Lower Back Pain Specialist
Lower Back Pain (LBP) is the most common reason patients seek the services of a spine surgeon. There are many causes to lower back pain and the majority of them do not require surgery. Dr. NaPier is happy to evaluate you and help you decide the best way to treat your back pain.
Expert Care for Lower Back Pain
Lower back pain is one of the most common reasons people seek spine care, but the cause isn’t always the same. Whether your symptoms stem from a herniated disc, spinal stenosis, arthritis, or another condition, Dr. NaPier provides a thorough evaluation to identify the source of your pain and develop a personalized treatment plan. From conservative therapies to advanced minimally invasive procedures, the goal is always to help you move comfortably again.
Lower Back Pain Q&A?
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Lower Back Pain (LBP) is pain that is localized to the central area of a patient’s lower back.
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Lower back pain is extremely common. Over 80% of the population will seek medical attention for lower back pain during their lives. Lower back pain is the 4th leading cause of physician’s office visits in the united states behind only routine health maintenance examinations, hypertension and diabetes
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There are many causes of lower back pain. Most commonly, lower back pain is caused by age related wear and tear to the bones, discs and ligaments that make up your spine. Just as your hip or knee can develop arthritis, your spine can as well. The most common features of spine arthritis are collapse and degeneration of the discs in the front of the spine and the facet joints in the back of the spine. Lower back pain can also be caused by an injury such as a strain to the paraspinal muscles or a herniated disc.
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Dr. NaPier will review imaging including x-rays, CT, and MRI when appropriate. He will perform a physical examination to assess for spine and nerve function. Finally, he will discuss your results with you and formulate a treatment plan to help you feel your best.
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Nonsurgical treatments are usually the first line treatment for lower back pain. This includes anti-inflammatory medications and physical therapy to strengthen and train the important muscles that stabilize the spine. This relieves stress and improves function of the joints in the spine and protects them against further injury. Sometimes a pain management doctor will provide injections to reduce inflammation. In patient’s with lower back pain due to instability or a slipped disc, spinal fusion surgery can help to reduce pain. This surgery stabilizes a painful, unstably
Related Services
Adjacent Segment Disease
Adjacent segment degeneration is the process of rapid degeneration of the segment next to a spinal fusion. Historically, rates of ASD are 3% per year utilizing traditional open surgical techniques. Minimally invasive techniques may reduce the incidence of ASD by providing less disruption to the supporting tissues.
Ankylosing Spondylitis
Ankylosing spondylitis is an autoimmune inflammatory disease that causes auto-fusion of spinal vertebrae and loss of flexibility.
Annular Tear
Annular tear is a defect in the annulus fibrosis, the hard outer crust of the intervertebral disc. Annular tears can cause nagging lower back pain and usually improve with conservative treatment or an epidural steroid injection.
Car Accidents
Automobile accidents account for 34.5% of spinal cord injuries. If you are involved in an automobile accident and have pain, weakness, or numbness, you should see a spine surgeon.
Degenerative Disc Disease
Degenerative disc disease (DDD) is extremely common with >50% of asymptomatic patients over age 40 and >95% of asymptomatic patients over age 65 demonstrating signs of DDD on MRI. DDD in itself does not require surgery. However, which DDD leads to collapse of nerve root tunnels, spinal instability, or spinal deformity causing significant disability then surgery can provide significant relief of symptoms.
Disc Herniation / Herniated Nucleus Pulposus (HNP)
Disc herniation occurs when the nucleus pulposus or gelatinous inner filling of an intervertebral disc herniates through a defect or crack in the annulus fibrosis or outer crust. Herniated disc material can cause nerve pain by direct mechanical compression and also through chemical inflammation surrounding nerve roots. Most disc herniations can be treated nonsurgically and those that do not improve with conservative treatment can be removed with a minimally invasive, outpatient microdiscectomy.
Failed Back Syndrome
Failed Back Syndrome refers to any patient who has not obtained acceptable relief of pain or improvement in function after spine surgery. A significant portion of Dr. NaPier’s practice involves the treatment of failed back syndrome including the revision of prior spine surgeries. The most common reasons for failure are the inappropriate restoration of spinal balance and inadequate stabilization of the spine. If you have had prior spine surgery and are experiencing significant pain or disability or if you have been diagnosed with a failed back syndrome, you may benefit from a second opinion from Dr. NaPier.
Flat Back Syndrome / Sagittal Imbalance
Flat Back Syndrome or Sagittal Imbalance refers to a patient who has undergone spinal fusion surgery that has not restored the proper amount of lordosis for a given spine. Consequently, the patient often experiences significant disability due to having a severely pitched forward posture. Surgical treatment involves both minimally invasive reconstruction of the anterior column of the spine if the patient has open disc spaces and posterior-based osteotomies if the patient’s spine is fused. If open disc spaces remain then these disc spaces can be utilized to generate the necessary lordosis. If open disc spaces are not available then a wedge must be cut out of the back of the spine in order to restore appropriate spinal balance.
Kyphosis
Kyphosis is an excessive forward tilt of the spine. This can occur in the cervical, thoracic, or lumbar spine. Treatment involves reduction of kyphosis and restoration of appropriate lordosis.
