Back pain ranges from a dull, constant ache to sharp sensations that make movement difficult. When pain becomes chronic, it can affect daily activities; a pain clinic evaluates symptoms to identify the source of discomfort. Treatment options depend on the cause of pain; the findings from an evaluation help guide the approach.
Diagnosing Back Pain
Diagnosis begins with a review of symptoms and medical history. A physical exam assesses the back and how pain affects movement, while questions about daily activities provide additional information. When an examination does not identify the cause, imaging or other tests at a pain clinic can provide more information.
X-rays reveal arthritis or broken bones, while MRI or CT scans can show herniated disks and problems involving bones, muscles, tissue, tendons, nerves, ligaments, and blood vessels. Blood tests can help identify infections or other conditions; electromyography measures electrical impulses produced by nerves and the response of muscles. These tests can confirm pressure on nerves caused by herniated disks or spinal stenosis.
Managing Back Pain
Medications depend on the type of back pain. Nonsteroidal anti-inflammatory drugs, such as ibuprofen or naproxen sodium, can help; prescription NSAIDs are available when nonprescription options do not help. Muscle relaxants can help when mild to moderate pain does not improve with pain relievers, but they can cause dizziness and sleepiness.
Other medications provide additional options. Topical creams, ointments, and patches deliver pain-relieving substances through the skin, while opioids are used for short periods with close medical supervision. Certain antidepressants, including duloxetine and amitriptyline, have been shown to relieve chronic back pain; the medication used depends on the type of symptoms.
Physical therapy focuses on flexibility, muscle strength, and posture. A physical therapist teaches exercises that strengthen the back and abdominal muscles; regular use of these techniques can help keep pain from returning. Physical therapists also teach movement changes that help avoid flaring pain while staying active; the exercises can be adjusted during episodes of back pain.
Other therapies can provide additional approaches. Massage might help when tense or overworked muscles cause back pain; chiropractic care uses spinal manipulation to ease pain. Acupuncture uses thin, sterilized needles at specific points on the body, while a growing body of scientific evidence indicates that it can help treat back pain.
Applying Pain Procedures
Several procedures are used to treat back pain. Cortisone injections can help when pain radiates down a leg and other measures do not relieve it; the injections can decrease inflammation around nerve roots. Radiofrequency ablation uses radio waves to damage nearby nerves, while implanted nerve stimulators deliver electrical impulses to certain nerves to block pain signals. Surgery provides another treatment option. Surgery that creates more space within the spine is sometimes helpful for increasing muscle weakness or back pain that travels down a leg; these problems can be related to herniated disks or other conditions that narrow the spaces where nerves pass through the spine.
Visit a Pain Clinic
A pain clinic provides different approaches for managing back pain. Treatment can include medication, physical therapy, procedures, or other therapies; the diagnosis helps guide treatment decisions. An evaluation begins with an assessment of symptoms and physical function; additional testing can help identify the cause when needed. Visit a pain clinic in your area to learn more.
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