Most episodes of back pain will heal with time. About 50% of patients will get some relief from low back pain within two weeks of onset of symptoms, and 90% within three months, regardless of what treatment is given.

The majority of acute episodes are due to muscle strain, which tend to resolve with time because muscles have an excellent blood supply, thus delivering healing nutrients to the site of injury.

Many patients will seek medical care within three months, which is reasonable. After three months, or in patients who also have additional symptoms like associated leg pain or weakness, additional evaluation should be performed.

Common causes of leg or back pain in the younger (20-60 year old) population include disc problems like disc herniation, degenerative disc disease and spondylolisthesis.

Common causes in the older (over 60) population tend to be from the facet joints or osteoarthritis in the spine, including conditions like facet joint osteoarthritis and degenerative spondylolisthesis.

The problem is that traditional treatment options included waiting, addictive pain medicines, or huge back surgeries that always included long recovery times and often did not necessarily appear to help the original symptoms.

In the past few years a large number of new therapies have been developed for low back pain. These include better and less addictive pain medicines, back manipulation, and minimally invasive procedures.

There are a large category of modern treatments today that are considered minimally invasive, and that are performed by interventional radiologists. Spinal injections are often used to both treat and better delineate foci of back pain when related to a specific joint or disc.

Vertebroplasty and kyphoplasty are relatively recent procedures developed to stabilize compression fractures of the spine usually in situations of osteoporosis. There are also newer applications in stabilizing and treating metastatic or painful tumors of the spine. A very new procedure is that of percutaneous facet stabilization either through radiofrequency ablation of the facet joint or insertion of a bony allograft plug to fix the facet joint.

Both of these procedures only require a small needle hole on the order of a few millimeters for the procedure to be completed. Another procedure allows disc decompression through the use of a relatively small catheter and needle, again instead of a large surgical incision, and therefore allows a much shortened recovery time after treatment.

Dr. Dietrich Schultze is an Interventional Radiologist with Parker Adventist Hospital.

Contact information: Diversified Radiology of Colorado PC 938 Bannock St Ste 300 Denver, CO 80204 (303) 914-8800