Lower back pain is the most common form of back pain, and it is one of the most common reasons adults see any doctor. For most people it is a short-lived problem. For others, it becomes a recurring issue that returns every few months. And for a significant minority, it becomes chronic — a daily reality that shapes what feels reasonable to do.
If you live in Ventura and your lower back pain has outlasted the usual window of a few weeks, this guide explains what is most likely causing it, what non-surgical options exist, and when it is time to see a pain specialist.
The Anatomy of Lower Back Pain
The lumbar spine — the five vertebrae of the lower back — supports most of the weight of your upper body and absorbs much of the force of walking, lifting, and bending. It is also the part of the spine where disc problems, facet joint arthritis, and nerve root irritation are most common. Surrounding that structure are layers of muscle, ligaments that hold the vertebrae together, and the sacroiliac joints that connect the spine to the pelvis.
When lower back pain becomes chronic, it almost always traces back to one or more of these structures. The question for a pain specialist is: which one?
Common Causes of Chronic Lower Back Pain
Disc problems. A lumbar disc that bulges or herniates can press on a nerve root, producing sciatica — pain that travels down the leg, often past the knee — or cause inflammation that contributes to axial back pain.
Facet joint arthritis. The facet joints of the lumbar spine can develop arthritis, producing pain that is typically felt across the lower back and worsens with standing, walking, or arching backward.
Sacroiliac joint dysfunction. The sacroiliac joints can become a pain generator, producing lower back, buttock, or groin pain that is often mistaken for other sources.
Spinal stenosis. Narrowing of the lumbar spinal canal, typically from age-related changes, that can cause pain with standing or walking and relief with sitting (the classic “shopping cart” sign).
Degenerative disc disease. Age-related changes in disc structure that can produce axial lower back pain.
Muscle and myofascial pain. Persistent muscle-based pain, often layered on top of another underlying cause.
Many patients have more than one of these contributing to their pain, which is one reason a careful evaluation matters.
When Lower Back Pain Needs Specialist Care
Consider a pain management consultation if:
- Lower back pain has lasted longer than six weeks without meaningful improvement
- Pain radiates into the buttock, thigh, or below the knee
- You have numbness, tingling, or weakness in a leg
- Over-the-counter medications are no longer enough
- Pain is disrupting sleep or daily activities
- You have tried physical therapy without enough improvement
- You have been told surgery is an option and want to explore alternatives first
- Lower back pain is returning repeatedly even if each episode eventually resolves
Treatment Options Offered at Our Ventura Clinic
A modern pain management practice offers several non-surgical approaches for lower back pain, matched to the specific diagnosis:
Lumbar epidural steroid injections. A targeted injection of anti-inflammatory medication near an irritated lumbar nerve root. Often used for sciatica and other radicular pain. Typically performed with image guidance for precise placement.
Lumbar facet joint injections and medial branch blocks. When facet joints are identified as the pain source, targeted injections can reduce inflammation; medial branch blocks can help confirm the diagnosis and guide further treatment options.
Sacroiliac joint injections. A targeted injection into the sacroiliac joint when it has been identified as a pain generator.
Trigger point injections. For myofascial contributions to lower back pain, small-volume injections into tender muscle bands can reduce pain and improve function.
Radiofrequency procedures. For certain patients whose lower back pain is coming from the facet joints and who have responded to diagnostic blocks, a radiofrequency procedure can provide longer-lasting relief.
Medication management. A plan that may include non-opioid analgesics, anti-inflammatory medications, muscle relaxants, nerve-pain medications, and topicals.
Physical therapy coordination. Interventional pain reduction is often paired with physical therapy to rebuild function and address mechanical contributors.
How Diagnosis Shapes Treatment
A frequently overlooked point about lower back pain treatment: the same symptom (lower back pain) can come from very different sources, and treatments that work well for one cause do not necessarily work for another. A lumbar epidural injection is often excellent for nerve-related pain but is not the right treatment for purely facet-mediated pain. A sacroiliac joint injection helps SI joint pain but will not help a disc problem.
This is why a careful diagnostic process — history, physical exam, and sometimes imaging — usually precedes any interventional treatment. Treating the wrong pain source wastes time and money without delivering results.
Building a Treatment Plan for Ventura Patients
A strong lower back pain plan usually includes:
- A careful evaluation that identifies the likely source (or sources)
- A targeted treatment directed at that source, chosen from the options above
- Physical therapy when it is appropriate
- Strategic medication use
- A clear plan for what happens if the initial approach does not deliver enough benefit
Our team at Southwest Pain Management’s Ventura clinic focuses on matching treatment to diagnosis rather than defaulting to a single protocol for every patient.
Frequently Asked Questions
Do I need an MRI before starting lower back pain treatment? Not always. For some patients, history and physical exam provide enough information to begin treatment. For others — particularly those with nerve-related symptoms, a history of cancer, or pain that has not responded to initial care — imaging is useful. Your physician will discuss whether imaging is appropriate.
How do I know if my lower back pain is from a disc or from the facet joints? The pattern of pain offers clues. Disc-related nerve pain typically radiates down the leg; facet-related pain is typically axial and worsens with specific movements. A physical exam and, when needed, diagnostic blocks can help confirm the source.
Are epidural steroid injections safe? Epidural steroid injections are considered generally safe when performed by a trained specialist with image guidance. Your physician will review risks and expected benefits before you consent.
Will I need back surgery? Most lower back pain can be managed without surgery. Surgery is considered when non-surgical options have been exhausted or when a clear structural issue indicates surgical treatment.
How soon can I return to work after an injection? Most lumbar injections are outpatient procedures with short recovery times. Specific activity guidance depends on the procedure and your job; your physician will give you concrete post-procedure instructions.
Request a Consultation
Contact Southwest Pain Management to request an appointment at our Ventura clinic.
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The mission of Southwest Pain Management is to empower you to restore function, decrease pain, and live your life to its fullest.
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