Lumbar Strain
Kyphosis is an excessive forward tilt of the spine. This can occur in the cervical, thoracic, or lumbar spine. Treatment involves reduction of kyphosis and restoration of appropriate lordosis.
Spondylosis / Osteoarthritis of the Spine
Spondylosis or osteoarthritis of the spine is age related wear and tear of the spine. This is very common and usually improves with physical therapy and anti-inflammatory medications.
Scheuermann’s Kyphosis
Scheuermann’s Kyphosis is caused by anterior wedging of more than 5 degrees across three consecutive thoracic vertebrae. Mild and moderate cases can be treated with physical therapy and bracing. Severe cases show significant improvement with surgical correction.
Scoliosis
Scoliosis is a sideways or “S” shaped curvature of the spine in the frontal view. Most cases of scoliosis are mild and do not require surgical treatment. Severe cases, especially those with nerve root compression, can benefit from surgical reconstruction.
Spinal Deformity
In a balanced spine, the headrests directly over the pelvis, which rests directly over the feet. A patient with a balanced spine is able to remain balanced and stand upright with minimal effort. Unfortunately, as we age discs collapse and tilt resulting in a posture that is pitched forward (sagittal imbalance) and sideways (degenerative scoliosis). These conditions are broadly referred to as adult spinal deformities. Many times adult spinal deformity is the result of age-related degeneration of the spine, but frequently spinal deformities are caused by prior spine surgeries that did not restore balance to the spine.
Spinal Fractures / Compression Fractures
Spinal fractures can occur as the result of trauma or injury or as a result of insufficient bone strength. Many fractures can be treated nonoperatively, but some require surgical stabilization in order to heal appropriately.
Spinal Infection
Spinal infections typically occur in immunocompromised patients or in healthy patients after spine surgery. If the infection is causing mechanical instability or neurological symptoms surgical intervention may be required.
Lumbar Spinal Stenosis / Neurogenic Claudication
Spinal stenosis is the most common reason for lumbar spine surgery in a patient greater than 65 years old. Neurogenic claudication refers to a heaviness, cramping, or aching in the thigh or buttocks due to nerve compression. Typically, symptoms improve with leaning forward or sitting down as these positions enlarge the volume of the spinal canal. Patients experience significant relief when leaning forward on a shopping cart and prefer a stationary bike to a treadmill. Most patients with lumbar stenosis at one or two levels can be treated with an outpatient minimally invasive decompression surgery. If you are experiencing these symptoms you should schedule a consultation with Dr. NaPier.
Spine Trauma
A spinal cord injury — damage to any part of the spinal cord or nerves at the end of the spinal canal (cauda equina) — often causes permanent changes in strength, sensation and other body functions below the site of the injury. If you've recently injured your spinal cord, it might seem like every aspect of your life has been affected. You might feel the effects of your injury mentally, emotionally and socially.
Spine Tumors
A spinal tumor is a growth that develops within your spinal canal or within the bones of your spine. A spinal cord tumor, also called an intradural tumor, is a spinal tumor that that begins within the spinal cord or the covering of the spinal cord (dura).
Spondylolisthesis
Spondylolisthesis or slipped vertebrae refers to a slip of one vertebra forward in relation to neighboring vertebrae. This can cause back pain and compression of the spinal canal or the nerve root tunnels. Degenerative spondylolisthesis typically occurs at the L4-5 level due to degeneration and failure of the lumbar facet joints. Isthmic or lytic spondylolisthesis usually occurs at the L5-S1 level due to a defect in the pars interarticularis. Patients with spondylolisthesis should see Dr. NaPier for evaluation.
Sports Injuries
The sports with the highest risk of catastrophic spinal injuries are football, ice hockey, wrestling, diving, skiing and snowboarding, rugby, cheerleading, and baseball. A common mechanism of injury for all at-risk sports is an axial compression force to the top of the head with the neck slightly flexed.
Thoracic Radiculopathy
When a nerve root is compressed in the thoracic spine, the patient may experience pain radiating around the trunk or chest.
Work Related Spine Injuries
Many common spine injuries such as disc herniation or spine fracture can occur as a result of work-related injuries. It is important to seek medical care in order to determine the extent of these injuries and whether there may be any lasting consequences of the injury.
OCCUPATIONAL SPINE CARE · WORKERS’ COMPENSATION
Where Exceptional Patient Care Meets Better Employer Outcomes.
Occupational spine care requires much more than simply treating an injury. Effective occupational spine care requires a detailed understanding job demands, constant coordination and communication with employers, adjusters, nurse case managers, physical therapists, and other dedicated providers to developing treatment plans that support safe, successful return-to-work outcomes.
Dr. NaPier has a passion for occupational medicine and has pioneered several techniques that allow for less postoperative pain and faster return to work including:
Dr. NaPier has presented his work nationally and locally and was recently a featured speaker at the Indiana Worker's Compensation Institute (IWCI) Annual Seminar.
Dr. NaPier and his team at Indiana Spine Group work proudly with Workers’ Compensation and self-insured employers, with the flexibility to help organizations navigate benefits and access highest-quality, lowest-cost spine care for their employees.
SCHEDULE A CONSULTATION
Take the First Step Toward Lasting Relief
Whether you’re experiencing chronic back pain, recovering from a workplace injury, or exploring treatment options, our team is here to help you move forward with confidence.