Low Back Pain

Low back pain is one of the leading causes of disability worldwide and the most common reason patients seek medical care. It can arise from many sources: muscle or ligament strain, herniated or degenerative discs, facet joint arthritis, spinal stenosis, sacroiliac joint dysfunction, or nerve compression (lumbar radiculopathy/sciatica). Pain can range from a dull, constant ache to sudden, sharp sensations. It may stay localized in the back or radiate into the buttock and leg. While most acute episodes resolve within weeks, chronic low back pain (lasting more than 3 months) requires a systematic approach to identify the specific pain generator and develop an effective treatment plan.

Dr. Zhou's diagnostic approach begins with a detailed history and physical examination, including assessment of posture, gait, range of motion, and a comprehensive neurological exam of the lower extremities. Specific tests help localize the pain source — straight leg raise for disc herniation, facet loading tests, and sacroiliac joint provocation maneuvers. EMG and nerve conduction studies are used when radiculopathy or other nerve conditions are suspected, helping distinguish nerve-related pain from musculoskeletal sources. Imaging (X-ray, MRI) may be ordered to visualize structural changes. Dr. Zhou emphasizes correlating clinical findings with imaging, as many structural abnormalities on MRI are asymptomatic.

Dr. Zhou develops comprehensive, individualized treatment plans for low back pain. The foundation is typically a structured physical therapy program designed to strengthen the core, improve spinal stability, and restore functional mobility. For pain management, he may use oral medications, topical treatments, or targeted injections — including epidural steroid injections, facet joint injections, or sacroiliac joint injections depending on the pain source. Regenerative medicine approaches may benefit patients with disc degeneration or facet arthritis. For chronic cases, a multidisciplinary approach combining rehabilitation, interventional procedures, and lifestyle modifications often achieves the best outcomes.