At times, patients are told by their friends, family, or doctor that they should get an epidural because of their back pain. However, an epidural is not always the right answer for eliminating pain in a patient's back. Within the lumbar spine, there are many different structures that can cause pain - each of which responds to different treatments. The more you know about each treatment, the better educated you'll be when considering which route is best for your health.
Physical Therapy: Usually, physical therapy is the most optimal first treatment option for those with low back pain. If there is no fracture or other spine abnormality found in the examination, physical therapy should be initiated early on to help alleviate low back pain. A trained physical therapist will work together with patients to work on stretching, range of motion, strengthening, and posture correction that can be practiced with the goal of long term correction. In short; physical therapy provides great relief and lasting results for the majority of patients with low back pain when done properly and consistently.
Medications: There are a number of medications for low back pain that can temporarily help to decrease your symptoms while you are working on your physical therapy. These medications are used strictly on an "as needed basis" as a short term solution to helping with pain until it is relieved by therapy. Non-opioid medications such as anti-inflammatories and muscle relaxers can provide effective but fleeting symptomatic relief.
Spine Injections (Including Epidural Injections): When physical therapy and medications are not able to relieve low back pain over 4-6 weeks, a spine injection is considered an option that is beneficial in reducing pain in multiple scenarios.
Surgery: When the options above have been unsuccessful in relieving pain, surgery is always the last consideration for any patient. If all conservative treatments have failed, a consultation with a fellowship-trained spine surgeon may be indicated. All surgery comes with risks, but it could potentially be a long-term solution to your low back pain.