Atypical Back Pain: When Pain Doesn't Stem From Your Spine

Sciatica, facet joint arthritis, spinal stenosis — these are just some of the spine-related roads to lower back pain, which affects up to 80% of people at some point during their lives.

While those conditions account for a fair share of the overall low back pain burden, there are other, atypical roads to low back pain that aren’t related to your spine.

As a neurosurgeon who helps patients to overcome back pain, Dr. Ali H. Mesiwala is well-versed in the many drivers behind low back pain, including those issues that aren’t based in your spine.

Beyond the spine to the muscles

The column of vertebrae and intervertebral discs that create your spine rely on a network of connective tissues for support and mobility. 

One of the most important muscles in this regard is what we call your multifidus muscle, which is a narrow tissue that runs down each side of your spine.

Your multifidus muscle attaches to your spine at four points:

1. Your thoracic spine
2. Your lumbar spine
3. Your iliac spine
4. Your sacrum

In brief, your multifidus muscle provides stability in your lumbar spine and at the same time, it allows the vertebrae to move individually.

If this muscle weakens or atrophies, it can lead to low back pain as well as pain in your legs. In fact, researchers have found that multifidus muscle atrophy is common among people with degenerative conditions in their spine.

Other roads to multifidus muscle atrophy are injury and inactivity, including problems with low back pain that force you into inactivity.

The good news is that we offer a fantastic way to regain strength in your multifidus muscle to better support and stabilize your spine — ReActiv8®. With this muscle-restoring neuromodulation technique, we implant a device that stimulates the nerves that control the muscles. This stimulation causes contractions that work the multifidus muscles. Each time you activate ReActiv8, you get stronger, which helps you break the cycle of low back pain.

Sacroiliac joint dysfunction and low back pain

Just below your spine there’s a triangular bone called your sacrum, which forms the connection point between your upper body and your lower body. On either side of your sacrum there are joints that attach to the iliac crests in your hip bones, which are appropriately called sacroiliac (SI) joints.

If these joints become too loose or too tight, it can lead to SI joint dysfunction and low back pain. And this issue is quite common and accounts for 15% to 30% of cases of low back pain.

If we find that your low back pain is tied to SI joint issues, you’ve come to the right place. Dr. Mesiwala has not only been performing minimally invasive surgeries that resolve SI joint dysfunction for more than a decade, but he’s also considered a pioneer in this arena.

In brief, during SI joint surgery, Dr. Mesiwala stabilizes your SI joints with small pins. And the best part? The procedure takes only about half an hour, and most patients can go home afterward without any restrictions on walking. 

For both of these scenarios, a thorough history, physical/neurological examination, and review of imaging are conducted to accurately diagnose the condition. It is important to keep in mind that because these are atypical causes of low back pain, you want to ensure that you are evaluated with a doctor with comprehensive experience in the diagnosis and treatment of those conditions. Dr. Mesiwala is a faculty member for these conditions/treatments, and also regularly participates in research studies to advance the field to deliver the optimal treatments to his patients. 

If there’s one thing we want to impart here, it’s that whether your low back pain is spine-related or atypical, there are solutions that allow you to move without pain again.

To get to the bottom of your low back pain and get on the road to pain relief, please contact one of our offices in Newport Beach, Marina del Rey, or Rancho Cucamonga, California, to set up a consultation with Dr. Mesiwala.