Back pain and sciatica treatment in Austin

• The lumbar discs. The most common culprit. The disc’s collagen develops small tears that grow over time. A disc that herniates can press on, or chemically irritate, a nerve root.
• Sciatica. Burning pain that travels down the leg when the nerve roots that form the sciatic nerve (L4 to S3) are compressed or inflamed. Up to 90% of sciatica comes from a herniated lumbar disc.
• The facet joints. The small joints at the back of the spine wear down like any other joint and can become a separate source of pain.
• The vertebrae. The bones on either side of a degenerating disc can become inflamed and painful too.
• Spinal stenosis. Narrowing of the spinal canal crowds the nerves, causing leg pain, heaviness or weakness with standing and walking that eases when you sit or lean forward.
• The sacroiliac joint and piriformis muscle. Pain in the buttock and pelvis can come from the SI joint or from a muscle in the buttock tightening around the sciatic nerve.

No two back pain sufferers are alike. Dr. Dumitrescu combines a careful history and examination with your MRI and other imaging, and when needed, diagnostic spinal injections, to answer specific questions: Is it a disc? Which one? Is it the facet joints? Is the spine unstable, so that ligaments and muscles need strengthening first?

Imaging alone can mislead. Normal-looking joints can hurt, and badly worn ones can be painless, which is why diagnostic injections are often what settles the question.

• Physical therapy and core strengthening. Including McKenzie mechanical diagnosis and treatment, which often works well for disc herniations. We work closely with chiropractors and physical therapists to provide you with an appropriate referral.
• Epidural steroid injections. For sciatica, a transforaminal epidural injection in our office places anti-inflammatory medication at the irritated nerve under X-ray (fluoroscopic) guidance.
• Radiofrequency ablation. For facet joint pain confirmed by diagnostic blocks, heat is used to quiet the small nerves that carry pain from those joints.
• Basivertebral nerve ablation. For pain coming from the vertebrae, heat can also be applied inside the vertebral bodies to cauterize the nerves that transmit pain from these bones.
• Spinal cord stimulation. For persistent pain that has not responded to anything else.
• Regenerative treatment. After exhausting traditional treatments, most of our patients opt for regenerative treatment. Regenerative treatments aim to restore the integrity of the injured tissue, or at least slow down the process of degeneration. We use a vast array of regenerative treatments, tailored specifically to every patient, their condition, and the severity of injury or degeneration.
• Weight, metabolism and hormones. Back pain is as much a lifestyle problem as an anatomical one. Through our Health Optimization membership we help patients improve body weight, metabolism and hormones, which supports long-term results.

Most causes of low back pain can be treated without surgery, and fusion surgery for back pain that does not travel into the legs has a low success rate. But some problems do need a surgeon, and we will point you in the right direction.

Seek emergency care right away if back pain comes with new leg weakness, numbness in the groin or inner thighs, or loss of bladder or bowel control.