FAQs on Back Pain and Treatment



Back pain is a common problem among adults. Experts estimate that 90% of adults experience low back pain at some time during their lives. Back pain is reported as the most common job-related disability, which contributes to missed workdays.

Men and women are affected equally by lower back pain. Statistical estimates of 1-year incidence of first episode of low back pain range between 6% and 15%, with estimates of any episode ranging between 1.5% and 36%. Most individuals who have activity-limiting back pain proceed to have future episodes, with the rate of recurrence at the 1-year range from 24% to 80%.

What is chronic back pain?

Chronic back pain is defined as discomfort that lasts for 12 weeks or more, even after the initial injury or cause has been treated. Approximately 20% of people who suffer an acute back pain incident go on to develop chronic low back pain.

What are the symptoms associated with back pain?

Back pain varies from person-to-person. Some people have pain that affects the entire back, whereas others report just low back pain. The pain severity will differ, from mild to so severe that the person can barely move. People who suffer from back pain usually report dull aching of the back region, as well as sharp, shooting pains, tingling and/or burning sensations, and weakness in the legs and/or feet.

What conditions and factors can cause back pain?

The majority of back pain cases are mechanical in nature. For many people, low back pain is the result of spine degeneration, which is the result of normal wear-and-tear of age that affects the joints, discs, and bones of the spine. Mechanical causes of back pain include:

 

  • Disc degeneration – The most common cause of chronic back pain is degenerative disc disease (DDD). This occurs when the discs of the spine lose their integrity from aging, causing problems with bending and flexing.

 

  • Herniated or bulging discs – This occurs when a disc becomes compressed and bulges outward, causing pressure and irritation of nerves.

 

  • Radiculopathy – With this condition, there is inflammation, compression, and/or injury to a spinal nerve root, which causes pain, tingling, and numbness that can radiate to other regions of the body.

 

  • Spinal stenosis – This is narrowing of the spinal column that causes pressure on the spinal cord and nerves that branch from the cord. This condition results in pain and/or numbness with walking, and can lead to leg weakness and loss of sensation of the extremities.

What are the risk factors for back pain?

  • Medical conditions – Inflammatory joint disease, osteoporosis, endometriosis, and fibromyalgia are all conditions associated with back pain.
  • Age – Most people start to experience back pain between the ages of 30 and 50 years, but it is more and more common with advancing age.
  • Weight gain – Being overweight or obese puts stress on the spine and back muscles, which leads to back pain.
  • Fitness level – Back pain is more common among individuals who are not physically fit.
  • Genetics – One condition that causes back pain is ankylosing spondylitis, which is a hereditary form of arthritis that involves fusion of spinal joints.
  • Occupation – Having a job that involves lifting, pulling, pushing, and/or twisting puts a person at risk for back injury.

How is back pain diagnosed?

To diagnose your back pain, the Atlanta pain management doctor will take a detailed medical history and conduct a comprehensive physical examination. Diagnostic tests and imaging scans are used to rule out serious problems and pinpoint the cause of your pain. These include blood tests (erythrocyte sedimentation rate, complete blood count, renal studies), computed tomography (CT) scan, magnetic resonance imaging (MRI) scan, x-rays, and myelogram.

How is back pain treated?

Treatment is focused on the exact cause of the back pain. Depending on the severity and location of the pain, treatment options include:

  • Epidural steroid injection (ESI) – This procedure is performed to relieve neck or back pain. The doctor uses x-ray guidance to place a needle into the epidural space near the inflamed back area. A long-acting steroid is instilled into the space. According to recent clinical studies, this procedure has an 80% to 90% success rate.
  • Facet joint injection (FJI) – To aid with spine mobility, the doctor injects a long-acting anesthetic agent and/or a potent corticosteroid into the facet joint space of the spine. Under x-ray guidance, this procedure is often used to diagnose the exact area that is causing the pain. Researchers recently reported that up to 85% of patients had notable pain relief and functional improvement following this injection.
  • Lumbar sympathetic nerve block (LSNB) – Using fluoroscopic guidance, the doctor injects an anesthetic near the lumbar sympathetic nerves to relieve any back pain associated with this area. There may be temporary numbness and soreness following the procedure for 24 to 48 hours. In recent clinical studies, more than 70% of patients reported pain relief with minimal effect on sensory and motor function.

 

Resources

Hoy, D, Brooks, P, Blyth, F, & Buchbinder, R (2010). The Epidemiology of low back pain. Best Pract Res Clin Rheumatology, 24(6), 769-781. doi: 10.1016/j.berh.2010.10.002.

McLain RF, Kapural L, & Mekhail NA (2005). Epidural steroid therapy for back and leg pain: mechanism of action and efficacy. Spine Journal, 5:191-201

National Institute of Neurological Disorders (2014). Low back pain fact sheet. Retrieved from: http://www.ninds.nih.gov/disorders/backpain/detail_backpain.htm

Riew KD, Park JB, Cho YS, et al. (2006). Nerve root blocks in the treatment of lumbar radicular pain. A minimum five-year follow-up. J Bone Joint Surg Am, 88(8):1722-1725.

Veizi E & Hayek S (2014). Interventional therapies for chronic low back pain. Neuromodulation, 17(2), 31-45.