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Strategies for managing back pain

Last Modified: February 17, 2023

Family Medicine

back pain

Back pain is a common medical problem and can range anywhere from constant aches to sharp pains, making diagnosis and treatment somewhat of a challenge. For guidance, we turned to Micah Smith, MD, Orthopedics Northeast, Parkview Health. He discusses the most common reasons for back pain, when to see your provider and possible treatment options available for patients looking for relief.

Why it happens

Most adults will experience back pain at some point during their lifetime. Typically, back pain occurs due to a strain and overuse of the muscles around the spine or a pinched nerve. The two leading causes of a pinched nerve are:

  • A herniated disc – This occurs when a bulge of the disc (the shock-absorbing part of the spine) compresses the nerve against the back of the canal.
  • Arthritis bone spurs – These can develop at the joints of the spine that connect each vertebra. They take up space in the canal where the nerves live and pinch the nerves, causing radiating pain.

Thankfully, we can manage most occurrences of back pain conservatively and without surgery.

When to see a doctor

If you have been experiencing back pain for more than a week or have any pain, numbness or tingling running down your leg, you should get evaluated by your provider. These symptoms could be a sign of a pinched nerve or something more.

What to expect during a visit

If you have issues with back pain, the first thing we will do is a physical exam. This will help us determine the type of pain you are experiencing and where it is located (i.e., muscle issues, nerve-related problems or the sacroiliac (SI) joint).

The next step would be to get an X-ray. This will help show various aspects and the alignment of your spine, including if you have scoliosis (a curve in your spine), a spondylolisthesis (slipped vertebrae), a fracture or other aspects of wear and tear of the back.

Most of the time, there’s no need to rush into getting an MRI unless your condition worsens or the situation warrants it. Reasons for getting an MRI could involve:

  • Weakness
  • A pinched nerve
  • Decreased sensation in your legs
  • Signs of a fracture
  • Concerns for a pathologic reason for the pain
Possible treatment options

When it comes to managing back pain and injuries, we like to approach treatment conservatively. During your visit, we will discuss and possibly have you start with options such as:

  • Temporary activity modifications
  • Oral medications like acetaminophen or NSAIDs
  • Physical therapy exercises
  • Chiropractic care

If these treatment options do not alleviate your pain, we may need to consider more aggressive forms of treatment like injections or surgery.

Final thoughts

It’s important for people to understand that they do not have to suffer in silence with their back pain. There are things we can do to help. Once we know what we are addressing, we can tailor a treatment plan for your situation. If medication, physical therapy and chiropractic care still aren’t taking care of your symptoms, then we can discuss other forms of intervention that could benefit you.

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