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Conditions We Treat
Beat Back PainChances are it will clear up on its own, but never assume that until you know the causeIs there anyone out there who hasn’t had back pain? It’s one of the top reasons people go to the doctor, says internist Jon Brndjar, D.O. But common as it is, back pain is tricky to diagnose and confusing to treat. Should you call the doctor, chiropractor, massage therapist, acupressurist—or just lie down and take an aspirin? The answer, of course, is “it depends.” One factor is the pain itself. While our perception of pain is highly individual, there are clues that point to specific problems. “For example, if you have piercing pain that shoots down your leg and you can’t sit or stand for long periods, you may have a herniated disc,” says anesthesiologist Robert Corba, D.O., of the Center for Pain Management at Lehigh Valley Hospital and Health Network. Another factor is your age and condition. “In a healthy younger person whose back pain does not radiate down the leg, the problem is usually muscular and can be treated at home,” Corba says. “As you get older, a doctor visit may be the wisest course. If you’re over age 55 and have an increase in pain from arthritis or spinal degeneration, seek medical care immediately.” A doctor’s care also is important if you’re overweight, a smoker (which affects the health of discs and spine) or have a chronic condition like osteoporosis. The two main causes of back pain are herniated discs and pulled muscles, but don’t just assume that’s what your problem is. Back pain can be traced to something as serious as a kidney infection, tumor or abdominal aneurysm—or as common as monthly ovulation. If the pain is persistent or severe or you feel ill in other ways, seek medical care. In the vast majority of cases an achy back clears up on its own. “But why be uncomfortable for weeks if you don’t have to?” says physiatrist Brent Millet, M.D., who specializes in treatments such as massage, heat and exercise. (See The Do-It-Yourself Approach for pain-relief suggestions.) And if you decide it’s not a do-it-yourself situation? The best place to start is your family physician, who knows what questions to ask to pinpoint what’s wrong. Don’t expect an immediate MRI; not everyone needs fancy tests. Depending on your problem, treatment may include anti-inflammatory medication, physical therapy, steroid injections and/or hands-on therapy such as massage, acupressure, acupuncture or chiropractic. “Studies now show that some types of back pain respond better to chiropractic care than standard medical management,” says orthopedic surgeon James Weis, M.D. Surgery rarely is needed for low back pain, he says, but can be a good option for a herniated disc or spinal degeneration if more conservative approaches fail. If you’re told you need surgery, Weis adds, get a second opinion: “One of the main reasons for unsuccessful surgery is that the patient shouldn’t have had it in the first place.” Recovering from back pain takes patience and persistence. Stick with the treatment long enough for it to work, Brndjar says: “It can take up to a week for an anti-inflammatory drug to actually reduce the inflammation, even if it relieves pain sooner.” But if a given treatment isn’t working, talk to your doctor about trying something else. Steroids and narcotics aren’t meant for long-term use. While there’s no guarantee your back always will be pain-free, you can improve the odds by practicing good prevention. Exercise is especially vital, Millet says. “Include aerobic conditioning, strength building and flexibility; your back needs all three.” And don’t neglect your prevention program just because you feel better. “Get to know your body and what you can and can’t do,” says neurosurgeon Joseph Coladonato, M.D. “You’ll need to make adjustments as you grow older.” The bottom line: A pill might ease the immediate problem, but maintaining a strong, flexible, pain-free back is a lifelong process. This page last updated 3/30/08 08:47 PM
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