Low back & Leg pain
Low back pain is the leading cause of disability globally. In Australia, about 4.0 million people or 1 in 6 Australians (16%) had back problems in 2017-2018 and back pain led to181,000 hospitalizations. It accounts for 4.1% of Australia's total disease burden.
Back pain can occur anywhere along the spine including the neck (cervical), upper back (thoracic), lower back (lumbar) as well as the sacrum and coccyx (tailbone). The pain can be located solely in your back, or may be associated with a radiating pain into one or both your legs. Sometimes there may be associated muscle tightness, muscle spasms, or a numbness/tingling sensations in your legs In severe cases, it may affect your bowel or bladder control.
Chronic back pain can arise from multiple causes. Some of these include:
- Facet joint arthritis
- Disc degeneration, disc prolapse, disc herniation
- Spinal canal stenoses
- Foraminal narrowing with nerve compression
- Sacroiliac joint arthritis
- Coccyx pain
- Fractures
- Paraspinal muscles (rotatores, multifidus, interspinalis, semispinalis) located between the spinous and transverse process
- Referred pain from other systems (GIT, renal, vascular, pelvic)
In some cases, it may not be possible to identify the exact cause of the back pain. The pain experienced may differ depending on the cause. For example, facet joint arthritis is often experienced as a constant, dull aching pain localized to the back, that is exacerbated by activity and relieved with rest. Whereas nerve root compression results in a sharp, shooting pain down one or both legs that may be associated with numbness and tingling.
A careful and comprehensive assessment is required to determine the 'pain generator,' that is the cause of your back pain. Often imaging will help supplement the findings from a standard assessment via history and examination. Management of back pain requires a multimodal approach utilizing physiotherapy, pharmacology (analgesia), procedures and sometimes psychological input.
Procedures that may provide substantial relief of back and leg pain include:
- Facet joint injections
- Facet joint rhizotomy (of the median branch)
- Nerve root sleeve injections
- Dorsal root ganglion pulsed radiofrequency ablation
- Epidural steroid injection
- Sacroiliac joint rhizotomy
- Ganglion impar block and pulsed radiofrequency ablation
- Paravertebral block
Helpful Resources:
- Musculoskeletal Australia: Back pain information
- Educational video: Back pain
- Educational video: Herniated disc
- Educational video: Sciatica
- Musculoskeletal Australia: Managing your pain
- The Pain Toolkit
DisclaimerThe above information is for general education only and is not intended as a substitute for your own independant health advice. At Western Pain clinic we comprehensively assess each patients pain condition and provide advice using the latest evidence-based treatments. If you would like to find out more information about back and leg pain, please discuss this with our doctor during your consultation.