Dr. Robert Harper on relief for painful back problems

Back pain can be a mild inconvenience or a life altering challenge. For some, it appears suddenly after a specific injury. For others, it builds slowly over time with no clear cause. But one thing is certain — you’re not alone. Four in five people will experience back pain at some point in their lives.

“There’s no single cause,” said fellowship trained orthopedic spine surgeon Robert Harper, MD of BoulderCentre for Orthopedics and Spine, during a recent free health lecture hosted by Boulder Community Health. “It can be arthritis, it can be disc degeneration, muscle strain, even sacroiliac joint problems. Sometimes there’s a clear cause, sometimes there’s not.”

The good news? Many cases can be treated successfully without surgery.

Common spinal conditions & symptoms

Herniated disc

Also known as a slipped, ruptured or bulging disc, this happens when the soft, gel like center of a spinal disc pushes out through a tear in its outer layer, pressing on nearby nerves.
“A herniated disc can happen after lifting something heavy, but a lot of times people can’t remember exactly what triggered it,” Dr. Harper explained.
Symptoms may include:

• Pain down one leg

• Numbness, tingling, or weakness

For most people, symptoms improve without surgery, but some may need additional treatment.

Lumbar stenosis

This narrowing of the spinal canal in the lower back puts pressure on the nerves that travel to the legs.
“People often say they can walk a block or two, then the pain hits. But if they sit down or lean forward, it eases up,” Dr. Harper said.
Common causes include degenerative disc disease, lumbar arthritis or disc bulging.

Spondylolisthesis

When one vertebra slips forward over another, it can pinch nerves in the spinal canal or openings between vertebrae. Like stenosis, it can cause leg pain, tingling and numbness when walking that eases with sitting or leaning forward.

Adult degenerative scoliosis

More common in postmenopausal women, this condition develops when age-related changes cause the spine to curve.
“It’s not just about the curve,” Dr. Harper noted. “It’s about balance, posture, and pain that limits how you live your life.”

Nonsurgical treatment options

Dr. Harper’s approach always starts with the least invasive methods:

• Ice or heat to reduce discomfort

• Physical therapy to strengthen supporting muscles

• Cognitive behavioral therapy to help manage pain perception

• NSAIDs, Tylenol or prescription medications for pain relief

• Epidural steroid injections to reduce inflammation

• Radiofrequency ablation to disrupt pain signals

When surgery may be needed

If conservative treatments fail and symptoms persist, surgery may be an option. Dr. Harper uses minimally invasive techniques whenever possible to preserve healthy tissue and speed recovery.
Examples include:

• Microdiscectomy for herniated discs — removing disc fragments pressing on nerves

• Decompression surgery for lumbar stenosis — widening the spinal canal

• Decompression and fusion for spondylolisthesis — stabilizing the spine to reduce nerve compression

• Reconstructive surgery for severe scoliosis — restoring spinal alignment and improving balance

Individualized care is key

“We always start with the least invasive approach,” Dr. Harper emphasized. “Surgery is for the few cases where nothing else works and the problem is truly mechanical.”

If you’re experiencing persistent back pain, it’s important to seek evaluation. A tailored approach — starting with conservative care — can often bring relief and help you return to an active, fulfilling life.

Schedule an appointment
To schedule a consultation with Robert Harper, MD, at BoulderCentre for Orthopedics & Spine, a BCH strategic partner, call 3034492730.

Watch the lecture below: