Back pain treatment without surgery in Chennai

Most back pain comes from one of a small number of structures — a disc, a facet joint, the sacroiliac joint, or the muscles and ligaments around them. Surgery is needed in a minority of cases. Dr. Kiruthika identifies the source with examination, imaging and where needed a diagnostic block, and treats it with a targeted, image-guided procedure as day-care.

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Why it happens

The lumbar spine is a stack of vertebrae separated by discs, linked at the back by small facet joints and anchored to the pelvis at the sacroiliac joints. Any of these can generate pain, as can the muscles and ligaments that stabilise them. Age-related change on an MRI is common and often painless, which is why a scan alone rarely explains the pain.

How Dr. Kiruthika assesses it

A structured history and examination first; the pattern of pain usually points to the structure. Ultrasound is used for the sacroiliac joint, muscles and superficial structures; MRI and X-ray for discs and nerve roots. Where the source is still uncertain, a diagnostic block — a small dose of local anaesthetic at the suspected structure — confirms it before a longer-lasting treatment is planned.

Conditions treated

Slip disc (lumbar disc prolapse)

The soft centre of a disc bulges or pushes through its outer ring and presses on a nerve root, causing back pain with pain, tingling or numbness down the leg. Most prolapses shrink over weeks to months. Treatment: medication, targeted physiotherapy, and a transforaminal epidural steroid injection under X-ray guidance when leg pain is severe or not settling. Surgery (microdiscectomy) is the right answer for progressive weakness, bladder or bowel symptoms, or pain that does not respond.

Sciatica

Pain along the sciatic nerve — buttock, back of the thigh, calf, sometimes the foot — usually from a disc or a narrowed nerve exit. Nerve root blocks and epidural injections reduce the inflammation around the nerve; relief typically begins within one to two weeks and allows rehabilitation to progress.

Facet joint pain

The small joints at the back of the spine wear like any other joint. Pain is worse on standing, arching backwards and twisting, and usually stays in the back and buttock. Diagnostic medial branch blocks confirm the joints involved; radiofrequency ablation of those nerves then gives relief that commonly lasts many months.

Sacroiliac joint pain

Pain at the top of the buttock, usually one side, worse on stairs, getting out of a chair or turning in bed. Often misread as a disc problem. Treated with an ultrasound- or X-ray-guided joint injection; radiofrequency for pain that keeps returning.

Spinal stenosis

Narrowing of the spinal canal, usually with age. Heaviness, cramping or pain in both legs on walking, relieved by sitting or leaning forward. Epidural steroid injections and a graded walking programme help many patients; surgery is discussed when walking distance keeps shrinking despite treatment.

Degenerative disc disease

Discs lose water and height with age and can become painful in their own right — a deep, central back pain worse with sitting. Treatment centres on core strengthening and medication; in selected cases a regenerative injection into the disc (BMAC) is considered.

Pain after spine surgery

Persistent pain after a disc or fusion operation, sometimes from scar tissue around a nerve, sometimes from a facet or sacroiliac joint above or below the operated level. Careful re-diagnosis matters more than another operation; targeted blocks and radiofrequency often help. Where an implant problem is suspected, the surgeon is involved.

Muscular and postural back pain

The commonest and most benign form, from prolonged sitting, weak core muscles or a sudden load. Trigger point injections under ultrasound, a physiotherapy programme and posture correction. Rarely needs imaging.

Coccyx pain (coccydynia)

Pain at the tailbone on sitting, often after a fall or childbirth. A ganglion impar block — an injection at the nerve cluster in front of the coccyx — and a cut-out cushion. Surgery is rarely needed.

Treatment options, least to most invasive

  1. Medication, activity modification and a targeted physiotherapy programme
  2. Trigger point or sacroiliac joint injection under ultrasound
  3. Epidural steroid or nerve root injection under X-ray guidance for disc-related leg pain
  4. Radiofrequency ablation of the medial branch nerves for facet pain
  5. Regenerative injection (BMAC) for selected disc problems
  6. Surgery — right when there is progressive weakness, loss of bladder or bowel control, or pain that has not responded to the steps above. Dr. Kiruthika refers directly to a spine surgeon in these cases.

On the day

Procedures take twenty to forty minutes in a day-care procedure room, under local anaesthesia with light sedation if needed. You are observed briefly, walk out, and can return to desk work within a day or two.

Red flags

Seek urgent medical attention today if you have loss of bladder or bowel control, numbness in the area you sit on, weakness that is getting worse, fever with the pain, a recent fall or major injury, or unexplained weight loss. These are not conditions for an outpatient injection.

Questions patients ask

Do I need an MRI before the consultation?

Bring any scans you have. If you have none, Dr. Kiruthika will say after examination whether one is needed. Not every back pain needs an MRI.

Are epidural injections safe?

They are performed under X-ray guidance with sterile technique. Temporary numbness or a headache can occur; serious complications are rare.

How many injections will I need?

Often one. Some conditions need a series of two or three, spaced weeks apart, decided at review.

Will the pain come back?

Facet and sacroiliac pain can recur as joints continue to age; radiofrequency can be repeated. Disc-related pain often settles permanently once the episode has passed.

When is surgery unavoidable?

Progressive weakness, numbness in the area you sit on, or loss of bladder or bowel control. These are urgent and need a surgeon.

Book your consultation

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Epidural & nerve root injections

For slip disc, sciatica and cervical radiculopathy.

Ultrasound-guided injections

Precise injections into joints, tendons, bursae and around nerves — no blind injections.

BMAC therapy

Bone marrow concentrate for disc degeneration and tendon tears.

Read more

What to bring to your first pain consultation

A short, practical checklist so your first visit moves straight to answers — scans, medicines and the questions worth asking.