Updated: Sep 12
Most people will eventually experience some kind of back pain in their lives, since it is one of the most common of all medical conditions. In the majority of cases, this pain will be of the acute variety, meaning that it will subside all on its own, without treatment. Chronic back pain is altogether different, and is characterized by lasting at least 12 weeks. Unlike acute back pain, which is generally caused by a single incident, chronic back pain is often linked to some kind of underlying medical condition. Some possible causes of chronic back pain include disease or injury to the spinal vertebrae, degenerative arthritis, kidney stones, spinal tumors, and infections.
Determining the cause of back pain
It’s very important to determine the cause of your back pain, because that will indicate what form of treatment will be most effective at managing the back pain. In an effort to diagnose the cause, your doctor will interview you about your medical history, to see if anything there has impacted the present back pain. A physical examination will usually follow, so it can be seen how you react to specific movements and pressures. In some cases, this will be enough to determine the cause of your discomfort, but in other cases it will be necessary to take additional steps.
It may be necessary to take x-rays of your back, and you may have to take blood or urine tests to provide more information. You may have to undergo a computed tomography (CT) scan, or you may need to have a spinal magnetic resonance imaging (MRI) test performed. To find out whether nerves have been damaged, it may be useful to have electromyography performed, or to do a nerve conduction study. If you have some kind of cancer history, it might be necessary to conduct a bone scan. All these procedures can help narrow down the underlying cause of your chronic back pain.
Recommended treatments without surgery
In an effort to manage back pain, there are many situations where your doctor will prescribe specific medications which have proven to be effective historically. Physical therapy can also be effective when any kind of strains or damaged muscle tissue has occurred. To relieve more severe pain associated with a chronic back condition, it may be necessary to do injections in the affected area. Steroid injections are commonly performed because they can deliver anti-inflammatory corticosteroids that reduce inflammation and pain levels. The advantage of doing injections is that they speed relief directly to the area where pain is being felt.
Another tactic is to use medial branch blocks, and these prevent pain signals from being sent to the brain. To do this, it will be necessary to inject an anesthetic solution that accomplishes the blocking activity. This procedure will generally provide at least temporary relief, but it can also be used as a diagnostic tool, to help pinpoint where the problem is. A majority of patients suffering from chronic back pain can receive significant relief through non-invasive methods such as these.
Recommended treatments with surgery
Surgery is saved as a kind of last resort option, when other methods fail to provide relief. The good news is that surgical techniques have advanced greatly in the past decade, and it is now possible to use minimally-invasive methods that require less recovery time. It is now possible to emplace a spinal cord stimulator, which can generate electric pulse signals that mask any pain signals sent to the brain. This device is controlled by the patient, and would be used during times of more severe pain.
Another recently developed innovation in managing back pain is the Vertiflex Superion Implant. This device is ideal for treating lumbar spinal stenosis, since it can serve as a spacer between vertebrae and relieve the pain from bone rubbing against bone. Pain pumps are a possible solution for patients who have historically responded well to pain medication, but who require a more long-term solution. A pain pump will deliver medication directly to an affected area, and it will be programmed by your doctor, so as to provide the right amount of medication to the right area of the body.
Radio-frequency ablation uses heat to disable nerve endings, when nerves are being pressured into sending pain signals to the brain. In effect, this is another method for blocking pain signals that would otherwise reach the brain, and felt as pain by the patient. An electric current is used in this process to literally burn certain nerve endings, thus effectively preventing pain signals from reaching the brain.