Lower Back Pain
Expert Lower Back Pain Treatment in Bergen County, New Jersey.
Lower back pain is the most common reason adults visit a spine specialist, and one of the most misunderstood. It is not a diagnosis in itself. It is a symptom. And that distinction matters more than most people realize, because treating lower back pain without identifying its true cause is one of the main reasons patients end up suffering for years longer than they should.
The lower back, or lumbar spine, is made up of five vertebrae that bear the majority of the body’s weight with every movement you make. It is constantly under load. Over time, or after an injury, the structures within and around the lumbar spine can break down, compress nerves, or become inflamed in ways that produce pain ranging from a dull, persistent ache to sharp, debilitating agony that radiates all the way down the leg.
At Spine Care New Jersey, Rishi N. Sheth, MD approaches every case of lower back pain the same way: by finding out exactly what is causing it. Not guessing. Not treating a symptom and hoping for the best. A thorough evaluation, the right imaging, and an honest conversation about what your options actually are.
SymptomsWhen Lower Back Pain Is Telling You Something Important.
Most people experience lower back pain at some point in their lives. A pulled muscle from lifting, a stiff back after a long flight, soreness after a day of yard work. That kind of pain usually resolves within a few days to a couple of weeks with rest and basic care.
But there is another kind of lower back pain that does not go away. The kind that wakes you up at night, makes sitting at your desk unbearable, or sends a sharp electric sensation shooting down your leg every time you take a step. That is the kind that deserves a proper evaluation from a spine specialist.
The following symptoms are particularly important to pay attention to.
Pain that radiates from the lower back down into the buttock, thigh, calf, or foot on one side of the body. This pattern is known as sciatica and is typically caused by a compressed nerve in the lumbar spine.
Numbness or tingling in one or both legs, the feet, or the toes. This is a sign of nerve involvement and should not be dismissed as pins and needles.
Weakness in one leg, difficulty lifting the foot, or a change in your normal walking pattern. Progressive leg weakness in particular is a symptom that warrants prompt evaluation.
Lower back pain that is significantly worse when sitting for extended periods, standing for a long time, walking downhill, or bending forward. Each of these patterns points toward different underlying causes.
Pain that worsens at night or when lying flat. Many patients ask why their lower back hurts when they lay down. This can indicate disc pathology, nerve compression, or in rare cases something that requires more urgent attention.
Any loss of bladder or bowel control accompanied by lower back pain or leg weakness requires emergency evaluation. This combination of symptoms may indicate cauda equina syndrome, which is a surgical emergency.
CausesLower Back Pain Has Many Causes. The Right Diagnosis Changes Everything.
One of the most important things Rishi N. Sheth, MD can do for a patient with chronic lower back pain is give them an accurate diagnosis. It sounds simple, but a surprising number of patients come to Spine Care New Jersey having been told for years that their MRI shows nothing significant, when a more careful review reveals the precise structural cause of their pain.
These are the most common conditions that cause lower back pain in adults.
Herniated or Bulging Disc
When the soft center of a spinal disc pushes through its outer layer and compresses a nearby nerve, the result is often severe lower back pain combined with radiating leg pain, numbness, or weakness. This is one of the most common sources of lumbar pain in adults under 50.
Lumbar Spinal Stenosis
As the spine ages, the spinal canal can narrow due to bone overgrowth, thickened ligaments, or degenerative changes. This narrowing compresses the spinal cord and nerve roots, causing lower back pain that is often accompanied by leg cramping, heaviness, or pain with walking that improves when sitting down.
Degenerative Disc Disease
Over time, spinal discs lose their height and water content, reducing their ability to absorb shock between vertebrae. Degenerative disc disease is an extremely common source of chronic lower back pain, particularly in adults over 40.
Spondylolisthesis
This condition occurs when one vertebra slips forward over the one beneath it, placing stress on nearby nerves and causing lower back pain, leg pain, and sometimes a visible change in posture or gait.
