Chronic back pain affects one out of every five Americans, making it one of the most common health complaints in the country. Some of the most common causes include degeneration, muscle strain, mechanical problems and vertebral fractures from osteoporosis. Since the lower back carries most of the body’s weight, pain in that area is more common than in the upper back. Back pain can be aggravated with movement or can radiate into the extremities.
More serious conditions may be indicated by weakness, numbness, tingling, fever or problems with bowel or bladder control. A pain doctor will diagnose this condition by performing a physical exam and collecting a comprehensive medical history. If nerve pain is present, a neurological workup may be necessary to identify nerves that may be compressed by a herniated disc.
The doctor may order imaging if the pain persists for more than two weeks or if a more serious condition is suspected. Treatment goals will include relieving current symptoms and improving function.
For short-term relief, over-the-counter pain medications, muscle relaxants or opiate medications may be the treatment of choice. Over the course of a longer time, physical therapy and exercise may be ordered to strengthen the area and prevent reinjury. Alternative therapies like yoga, acupuncture and massage may be helpful for some patients.
Preventative measures like quitting smoking, treating obesity and avoiding twisting and bending may go a long way in helping to stop back pain before it starts.
Possible procedures include medial branch blocks, epidural steroidal injections, facet injections and radiofrequency ablation.