What are the most common problems in the lower back?
We see mostly lumbalgias and lumbo-ciatalgias. Low back pain is pain in the lumbo-sacral area and the sciatica gives irradiation to one or both legs. These pains are formed on the basis of degenerative changes in the spine that we all suffer throughout our lives. Low back pain is produced mainly by facet pain. The facets are the joints of the spine, or also degenerative changes in the disc. They can also be produced by irradiating the legs when there are nerve compressions due to herniated discs, protrusions or even by stenosis of the canal that is produced by degenerative changes of the facets.
What treatments can we perform?
In most cases we can perform conservative and minimally invasive treatments. Conservative treatment includes rehabilitation and all physiotherapy techniques that exist. The minimally invasive treatment is the infiltrations, for example epidural, to the small joints of the spine, the facets, where the medication is placed exactly where the problem occurs. It is a very effective and safe treatment. However, there are cases where this treatment does not solve the problems, that's where the surgery remains.
What role does surgery play in low back pain?
Surgery should always be the last resort. Today, new techniques allow us to cause minimal discomfort, such as surgery of the herniated disc and stenosis of the lumbar canal, where a microscope is used. The patient goes home the day after surgery. If the placement of an implant is indicated, such as severe instability or a degenerative deformity, thanks to advances in this field the patient recovers more quickly and can be discharged before returning to a normal life without pain.