Facet Joint Disease
The facet joints connect the vertebrae to each other and allow the spine to move. Arthritis and inflammation of these joints is a frequent but underdiagnosed cause of axial lower back pain, particularly in older adults.
Sacroiliac Joint Dysfunction
The sacroiliac joints connect the base of the spine to the pelvis. When they become inflamed or dysfunctional, they produce lower back and buttock pain that is often mistaken for a lumbar disc problem.
TreatmentsStarting with the Right Treatment, Not the Most Aggressive One.
There is no single treatment that works for every patient with lower back pain. The right approach depends entirely on what is causing the pain, how long it has been present, how severe the symptoms are, and how significantly it is affecting your life. Rishi N. Sheth, MD evaluates all of these factors carefully before making any recommendation.
Surgery is rarely the right first step. For the vast majority of lower back pain patients, a well-structured non-surgical treatment plan provides meaningful and lasting relief.
Non-Surgical Treatments
Physical Therapy
Physical therapy is often the most valuable non-surgical tool for lower back pain. A properly designed program targets the specific muscles and movement patterns contributing to your pain, builds core stability that takes pressure off the lumbar spine, and teaches you how to move in ways that protect the spine long-term.
Epidural Steroid Injections
Epidural steroid injections deliver anti-inflammatory medication directly to the space surrounding an inflamed or compressed nerve root. For patients with lower back pain and radiating leg pain caused by a herniated disc or spinal stenosis, a well-placed epidural injection can provide significant relief and allow a patient to participate more fully in physical therapy.
Transforaminal Injections
Transforaminal injections offer a more targeted approach, delivering medication directly to the specific nerve root involved. Medial branch blocks and facet joint injections are used for patients whose lower back pain originates primarily from the facet joints. Conservative pain management with anti-inflammatory medications, muscle relaxants, or nerve pain medications may be appropriate as part of a short-term plan.
SURGICAL TREATMENTS
Surgical treatment for lower back pain is recommended only when conservative care has not produced adequate relief, when there is clear structural pathology on imaging that explains the symptoms, or when neurological compromise is present or worsening.
Microdiscectomy
Microdiscectomy is the most commonly performed minimally invasive procedure for a lumbar herniated disc causing significant leg pain. It relieves nerve compression with a small incision and a short recovery.
Spinal decompression
Spinal decompression, also called laminectomy, is performed for lumbar spinal stenosis when the narrowing of the spinal canal is causing significant and disabling symptoms that have not responded to non-surgical care.
Sacroiliac joint fusion
Sacroiliac joint fusion is a minimally invasive procedure for patients with confirmed sacroiliac joint dysfunction that has not responded to conservative measures.
Lumbar disc replacement
Lumbar disc replacement with the ProDisc-L system is an alternative to fusion for carefully selected patients, preserving natural motion at the treated level. Rishi N. Sheth, MD is ProDisc-L certified, one of the few spine surgeons in New Jersey with this specific training.
The Right Diagnosis First. The Right Treatment Second.
Patients come to Spine Care New Jersey from all over Bergen County and northern New Jersey, and many of them share a similar story. They have been living with lower back pain for months or years. They have seen multiple doctors. Some have been told nothing is wrong. Others have been told they need major surgery. Many are simply frustrated and do not know who to trust.
Rishi N. Sheth, MD's approach starts with listening. Understanding the full picture of a patient's pain, their lifestyle, their goals, and their concerns before ever looking at an image or recommending a treatment. Because lower back pain is one of the most over-treated and under-diagnosed conditions in medicine, and the difference between a patient who gets better and one who does not often comes down to whether the right diagnosis was made in the first place.
As the only spine neurosurgeon in Bergen County fellowship-trained at Memorial Sloan Kettering Cancer Center, Rishi N. Sheth, MD brings a depth of diagnostic and surgical expertise to every lower back pain case that is simply not available at most practices in New Jersey. And
as a boutique private practice dedicated exclusively to the spine, every patient benefits from direct, unhurried access to their surgeon at every stage of their care.
