Back Pain

Most individuals will experience back pain in their adult life. Back pain is one of the most common complaints which will lead to a physician visit. It is the most common complaint seen by most Pain Management Physicians. Common causes of back pain include lifting injury, falls, bulging disc, arthritis, facet joint disease, sciatica, sacroiliac joint disease, spinal stenosis, post surgical pain. Smoking and manual labor have been associated with an increased risk of back pain.

Nearly 2/3 of individuals respond to conservative therapy (rest, ice, physical therapy, pain medications and targeted injections). About ¼ of individuals will redevelop back pain after the initial occurence. In some individuals the condition will go on to become a chronic pain and present significant disability and decreased function.

Individuals will usually present complaints of low back, hip or buttock which may or may not extend down into the leg. There may also be associated neurologic symptoms, such as tingling, numbness or weakness.

Medical assessment starts with a comprehensive history and physical exam. If warranted diagnostic studies including: imaging (x-rays, CT scan, MRI’s), Electrodiagnostic studies (EMG/NCV), diagnostic injections and occasionally blood work may be completed.

How do you treat Back Pain?

Identifying a cause of the back pain will help to develop a treatment protocol. Common treatment includes rest, medications (anti-inflammatories, pain killers, muscle relaxers, neuropathic pain medications), physical therapy, exercise, modalities (heat, ice, ultrasound, TENS unit), lumbar bracing, interventional injection therapy and occasionally surgery. Diagnostic and therapeutic interventional injection may be performed, which will vary depending on the source of the back pain. Common injections include trigger point injections, epidural steroid injections, facet joint blocks, sacroiliac joint injections, selective nerve root blocks, and more advanced treatments include spinal cord stimulation.

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