If you’ve been living with back pain, chances are you can’t wait to put it behind you, and as a pain management specialist, I want to help you do that.
Back pain is one of the most common types of chronic pain, and comes in many different forms. Because you can’t live life without moving your back (unless you’re lying down absolutely still, and even then it might still hurt), it can also be extremely debilitating and frustrating. Back pain is commonly caused by these sources:
- Muscular: This kind of pain happens with injury or inflammation to the muscles along and surrounding the spine. In more severe cases, the muscles can begin to contract uncontrollably, causing moderate to severe pain.
- Arthritis: There are joints in the spine called “facet joints” which can become arthritic and painful just like a knee or hip joint can. Many times, they cause pain when extending the back or leaning backwards, and require a more targeted treatment.
- Nerve root: Irritation or injury to nerves in the back is a common cause of chronic back pain.
- Discogenic pain: Deterioration of the discs between the vertebrae in your spine is a normal process as we age, but can be accelerated by injury. As these discs degenerate, it can cause pressure or inflammation of nerves or the spinal cord, leading to pain, numbness or tingling sensations in the arms and legs.
- Fracture: Injury to the spine can cause cracks or breaks of the vertebrae which surround and protect the spinal cord. When this happens, it can lead to swelling and pain.
- Idiopathic: Back pain with an unknown cause.
Pain in your back can range from mild (which is easy to treat with heat, cold or over-the-counter medications) to severe, preventing you from working, enjoying hobbies or even moving. Knowing when to see a doctor is important, because pain isn’t the only indicator that you need medical treatment. If you have any of the following, talk to your primary care doctor. You’ll need to see them so you can be referred to see a pain management specialist like me.
- Pain that continues or doesn’t improve with over-the-counter anti-inflammatory medications, hot/cold therapy or rest.
- Radiating pain: Pain that moves throughout the back can be a symptom of more severe injuries.
- Numbness, tingling around the back or in the arms or legs: These symptoms indicate a nerve component to your back pain, which requires medical treatment in order to prevent further damage or more severe pain.
There are also some symptoms that indicate a need for immediate medical attention. If you have any of these symptoms, go to an emergency room or call 911:
- Loss of bladder or bowel control
- Weakness in the arms or legs related to back pain, or difficulty walking
- Pain that occurs after a sports injury, fall or after a car accident
In order to diagnose your back pain, I will talk to you about how and where it hurts and how it’s affecting your life. I will also do a thorough physical, musculoskeletal and neurological examination to determine the cause. If necessary, I can use diagnostic imaging, including x-rays, MRIs or CT scans.
The good news about back pain is that there are often multiple options to treat it. Back pain also commonly responds to combinations of treatments better than it does to just one. That’s why it’s important for me to work on a treatment plan with my patients, because everyone has different needs.
When it comes to treating back pain, here are some of my most common options:
- Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): These are typically available over-the-counter, and include ibuprofen, acetaminophen and naproxen.
- Muscle relaxers: These help relieve pain by stopping muscle spasms.
- Physical and massage therapy: Expert assistance to overcome injuries can be invaluable in getting lasting relief from pain.
- Numbing creams: Applied topically, these medications can be effective in relieving surface muscle pain.
- Injection therapy: Doses of pain-relieving drugs can be delivered with targeted precision, often through use of x-rays, ultrasound or fluoroscopy to show me exactly where to administer the medication.
- Opioid medications: These drugs are only used for certain types of injuries or pain, and even then they are only used as a last resort. These are good only for temporary relief, and aren’t meant for long-term use. They buy us time while we work to remedy the problem that’s actually causing the pain.
Lastly, the best way to deal with back pain is to avoid it in the first place. Avoiding injury is a matter of being cautious, especially when it comes to lifting and not straining. Remember to exercise proper lifting technique (lift with your legs, not your back) and always be sure to stretch. There are also a number of exercises for your core that can help, because the stronger your core muscles are, the better they can support your back.
If you’ve been dealing with back pain, don’t hesitate to talk to your primary care doctor. They can offer you a lot of options and can help put you in contact with me if necessary. We can work together to improve your back pain so you can get back to living – and enjoying – life.
Dr. Jason Lee is a pain management specialist with One Health Pain Management. For more information, call 844-44-MY-ONE (844-446-9663).