Let’s Talk Back Pain

Back pain will affect approximately three in four adults during their lifetime. That is a big number! Today we will talk about back pain and your options for pain relief.

There are several different types of pain, especially when it comes to back pain. There is acute back pain, which can be severe but has been present for less than 12 weeks. Chronic back pain is defined as pain that persists for 12 weeks or longer, even after an initial injury or underlying cause of acute low back pain has been treated. There is also a difference between axial and radicular back pain. Axial will generally present as back pain in a belt like distribution vs radicular pain which is commonly referred to as sciatica. Axial back pain is generally caused by a structural issue, such as arthritis of the joints of the spine or degenerative disk disease. Radicular pain, on the other hand, is caused by nerve compression either in the spinal canal or as the nerves are exiting the spine.

Not all incidences of back pain are injury or trauma-related. Many back problems are congenital/genetic, degenerative, age-related, disease-related, and may be linked to poor posture, obesity or unhealthy lifestyles.

You may notice an increase in pain while being active, or you may notice more pain with inactivity. Everyday things such as sitting, walking, standing, bending over can make back pain even worse. This pain can become a part of your everyday life and can get worse if left untreated.

When do you seek professional help?
That is a great question. It seems that people often wait until it’s unbearable, until they can’t stand up, or have significant weakness, or even begin to have bowel and bladder changes. The fact of the matter is, it is more common to get relief/resolution of your pain the closer you are treated to when the pain began. In other words, acute pain quickly can become chronic pain if left untreated, and pain that has been an issue for two years is much more treatable than pain that has been present 20 years.

What can I expect from my Pain and Spine Specialists doctors and physician assistants?
We will do an in-depth review of your medical history. Be prepared to discuss when back pain started, what you were doing when pain began, if anything you do gives you relief, current pain severity, and describe the characteristics of your pain (sharp, dull or aching). Your doctor wants to learn as much as possible about your pain and symptoms before he examines you. Be aware that our physical exam may provoke pain while we try and pinpoint the area and source of your pain.

After a thorough review of your history which includes reviewing any X-ray, MRI, or CT, you and your doctor will develop a plan to address your pain. Treatment options will generally focus initially on conservative measures (physical therapy, medication management) followed generally by interventional therapies (epidural injection, nerve ablation, joint injection, etc.). Also, in recent years the opioid epidemic has spurred innovation and we have many advances in treating chronic pain such as spinal cord stimulation, dorsal root ganglion stimulation, target drug delivery, with many more therapeutic options in development.

Living with back pain and be challenging physically and emotionally. At Pain and Spine Specialists we pride ourselves in helping patients manage their pain and assisting these patients return to an active lifestyle. If you are someone or know someone who is living with or limited by back pain we would love to discuss options that can help.