One of the most common ailments that physicians see is lower back pain. Despite how common lower back pain is, sometimes the underlying cause and solution can be elusive for many practitioners. We are quick to assume that back pain is a problem of bones, muscles and joints, but is it? With the increasing availability of more focused, diagnostic tests, we are finding more frequently that back pain is caused by vein problems. In the same way that a herniated disc can press on a nerve and cause pain, tingling, and numbness, swollen veins in the pelvis and lower back can also cause these same symptoms.
When you have a sinus infection, you know that pressure and pain you feel in your nose, forehead and sinuses? That is venous congestion. Imagine now what that type of congestion would be feel like in your lower back.
How Veins Can Cause Back Pain
Veins are affected significantly by gravity. Just like the veins in your arm fill up with blood and bulge when a tourniquet is applied to take a blood sample, every time you are sitting or standing, the veins in your abdomen and lower back are swollen due to the action of gravity. When these veins have been chronically swollen over the course of several years, they can press on the nerves of your lower back and pelvis. This nerve compression can mimic the exact same symptoms of musculoskeletal back pain. It can even cause sciatic nerve pain and numbness that travels down the outside of your thigh.
The process that causes veins to compress nerves begins during fetal development. As many as 2 out of every 3 people are born with some sort of venous abnormality in the lower abdomen. Narrowing or stenosis of the veins in your central abdomen and pelvis causes pressure to increase downstream, just like a tourniquet. This increase in pressure won’t always cause problems until later in life when the collagen in the veins wears out and the veins start dilating. Those dilated, pressurized veins communicate with the veins around the spine, and so the entire network of veins becomes chronically pressurized and dilated. These dilated veins can cause all sorts of issues by pressing on anatomic structures, such as nerves, the bladder, the uterus and ovaries.
If left alone and not corrected, the veins continue to pressurize additional branches of veins and can even dilate veins that are farther away. The longer this goes on, the more severe the symptoms will be, and the more likely it is that a patient will have symptoms of some kind.
How Can Venous Back Pain Be Treated?
Venous back pain is diagnosed by taking X-rays of the area. Often that back pain can be fixed on the spot through an IV, with almost no recovery or down time. The treatment is less invasive than current treatments for musculoskeletal back pain.
Correction of this problem involves preventing these dilated veins from filling up and pressing on the nearby structures. This can be accomplished by several methods that are done through an IV. Repair does not involve much discomfort or recovery time.
It is truly a good time historically to have this problem. We see a number of patients who have had spinal surgery that didn’t fix their pain. Being able to solve a problem that these patients have been struggling with for years is extremely gratifying. It is my hope that if we continue to increase awareness of venous causes of back pain, that we will solve more of these problems before patients are put through an invasive spinal surgery.
