Lumbar Pain | Lower Back Pain

What is chronic back pain?

Chronic back pain is an extremely common musculoskeletal disorder. It can range from annoying to debilitating, and treatment options vary accordingly. The causes of back pain are numerous, but they break down into spinal and non-spinal categories. Spinal causes include pain resulting from injured discs, joints, nerves, muscles, or bones of the spine. Non-spinal causes include pain from abdominal organs, infection, metabolic syndromes, and psychological disorders. Risk factors for back pain are numerous and include genetics, smoking, posture, intense physical activity, and work conditions. Immediate medical attention should be sought if back pain is severe and continuous or associated with progressive leg weakening, severe fever or chills, and/or sudden incontinence, as these may be signs of a more serious disorder

How is a cause of my pain determined?

The cause of an individual’s pain is determined through a careful history, physical examination, and diagnostic testing. Serious causes of lower back pain should be ruled out depending on the patient’s signs and symptoms. Diagnostic testing usually consists of radiographic imaging such as plain x-rays, MRI scans, quantitative sensory testing, and targeted diagnostic nerve blocks. In most cases, combinations of tests are required for a specific diagnosis. Consistent, reproducible relief from specific targeted nerve blocks is often the best way to determine the site of the patient’s pain.

How does one decide the best treatment for me?

After determining that there are no potentially serious causes for lower back pain, several factors need to be taken into consideration. The intensity and degree to which the pain interferes with your life will help determine the course of action. Patients with minimal and occasional pain may do well on anti-inflammatory medications and home exercises. Patients that have already tried physical therapy, spinal manipulation, anti-inflammatory medication and continue to have significant pain usually require a more targeted approach to their treatment.

Why can’t I just take a pain killer?

Medical management is certainly an important part of pain therapy. Non-narcotic medications such as anti-inflammatory, low dose antidepressants, and other agents that act on nerves are considered the first line treatment in the medical management of chronic pain. Potent narcotic medications may also be used when in conjunction with other treatments such as nerve blocks and physical therapy. Please see the list of procedures for more details about treatments of back pain.

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