Find Relief From Chronic Lower Back Pain

Lower back pain is one of the most common medical conditions, affecting people of all ages and activity levels.

It may begin suddenly after lifting something heavy or develop gradually over time because of arthritis, disc degeneration, or other changes in the spine.

While many episodes improve with rest, persistent lower back pain often has an underlying cause that requires a more targeted approach.

For nearly 30 years, Todd Koppel, MD, has served as a trusted pain management doctor in New Jersey, helping patients find relief from lower back pain through personalized, minimally invasive treatment options designed to reduce pain, restore function, and help many patients avoid surgery.

“The approach that has defined my practice for nearly 30 years is identifying the pain generator. Before I recommend anything, I want to know exactly which structure is causing the pain. After reviewing diagnostic imaging, I usually recommend a diagnostic injection. Once I find the pain generator, it can be treated precisely.and eliminated,” says Dr. Todd Koppel.

Common Symptoms

Lower back pain can present in many different ways.

Symptoms may include:

  • Dull aching pain
  • Sharp pain with movement
  • Muscle spasms
  • Pain when standing or walking
  • Pain after prolonged sitting
  • Pain that radiates into the buttocks
  • Sciatica
  • Numbness or tingling
  • Leg weakness

Pain patterns often provide important clues about the underlying cause.

Causes of Lower Back Pain

Lumbar Disc Herniation

When a disc in the lower back tears and presses against a nearby nerve root, it causes both local back pain and radiating pain down the leg, sciatica. It can range from a manageable ache to a debilitating electric shock sensation that makes sitting impossible.

Facet Joint Arthritis

The facet joints connect vertebrae at the back of the spine. When they become arthritic or inflamed, they cause a deep, chronic aching pain that is typically worse in the morning and with extension movements like standing up straight or bending backward.

Sacroiliac Joint Dysfunction

The sacroiliac joint connects the spine to the pelvis. When it’s inflamed or unstable, it causes pain in the lower back and buttocks that’s frequently misdiagnosed as a disc problem. It’s one of the most commonly overlooked sources of lower back pain.

“I find Sacroiliac joint pain to be one of the most under diagnosed conditions I see when evaluating patients with low back pain. This pain in the saddle as I like to call it, can produce pain into the hips and thighs. It can worsen with prolonged sitting, standing or even lying down,” says Dr. Koppel.

Spinal Stenosis

Narrowing of the spinal canal compresses the nerves traveling through it, causing lower back pain combined with leg heaviness or weakness that worsens with walking and improves with sitting or bending forward. Spinal stenosis can lead to neurogenic claudication, which is leg pain which starts after walking several blocks.

Muscle and Ligament Strain

Acute strain from lifting, twisting, or direct trauma is very common and typically resolves within a few weeks with conservative care. When lower back pain persists beyond six to eight weeks, a structural cause in the spine is usually involved.

Finding the True Cause of Your Lower Back Pain

Most MRIs in patients over 40 show multiple findings. The scan alone cannot tell you which finding is causing the pain. Dr. Koppel uses detailed history, physical examination, and, when needed, diagnostic injections to confirm the pain source before treating it. A diagnostic nerve block that provides temporary relief confirms which structure is responsible; that information then drives the treatment plan.

Treatment Options

  • Epidural steroid injections: for disc herniations and nerve root compression
  • Lumbar injection therapy: targeted nerve root, facet joint, or SI joint treatment
  • Radiofrequency ablation: for confirmed facet joint or sacroiliac joint pain
  • Minimally invasive discectomy: for disc herniations not responding to injections
  • MILD procedure: for spinal stenosis causing leg pain with walking
  • PRP and regenerative cell therapy: for disc degeneration and soft tissue healing

Lower Back Pain After an Accident

Lower back pain frequently develops after:

  • Car accidents
  • Workplace injuries
  • Slip and fall accidents

Some injuries may not become fully apparent for several days.

Dr. Koppel accepts PIP insurance and treats workers’ compensation patients throughout New Jersey.

When Should You See a Doctor?

