OSMI Approach
Your back is your body’s central support beam — treat it with care. Understanding the causes of back pain and knowing when to seek help can make all the difference in recovery.
At the Orthopedic & Sports Medicine Institute (OSMI), our orthopedic spine specialists provide comprehensive care for back and spine conditions. We tailor each treatment plan to your unique needs, offering both conservative therapy and advanced surgical solutions.
With convenient clinic locations in Fort Worth, Mansfield, and Decatur, OSMI is here to help you restore mobility, ease pain, and return to the activities you love. Don’t let back pain hold you back — contact us today to schedule your appointment.