The Total Spine Health Program at Santa Rosa Orthopaedics (SRO) provides comprehensive quality care for spinal disorders in Sonoma County including lower back pain and related health problems.

with Dr. Christian Athanassious

According to the National Institute of Neurological Disorders and Stroke (NINDS) the vast majority of adults (up to 90 percent) will experience low back pain at some point in their lives, spending at least $50 billion on treatments. The most common causes of low back pain includes; spinal instability, stenosis, spondylolisthesis, and symptomatic degenerative disc disease. Chronic low back pain is generally caused by wear and tear associated with the aging process, but more frequently today it is due to inactive lifestyles providing too little exercise.

As the number one cause of job disability in the world, back pain most often occurs after lifting something too heavy or overstretching or straining the back, causing a sprain or spasm in one of the muscles or ligaments. This type of damage is usually caused by poor body mechanics affecting the way people stand, walk, lift, carry, reach, bend, sit and sleep – all situations in which the back is too often flat, not arched. However, when the spine becomes overly strained or compressed, a disc — the spongy, multi-function structures that lie between the spine’s vertebrae — can rupture or bulge outwardly, putting pressure on the bundle of nerves that are rooted to the spinal cord, causing pain (these nerves control body movements and transmit signals from the body to the brain).

Many Causes of Low Back Pain

Low back pain can be an indication of nerve or muscle irritation or even bone lesions. Additionally, scar tissue created when an injured back heals itself naturally lacks the necessary strength and flexibility of healthy tissue. The buildup over time of scar tissue from repeated injuries eventually weakens the back and can lead to greater injury. Most low back pain follows injury or trauma to the back, but pain may also be caused by conditions such as;

• arthritis or disc disease
• osteoporosis or other bone diseases
• viral infections
• irritation to joints and discs
• congenital abnormalities in the spine
• obesity
• smoking
• weight gain during pregnancy
• stress
• poor physical condition
• posture inappropriate for the activity being performed
• poor sleeping position

The more common back strains frequently heal with the help of a combination or rest, cold compresses and/or heat application, anti-inflammatory medications, gentle stretching and moderate lower back exercises. Depending on the individual patient’s condition, physical therapy programs can be prescribed to include exercises intended to strengthen back and abdominal muscles and to promote proper posture and balance. The types of exercises can include stretching, swimming, walking and yoga.

Treating Low Back Pain

Treatment for low back pain depends upon the patient’s history and the type and severity of pain. At one time, the treatment was to have the patient lie on his or her back until they felt better, but studies now show it that keeping the back inert after an injury does not necessarily help. In fact, following a short period of rest, light physical activity is the best option for most patients. Once recovered, a physician or orthopedic surgeon may recommend speed walking, swimming, or stationary bike riding to help increase muscle strength and flexibility. Yoga can also help stretch and strengthen muscles and improve posture.

When Low Back Pain Indicates More Serious Problems

Occasionally low back pain may indicate a more serious medical problem. People with these symptoms should contact a doctor immediately to help prevent permanent damage:

• pain accompanied by fever or
• pain associated with loss of bowel or bladder control
• pain when coughing
• progressive weakness in the legs (may indicate a pinched nerve or other serious condition)
• People with diabetes experiencing severe back pain or pain radiating down the leg

Since some symptoms of low back strain can point to more serious conditions, it’s important to consult a doctor. Any numbness and weakness in the legs, or bowel and bladder problems, can be a sign of nerve damage requiring immediate medical attention. More serious conditions that may cause low back pain and require treatment by a physician specializing in spine disorders include:

• Bulging disc (also called protruding, herniated, or ruptured disc)
• Cauda equina syndrome
• Sciatica
• Spinal degeneration
• Spinal stenosis
• Osteoporosis
• Skeletal irregularities
• Fibromyalgia
• Spondylitis

Treating Low Back Pain

Surgery for low back pain is usually considered only after symptoms have not been relieved with nonsurgical methods. When it comes to accessing quality care for spinal disorders and related health problems in Sonoma County, the Total Spine Health Program at SRO provides both patients and referring physicians a complete, balanced approach to the treatment of spinal pathology. Since there are a wide variety of effective operative and nonoperative routes of care that can be taken depending on the nature of patient conditions, it makes sense for spine surgeons and physical therapists to share a role in diagnosing and treating patients with spine problems. To schedule an appointment with Dr. Christian Athanassious or Dr. Michael Star of the Total Spine Health Program, call (707) 546-1922 or visit for more information.