BACK PAIN: WHAT TO DO WHEN YOU’VE TRIED EVERYTHING
Back pain can be caused by a variety of issues with the bones, joints, nerves, or muscles of the back. Some back pain is quickly gone, while other types linger. Reasons for back pain can include herniated discs, arthritis of the spine, spine curvature disorders, back sprains, or pinched nerves. To diagnose back pain, a doctor may take X-rays or EMG tests to find the issue. Depending on the cause, back pain may be treated with painkillers, physical therapy, back braces, or surgery.
Back pain can range in severity, and for many, it can be truly debilitating, requiring back pain treatments to manage daily activities. Some individuals have a higher tolerance for pain, allowing them to continue with their activities in spite of their pain. Others struggle with even a slight increase in pain. Because your pain is relative to your circumstances, you are the best candidate for determining whether a treatment is effectively resolving your pain or not.
In many cases, specific back pain treatments can provide temporary results. However, the return of an ache can involve a similar level of severity. It might be worse in other instances. At some point, you may have to make a decision to do something more extreme. However, this can be a challenging position to be in.
An Overview of Initial Back Pain Evaluation
Many initial steps in finding the right back pain treatments depend on the situation. For example, you might stop at the chiropractor’s office for an adjustment if you’re convinced that you are simply in dealing with an alignment issue. You may work with your primary care physician to determine whether there is any reason for concern. You may visit a specialist if pain has worsened. In each case, it is helpful to be ready to identify the exact locations that affect you.
In many cases, you will be able to pinpoint these locations on a diagram of the body. You might also be asked to complete an Oswestry questionnaire to assist a healthcare provider in understanding the impact of your pain on your personal and professional life. A physical evaluation may be conducted to identify areas of tenderness, limitations in your range of motion, and problems with moving your limbs, especially if your lumbar region is an issue. Don’t be surprised if you need to repeat these steps with specialists such as an orthopedic surgeon, neurologist, or pain management professional.
Review the Solutions You’ve Already Tried
Some of the simple steps you may have tried for relieving back pain prior to seeking further help could include:
- Ice
- Heat
- Rest
- Massage
- Essential oils
- Pain-relief creams
- NSAIDS
If you’ve already had some medical intervention, you may want to review the situation again with the provider to determine if it’s time to take your intervention to another level. A progressive approach can be helpful because spinal surgery can be extremely painful and may even intensify pain for some individuals. As you move beyond the basics, imaging may provide insight. In some cases, medical referrals to specialists are needed before more detailed imaging is possible.
What to Expect From a Spinal Pain Specialist
The order may vary, but a specialist might consider scheduling an MRI to get a view of spinal cord and disk conditions that are not visible on X-rays. In severe cases such as critical spinal stenosis, you may find that you are urged to have surgery to remove disk material or to fuse vertebrae. If a specialist is strongly urging surgery, it may be helpful to discuss the matter with another medical professional as you obtain a second opinion. Additionally, viewing the images yourself may provide you with visual confirmation of the severity. It is reasonable to ask a specialist to show you what they are talking about on an X-ray or MRI image.
In cases that aren’t urgent, steps can vary. You may be referred for a nerve study, especially if you are experiencing nerve pain. You may also be referred to a pain management professional for possible epidural injections or nerve blocks. These can be used in the diagnostic process as your specialist endeavors to identify the cause of your pain. They can also be used for temporary pain relief that can last from a few months to a full year. With long-term positive results, surgery might be delayed. However, a lack of results would potentially identify a need for surgery or the need to find a different cause of your pain.
Reconsider Your Source of Treatment and Information
The ability to obtain a second opinion may be helpful if your treating medical professional is not giving much attention to your complaints. It is helpful to be very focused during an appointment so that you are sure to address all major concerns. If you are concerned about the level of care or attention, a second opinion may help to confirm the existing course of action. It could also provide an alternative treatment plan.
What to Expect With Spinal Surgery
Some spinal surgeries are performed on an outpatient basis, allowing for an efficient rehabilitation process. However, major surgery can result in a lengthy hospital stay that is followed by months of rehabilitation. Because each surgery is unique based on the parties involved and the physical elements at play, it is important to discuss the possibilities with your surgeon. If a brace is required during your recovery time, you will want to become familiar with how to put it on and take it off in advance. You may also want to consider finding some specialized furniture for your home based on the extent of the surgery to be performed.
Occupational therapists may help you with concerns such as how to get dressed, wash, and reach dropped items. Ask about tools and techniques as you go through inpatient physical therapy. You may want to consider a lift-type chair for home if you expect to face severe mobility limitations. You may also want to rearrange furnishings in your room to ensure that you can easily reach pain medications, drinking water, electronic devices, and television remotes. A pedometer or other fitness monitor may be helpful as you start a walking regimen upon your return home. Being able to track your progress can be an encouragement if you face moments of fatigue or frustration.
Will Pain Be Resolved With Surgery?
Although back pain treatments involving surgery are often quite successful, there are many who deal with a return of the pain at a later date. You can discuss concerns about failed back surgery syndrome with your surgeon in advance to ensure that you have a clear understanding of the potential. In some cases, for example, a fusion can transfer stress to a higher or lower level of the spine. This means that you might anticipate similar pain and degeneration in the future. In other cases, severe nerve damage may be irreparable. This is an important reason for addressing major back pain at an early stage rather than pushing through the pain and hoping it will improve. Although most spinal surgeries are considered elective in nature, a delay could have devastating implications.
As you work through your back pain, reliable primary healthcare professionals and specialists can be a huge help. They may not be able to promise perfect results. However, they are typically committed to improving your quality of life as they work through their own progressive set of steps to diagnose and effectively treat your pain.