Schedule an evaluation if:

  • Pain lasts longer than four weeks
  • Pain continues returning
  • Pain travels into your leg
  • You experience numbness or tingling
  • Walking becomes difficult
  • Pain interferes with work or sleep

Seek emergency medical attention immediately if you develop loss of bowel or bladder control, numbness in the groin area, or sudden weakness in both legs.

Why Choose Dr. Todd Koppel?

Successful treatment begins with an accurate diagnosis.

Dr. Koppel has helped patients throughout New Jersey manage lower back pain using advanced interventional pain management techniques and personalized treatment plans.

Patients choose Dr. Koppel because he offers:

  • Nearly 30 years treating lower back pain
  • Fellowship training at the Hospital for Special Surgery
  • Advanced image guided procedures
  • Personalized treatment plans
  • Conservative care before surgery
  • Expertise treating both acute and chronic lumbar spine conditions

Frequently Asked Questions

Morning lower back pain is often caused by arthritis, spinal stiffness, or inflammation that develops while you’re sleeping. As you begin moving, the joints and muscles loosen up, which is why many people feel better after walking or stretching. If your pain is severe, lasts throughout the day, or continues for several weeks, it’s important to determine whether an underlying condition such as facet joint arthritis, a herniated disc, or spinal stenosis is contributing to your symptoms.

No. Chronic lower back pain often responds well to targeted treatment even when it has been present for years. The approach may differ from acute pain, but many patients who have been managing chronic pain for a long time find significant relief with the right diagnosis and plan.

MILD stands for Minimally Invasive Lumbar Decompression. Using a needle-sized instrument, excess ligament tissue is removed from the spinal canal, creating more space for compressed nerves in patients with lumbar spinal stenosis. Done in an outpatient setting with a brief recovery time.

Yes. He treats workers’ compensation cases and accepts PIP auto insurance for accident-related back pain. He provides thorough medical documentation for insurance carriers and legal cases.

Sitting places increased pressure on the discs in your lower back, particularly if you have a herniated disc or degenerative disc disease. Poor posture and prolonged sitting can also strain the muscles and joints that support your spine. Taking regular breaks to stand, stretch, and walk may help, but persistent pain should be evaluated to identify the underlying cause.

Yes. Pain that radiates into the hips, buttocks, or legs may indicate irritation of a spinal nerve, sacroiliac joint dysfunction, or another condition affecting the lower spine. Symptoms such as numbness, tingling, or weakness should not be ignored, as they may suggest nerve compression that requires medical evaluation.

For many patients, gentle walking is one of the best activities for lower back pain because it helps maintain flexibility, improves circulation, and strengthens the muscles that support the spine. However, if walking significantly increases your pain or causes leg weakness or numbness, you should stop the activity and schedule an evaluation to determine the cause of your symptoms.

The answer depends on the underlying cause. Some conditions improve on their own, while others, such as herniated discs, spinal stenosis, or nerve compression, may gradually worsen over time. Ignoring persistent lower back pain can lead to ongoing discomfort, reduced mobility, and, in some cases, progressive nerve irritation. Identifying the cause early gives you the best opportunity to explore conservative treatment options before more invasive care becomes necessary.

Todd Koppel, MD, interventional pain specialist

Todd Koppel, MD

Board-Certified, Fellowship-Trained Interventional Pain Specialist

“After seeing two previous doctors without results, Dr. Koppel helped me get my life back. I’m now more mobile and no longer in pain 24/7.” ✓ Verified Patient Review
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Precision Is the Difference Between Masking Pain and Actually Stopping It

Living with pain can affect every part of your life, but you don’t have to face it alone.

At Garden State Pain Management, Dr. Todd Koppel takes the time to understand your symptoms, identify the source of your pain, and recommend a personalized treatment plan designed to help you feel better and get back to the activities you enjoy.

Whether you’re experiencing neck pain, back pain, joint pain, or another chronic pain condition, we’re here to help.

Call (973) 473-5752 today to schedule your consultation.

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Clifton Location
1033 Clifton Ave., Suite 209 Clifton, NJ 07013

Elizabeth Location
230 West Jersey Street, Suite 306, Elizabeth, NJ 07202

Open Hours
Mon – Wed: 8:30am – 4:30pm
Thursday: 10:00am – 6:30pm
Friday: 8:30am – 4:30pm