my name is stephen levin. i'm a johns hopkins pain medicine specialistpracticing at howard county general hospital. there are multiple different origins of backpain. they can range from the very minor to thevery severe. muscle strains or sprains can cause spasmand the most common cause of back pain...fortunately, they can be very self-limited and go awayby themselves. patients can suffer inflammation or arthritis,which can affect the joints in the back including the sacroiliac joints and the facet jointswhich can cause pain with movement. there can also be pain that is referred fromthe hip.
patients can also experience degenerativedisc disease which can cause what we call axial back pain, which is pain in the middleof the back and in some cases those discs can herniate and create what we call sciaticaor radiculopathy and this is a result of pressure from the disc on the nerves in the back. posture or scoliosis, which is a curvatureof the back, can lead to biomechanical back pain, which is pain caused by abnormal movement. some individuals can experience infectionswhich can lead to back pain. some of those are very unusual infectionsthat include tuberculosis or lyme disease or can be a more common from bacterial infectionsand that can infect the bone or the epidural
space. patients or individuals as they age can experiencethinning of their bone or experience osteoporosis and that can be so severe that the bones fractureand cause back pain. and in some cases patients with kidney, breast,lung, thyroid and prostate cancers can have their disease spread to the back and thatcan also cause back pain. the diagnosis of low back pain starts witha careful medical history along with a complete physical examination. if those examinations suggest concerns, thenblood tests, x-rays, ct scans, and mris are sometimes needed in aiding the diagnosis.
in some cases, we use diagnostic injectionsthat are x-ray guided to help facilitate the diagnosis. most people experience back pain in theirlives. the peak incidence of back pain can occurat two different times in life. one time that it occurs most often is in themid-30s when people's discs start to dry out and they can be susceptible to injuries fromlifting which can cause disc herniation. later in life the incidence will go up againand will be associated with degenerative processes associated with aging so patients will experiencemore arthritic problems in the back or the thinning of their bones or osteoporosis.
in general, it's good to avoid lifting injuries,poor body mechanics, and it's also good to maintain a good body weight and have a balancedexercise program. doing these things can lessen the likelihoodthat you'll experience back pain in your life. determining the best treatment for back paincan involve the thoughtful application of interventional techniques, medication management,as well as rehabilitative and wellness programs. our program offers a full spectrum of themost sophisticated medication management, highly specialized interventional pain managementtechniques, as well as rehabilitative and wellness programs. the mainstay of conservative treatment forpatients with back pain is the use of physical
therapy. it can be also very helpful for individualsto use short courses of non-steroidal anti-inflammatory medications, muscle relaxants, oral steroids,or even in some cases a short course of opioid therapy to facilitate the physical therapy. consulting with one's primary doctor can bea good place to start for individuals experiencing back pain that lasts more than a week or issevere. they can help to determine if consulting witha pain management specialist could be helpful. most back pain, while uncomfortable, is nota medical emergency. however, in cases where people lose sensationin their limbs that is associated with weakness,
or a loss of control of their bodily functions,then more immediate medical attention is necessary. from a pain management perspective there hasbeen a steady evolution of treatments. there has been a steady advancement in thehighly specialized interventional pain management techniques, including high frequency neuralstimulation. there has been the advent of even more sophisticatedmedical management options and there have been the advent of innovation rehabilitationstrategies that have been very helpful for individuals.
