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Back Pain Treatment

Back pain is a common complaint. Four out of five people in the United States will experience lower back pain at least once during their lives. It's one of the most common reasons people go to the doctor or miss work. On the bright side, you can prevent most back pain. If prevention fails, simple home treatment and proper body mechanics will often heal your back within a few weeks and keep it functional for the long haul. Surgery is rarely needed to treat back pain When back pain does not subside, and the injury or illness that caused it has had sufficient time to heal, it is termed chronic back pain. Chronic back pain usually lasts more than three months and may be mild or severe. Amongst the common causes for your back pain may be facet joint or herniated intervertebral disc (slipped disc).

Causes of Lower Back Pain :

  • Bulging Or herniated (slipped disc)
  • Sciatica - Herniated disc pressing over the nerve going to your leg causing sharp shooting pain the back & leg
  • Arthritis - It can lead to narrowing of the space around the spinal cord called spinal canal stenosis. This can cause back & leg pain.
  • Structural irregularity - Your spine may have abnormal curvature either side to side or excessive curve in front/ back.
  • Osteoporosis can cause vertebra fracture & can cause back pain. common in old age.
  • Rare causes include Cancer, infection, cauda equina syndrome.

Contact your physician immediately when you have constant unrelieved pain, pain going in legs specially below knee, causing weakness & numbness, or loss of bowel / bladder control, follows fall or trauma, associated with abdominal pain or fever or associated with unexpected weight loss.

Commonly done tests are X-rays, MRI, Nerve conduction studies, Bone scan, blood tests. Treatment includes medicines, physical therapies for the first 4 weeks. Injections for spine pain like epidural steroid injections, facet joint or its nerve block, radiofrequency ablation (RFA), Provocative discography, Percutaneous Disc FX Discectomy, Dekompressor / ozone discectomy, Percutaneous endoscopic transforaminal discectomy.

Pain physicians at PCI are pioneer and leaders in these advanced minimally invasive techniques with more than 15000 procedures already being performed in last 12 years.

These procedures can cure patients and proven to be successful in avoiding surgery in almost 95% cases.

Surgery for spine pain is the last resort therapy and can be avoided in majority of patients with interventional pain procedures.

Surgery is only indicated when there are RED FLAG signs.

Lower Back Pain Symptoms - What are they? 

Features, signs and symptoms in a patient with lower back pain which indicate serious spinal pathology,


  • Previous history malignancy (however long ago)

  • Age 16< or >50 with NEW onset pain

  • Weight loss (unexplained)

  • Previous longstanding steroid use

  • Recent serious illness

  • Recent significant infection


  • Saddle numbness (around anus and testicals)

  • Reduced anal tone

  • Hip or knee weakness

  • Generalised neurological deficit

  • Progressive spinal deformity

  • Urinary retention


  • Non-mechanical pain (worse at rest)

  • Thoracic pain

  • Fevers/ rigors

  • General malaise

  • Urinary retention

How to identify

  • High index of suspicion

  • Majority of information in history

  • Simple inspection of back with movement

  • Simple neurological examination

  • Heel/ toe walk, squat


Cord Compression

  • Back pain

  • Leg weakness

  • Limb numbness

  • Ataxia

  • Urinary retention (with overflow)

  • Hyper-reflexia

  • Extensor plantars

  • Clonus

Cauda Equina

  • Bilateral leg pain

  • Back pain

  • Urinary retention

  • Perianal sensory loss

  • Erectile dysfunction

  • Reduced anal tone


When to investigate RED FLAGS-

  • Urgent when red flags present

  • To include:

    • Myeloma screen

    • ESR, CRP, FBC, U+E, Ca2+

    • Plain xray particularly osteoporosis / infection

    • Consider MRI

Pain Clinic of India • Lower Back Pain Testimonial

Lower Back Pain Testimonial

"Since december I started to feel the pain in my lower back. Initially for the pain I took medications from my family doctor. In May month the pain got worse, I was unable to stand, sit and even sleep properly. On doctor’s advice I got my MRI scan done. the doctor told me that I have reduced gap (herniated disc) in my vertebrae. The doctor recommend me to consult Pain specialist at padma spine and pain center (Goa Branch of Pain Clinic Of India Pvt. Ltd.) and show the MRI reports to them. The Dr. Vicky Nevagi Pain management specialist from Pain clinic of India advised me to go for minimally invasive endoscopy treatment.

First they started the treatment with medications and physiotherapy for back pain. They gave me a test injection to know if pain gets relieved, after the injections I got relief from unusual sensations in legs and back pain. I decided to go for endoscopy as I wanted permanent cure. Endoscopic stitchless discectomy operation has been performed by the specialists at Pain clinic and after the operation I could lift my leg as usual without any discomfort. There was great relief in my leg and back. After 1.5 months they told me to get physiotherapy treatment. I got the treatment over two weeks and tI felt very great. The improvement is almost beyond belief. Thanks Dr. Nevagi and staff at Pain clinic of India !!"

-- Ridhi Mahale, Age 27, Pain Clinic Of India (Goa Branch) Patient

Dr. Kailash Kothari,

Book Appointment With Dr. Kailash Kothari,Spine Specialist

Dr. Kailash Kothari

+91 - 93200- 27500

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