Back Pain Treatment

How Do I Know What Is Causing my Back Pain?

To diagnose back pain -- unless you are totally immobilized from a back injury -- your doctor probably will test your range of motion and nerve function and touch your body to locate the area of discomfort. Blood and urine tests will be performed to make sure that the back pain is not caused by an infection or other more widespread medical problem.

X-rays are useful in pinpointing broken bones or other skeletal defects. They can sometimes help locate problems in connective tissue. To analyze soft-tissue damage, computed tomography (CT) or magnetic resonance imaging ( MRI) scans may be needed. X-rays and imaging studies are generally used only for checking out direct trauma to the back, back pain with fever, or nerve problems such as extremity weakness or numbness. To determine possible nerve or muscle damage, an electromyogram (EMG) can be useful.

X-rays and magnetic resonance imaging (MRI) studies have limitations and must be interpreted with caution. Back pain may be incorrectly attributed to non-specific and unrelated abnormalities on the images. Ordinary and expected wear and tear in the spine and discs may be mistaken as the cause of a person’s back pain. Likewise, plain x-rays are usually not helpful in cases of chronic back pain without a significant injury or loss of sensation and movement in the extremities.

Most back pain originates in the back and not the actual spine. Because most back pain is related to the muscles of the back, the specific cause of most back pain cannot be determined by imaging studies.

What Are the Treatments for Back Pain?

Only after determining the cause of the problem can a doctor begin treating back pain.

Rest: The basic treatment for relieving acute back pain from strain or minor injury is a limited period of rest for 24 to 72 hours. An ice pack can be helpful, as can aspirin or another nonsteroidal anti-inflammatory drug (NSAID) to reduce pain and inflammation. After the inflammation subsides, applying heat can soothe muscles and connective tissue.

Long-term bed rest is not only no longer considered necessary for most cases of back pain, it is actually potentially harmful, making recovery slower and potentially causing new problems. In most cases, you will be expected to start normal, nonstrenuous activity (such as walking) within 24 to 72 hours. After that you should begin controlled exercise or physical therapy. Physical therapy treatments may employ massage, ultrasound, whirlpool baths, controlled application of heat, and individually tailored exercise programs to help you regain full use of the back. Strengthening both the abdominal and back muscles helps stabilize the spine. You can prevent further back injury by learning - and doing - gentle stretching exercises and proper lifting techniques, and maintaining good posture.

Medication: If back pain keeps you from normal daily activities, your doctor can help by recommending or prescribing pain medications. Over-the-counter painkillers such as Tylenol, aspirin, or ibuprofen can be helpful. Your doctor may prescribe prescription strength anti-inflammatories/pain medicines or may prefer to prescribe combination of opioid (narcotic) and acetaminophen medications such as Vicodin or Percocet. Some doctors also prescribe muscle relaxants. But beware, these medications have their main effect on the brain, not the muscles, and often cause drowsiness.