Pain Management

Low Back (Lumbar) Pain

There are many sources of pain in the lower back. The lumbar spine, including the lumbar disc, joints, and ligaments are all source of low back pain. In addition, the muscles in the lower back are a source of low back pain, particularly after strenuous activity. Most acute low back pain is musculoskeletal and can be treated with exercise and anti-inflammatory medications.

A program of home exercises can then help to prevent the pain from recurring. There are times when the pain comes from the deeper tissues and joints. Your doctor may want to do further evaluation to determine where in your spine the pain is coming from.

What Causes Low Back Pain?

There are many causes of low back pain. The most common is muscle spasms resulting from overactivity. Most acute low back pain eventually goes away with little or no treatment. However, some low back pain originates in the spine and may be more persistent. The facet joints, lumbar discs and sacroiliac joint are common spinal sources of low back pain.

The lumbar facets are often a source of low back pain in middle-aged to elderly patients or those following trauma. The pain is more often felt in the lower back and often made worse with changing position and other movements. The pain may spread to the back of the thigh but usually does not go down to the feet. There may or may not be signs of facet arthritis on imaging (x-ray, CT or MRI). At the Emory Pain Center we have very effective methods for treating pain that comes from the lumbar facet.

The sacroiliac joint is the largest joint in your body. It is supported by muscles and ligaments which also may be a source of low back pain. It is also a source of hip pain. Sitting or standing for a long time tends to aggravate pain from the sacroiliac joint. There are minimally invasive treatments performed in conjunction with physical therapy that are very helpful in relieving pain from the sacroiliac joint.

How is Low Back Pain Treated?

There are many options that the specialists at the Emory Pain Center offer for the treatment of low back pain. The most important first step is a diagnosis of the pain generator (where the pain is coming from). In addition to a thorough physical exam, we perform a full evaluation of your imaging (e.g., X-rays or MRI) and other testing to help us determine the precise origin of your pain. Pain coming from the lumbar facets or sacroiliac joint or even from the hip often is diagnosed as a result of targeted diagnostic blocks (e.g., lumbar facet blocks or sacroiliac joint injections to block the pain). Once the source is located, we have a variety of treatment options to block the pain. We also work closely with physical therapists to maximize your relief and provide comprehensive treatment of your pain.

Treatment options include:

  • Non-narcotic analgesic medications
  • Physical therapy
  • Lumbar Epidural Steroid Injections
  • Lumbar Facet Injections
  • Sacroiliac Joint Injections
  • Hip injections with steroid
  • Lumbar medial branch injections and radiofrequency denervation.