Back Pain – Diagnosis and Treatment
Diagnosis
Finding out why your back hurts usually starts with a hands-on physical exam. The doctor will watch how you sit, stand, walk, and lift your legs.
They’ll probably ask you to rate your pain from 0 to 10 and talk about how it affects your daily life.
If something serious like a fracture or infection seems possible, you’ll likely need more tests. X-rays can show problems with bones, like arthritis or fractures, but they won’t reveal issues with nerves or disks.
Doctors sometimes order MRI or CT scans for a closer look. These scans can spot herniated discs, injuries to muscles or ligaments, and changes in the spine or spinal cord.
Blood tests—like a complete blood count or erythrocyte sedimentation rate—can help rule out infections or other medical issues that might be causing pain.
If nerve damage or compression is a concern, your doctor might suggest an electromyogram (EMG). This test checks how your nerves and muscles work together and can point out problems like spinal stenosis or pinched nerves.
Some causes, like osteoporosis, spondylitis, or tumors, may need extra testing such as a bone scan or myelography. In rare situations, lab tests can uncover conditions like kidney disease or osteomyelitis that lead to back pain.
Treatment
Medication Options
Many people use medicines to lower pain and swelling.
Table: Common Medicines for Back Pain
| Medicine Type | When Used |
|---|---|
| NSAIDs | Mild to moderate pain |
| Muscle Relaxants | When muscle tension is present |
| Opioids | Severe pain, short term |
| Antidepressants | Chronic back pain |
| Topical Treatments | Local pain relief |
Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen are common for mild pain and inflammation.
You can pick these up over the counter, but if the usual dose doesn’t cut it, your doctor might prescribe something stronger.
If NSAIDs don’t help, muscle relaxers are an option. These can make you feel sleepy or dizzy, so it’s best to only use them with your doctor’s guidance.
Some individuals find pain-relieving creams or patches useful. You put these right on the sore spot. For severe pain, doctors might prescribe opioids, but only for a short period.
These drugs can cause side effects and need careful monitoring.
Surprisingly, some antidepressants can help manage back pain, even if you’re not feeling depressed.
Exercise, Movement, and Physical Therapy
Physical therapy helps a lot of people with back pain. A physical therapist can teach you stretches and exercises that keep your back and core strong.
These moves boost flexibility and help correct posture problems. Learning safe ways to move can stop pain from getting worse and prevent future flare-ups.
Therapists might:
- Give you muscle-building and stretching exercises.
- Show you how to sit, stand, or lift things safely.
- Suggest small daily changes to keep pain from coming back.
Staying active is better than lying in bed. Even simple activities, like walking, can speed up recovery.
Advanced Treatments and Surgery
If medicine and exercise don’t work, other options are available. Some people get corticosteroid shots, which deliver medicine right to the area around the spinal cord to reduce swelling.
This can help with pain that shoots down your legs, though the relief may only last a few months.
Other treatments include:
- Radiofrequency Therapy: A tiny needle delivers radiofrequency waves to block pain signals.
- Electrical Nerve Stimulation: A small device sends gentle electrical signals to nerves to help block pain.
- Spinal Procedures: Surgery may be needed if nerves are pinched or damaged. Common operations include discectomy, laminectomy, spinal fusion, and procedures for herniated disks.
Doctors usually reserve these steps for people who don’t get better with other treatments or who have worsening weakness or numbness.
Approaches Beyond Traditional Medicine
Lots of people try other methods besides standard treatments for back pain. These options can sometimes bring relief, especially with guidance from a healthcare professional.
Here’s a quick table with some common alternative approaches people use for back pain relief:
| Method | What It Involves |
|---|---|
| Massage | Hands-on manipulation of muscles |
| Spinal Manipulation | Adjustments of the spine |
| Biofeedback | Monitoring body functions |
| Stress Management | Relaxation and coping skills |
Massage therapy is a popular choice. It can loosen tight muscles and help with pain from tension or overuse. Some people go for spinal manipulation, usually done by a chiropractor. This involves gentle adjustments to the back.
Biofeedback is another approach. It helps you notice how your body reacts to pain and stress by using electronic monitoring, so you can learn to control things like muscle tension.
Stress management techniques—like relaxation exercises or deep breathing—can support your overall well-being and might ease pain.
Getting Ready for Your Visit
Before you see your healthcare provider about back pain, gather important details. Write down all your symptoms, when the pain started, and how it changes during the day.
Think about any stress or recent events that might affect your health.
Prepare a list of medicines, vitamins, and supplements you’re using:
| Name | Dose | How Often Used |
|---|---|---|
| Example: Acetaminophen | 500 mg | Twice daily |
| Example: Vitamin D | 1000 IU | Once daily |
Bring along questions for your doctor, such as what might be causing the pain, if you need more tests, or which treatments they suggest.
It’s a good idea to bring a friend or family member to help you remember what the doctor says.
Some helpful questions:
- What can I do to improve my posture and avoid future pain?
- Will I need to see a spine specialist?
- How long should I stick with the treatment plan?
- Are there things I should avoid to keep the pain from getting worse?
- Is there a way to keep a healthy weight to support my back?
What Your Provider Might Discuss With You
Your healthcare provider will ask about your health history, including any old back injuries or physical activities.
They may ask about your daily habits, exercise, sleep, and mood.
The doctor might ask:
- Has your ability to move or work changed?
- Are there any other symptoms besides pain?
- What self-care steps have you tried, and did they help?
- Do you have other health conditions that could affect your back?
They’ll probably do a physical exam and might suggest tests. They may also talk about how learning more, staying active, and keeping good posture can help manage and prevent back pain.