Common Questions About Lower Back Pain Treatment at Spine Care New Jersey.
The best clinics for lower back pain treatment in New Jersey are those led by spine-focused surgeons who offer both non-surgical and surgical treatment options under one roof, with the expertise to tell you honestly which approach is right for your specific diagnosis. Spine Care New Jersey in Maywood, Bergen County is led by Rishi N. Sheth, MD, a board-certified spine neurosurgeon fellowship-trained at Memorial Sloan Kettering Cancer Center and the University of Miami. The practice treats the full spectrum of lower back pain causes, from herniated discs and spinal stenosis to degenerative disc disease and sacroiliac joint dysfunction, using both conservative non-surgical treatments and the most advanced minimally invasive surgical techniques available in New Jersey.
Patients with chronic lower back pain in New Jersey have access to a range of effective non-surgical treatments at Spine Care New Jersey. These include physical therapy and rehabilitation tailored to the specific cause of pain, epidural steroid injections to reduce nerve inflammation, transforaminal injections for targeted nerve root pain, medial branch blocks and facet joint injections for facet-related pain, and conservative pain management with anti-inflammatory and nerve pain medications. The right combination depends entirely on the underlying cause of the pain, which is why an accurate diagnosis from a spine specialist is the
essential first step. Rishi N. Sheth, MD evaluates every patient comprehensively before recommending any treatment, and surgery is never suggested unless conservative options have genuinely been exhausted.
When looking for a spine surgeon for lower back pain in New Jersey, the most important factors to consider are board certification in neurological or orthopaedic surgery, fellowship training specifically in spine surgery, a practice that is focused exclusively or primarily on the spine, and a surgeon who sees patients personally at every stage of care. Rishi N. Sheth, MD at Spine Care New Jersey in Maywood meets all of these criteria. He is board-certified by the American Board of Neurological Surgery, completed fellowship training in spine surgery at the University of Miami and in neurosurgical oncology at Memorial Sloan Kettering Cancer Center, and personally manages every patient from first consultation through recovery. New patients in Bergen County and across northern New Jersey can request an appointment or submit their MRI for a free expert review before their first visit.
Physical therapy for lumbar back pain in New Jersey is most effective when it is prescribed by a spine specialist who understands the specific structural cause of the pain and can direct the physical therapist accordingly. At Spine Care New Jersey, Rishi N. Sheth, MD coordinates physical therapy as part of a comprehensive non-surgical treatment plan for appropriate patients. Effective lumbar physical therapy typically includes core stabilization exercises, lumbar flexibility and mobility work, manual therapy, postural correction, and education on safe movement mechanics for daily activities. Physical therapy works best when combined with other treatments such as epidural injections for patients with active nerve inflammation, and it is an important part of recovery after spine surgery as well. Rishi N. Sheth, MD will discuss whether physical therapy is the right starting point for your lower back pain during your initial consultation.
Before seeing a spine specialist, there are several evidence-based steps that NJ spine doctors generally recommend for managing lower back pain at home. Staying gently active rather than resting completely is one of the most important. Complete bed rest actually prolongs recovery for most types of lower back pain. Applying ice in the first 48 to 72 hours of an acute flare, then transitioning to heat for muscle relaxation, can help manage pain and stiffness. Over-the-counter anti-inflammatory medications such as ibuprofen or naproxen, taken as
directed, can reduce inflammation around irritated nerves and joints. Avoiding prolonged sitting or standing in one position, and sleeping on your side with a pillow between your knees to reduce lumbar stress, can make a meaningful difference in day-to-day comfort. That said, these measures manage symptoms, they do not address the cause. If your lower back pain has lasted more than six weeks, is radiating into your leg, or is accompanied by numbness or weakness, a consultation with a spine specialist is the appropriate next step.