Understanding Lower Back Pain
Lower back pain is the leading cause of disability globally and affects approximately 80% of adults at some point in their lives. Despite its prevalence, lower back pain is highly treatable — particularly when diagnosed accurately and managed with appropriate, evidence-based interventions early in the course of symptoms.
Most acute lower back pain (lasting less than four weeks) resolves with conservative management. Subacute and chronic lower back pain (persisting beyond 6–12 weeks) requires a more structured, multimodal approach to address the structural pain generators, associated muscle dysfunction, and the risk of central sensitization that develops with prolonged pain.
Common Causes and Diagnoses
- Lumbar disc herniation — nucleus pulposus material compresses a nerve root, producing radicular leg pain (sciatica) and neurological symptoms
- Lumbar degenerative disc disease — loss of disc height and hydration causing mechanical back pain
- Lumbar facet osteoarthritis — arthritic degeneration of the posterior spinal joints producing axial back pain and referred pain into the buttocks and thighs
- Lumbar spinal stenosis — narrowing of the spinal canal causing neurogenic claudication (leg pain with walking, relieved by sitting)
- Spondylolisthesis — slippage of one vertebra over another
- Sacroiliac joint dysfunction — SI joint inflammation or instability causing low back and buttock pain
- Myofascial lower back pain — trigger points in paraspinal, gluteal, and hip musculature
Treatment Approach at CHLMD
Treatment begins with a comprehensive history, physical examination, and review of imaging. For patients with suspected radiculopathy or nerve involvement, EMG and nerve conduction studies clarify the level and severity of neurological involvement. This diagnostic precision allows Dr. Lichtblau to select treatments targeted to the specific pain generator.
Therapeutic exercise — core stabilization, lumbar mobility, hip strengthening, and functional movement training — is the most important long-term treatment for lower back pain and the cornerstone of every treatment plan. For patients with significant acute pain, trigger point injections release myofascial contributors, and facet joint or epidural injections reduce inflammation and radicular pain to allow active rehabilitation to proceed. Physical rehabilitation advances patients through progressive strengthening and functional restoration.
Prevention and Long-Term Back Health
Preventing recurrence of lower back pain requires addressing the mechanical factors that generated it — core weakness, hip flexibility deficits, poor posture, and movement pattern dysfunction. Dr. Lichtblau incorporates education on body mechanics, ergonomics, and a home exercise program as essential components of every treatment plan, equipping patients with the tools to maintain back health independently.
