Chronic Back and Leg Pain

Spinal Arthritis

The joints and discs of the spine wear out as we age.

Everyone develops spinal arthritis to some degree, but not everyone experiences pain.

Common symptoms are stiffness in the morning and pain with bending motions.

Physical therapy to strengthen the back and core muscles is the mainstay of treatment.

When arthritis leads to painful nerve compression, surgery may be an option.

Spondylolisthesis

Spondylolisthesis occurs when a spinal bone slips forward on the bone below.

• This can occur due to arthritis, trauma, or stress fractures.

• Spondylolisthesis can cause pain when there is spinal instability or nerve compression.

• Types of spondylolisthesis can be treated with physical therapy and activity modification.

When the instability is causing back or leg pain from nerve compression, surgical fusion may be necessary.

Spinal Stenosis

Spinal arthritis can sometimes lead to compression of the nerves in the spine, called stenosis.

Spinal stenosis can cause both back and leg pain.

Pain is worse with walking and improves when you sit down. You may find yourself bending forward more than usual.

Injections are the first step in treatment of spinal stenosis.

To permanently treat spinal stenosis, a surgery called decompression may be necessary.

Sacroiliac Joint Pain

The sacroiliac joint, or SI joint, is where the spine meets the pelvis.

Abnormal movement or inflammation of this joint can cause pain.

SI joint pain can be acute or chronic.

Pain is in the lower back and buttocks region, and sometimes shoots down the leg.

Treatment includes physical therapy, injections, and SI joint fusion.

Stress and Depression

Psychological factors can cause back pain as well.

Stress and depression can cause back pain, or make existing back pain worse.

Increased pain can lead to worsening mood, which leads to a vicious cycle.

Cognitive behavioral therapy is a type of counseling and an effective treatment for back pain due to psychological factors.