Spine Pain? We’ve Got Your Back

A Tricky Diagnosis

Most of the time, back pain is diagnosed as nonspecific, meaning the exact cause of the pain is unknown. Worldwide, 90% of lower back pain is nonspecific, according to the World Health Organization. Other kinds of back pain are less well-studied, but they often are also classified as nonspecific, Bach said.

"Many people don't receive an exact diagnosis," Bach said. "In most cases, we can determine if the pain is musculoskeletal or skeletal, but because there are so many structures in the back, we might not know exactly where the pain is coming from."

Your doctor's visit will begin with a thorough physical and detailed health history, which can yield important information to guide the most accurate diagnosis possible.

Read: Seeking a Second Opinion for a Spine Condition

Movement Is Medicine

Physical therapy is the first line of treatment for many pain patients. Along with pain, many people bring misconceptions to physical therapy, said Glen Gomez, a physical therapist with Select PT, a Cedars-Sinaipartner.

Physical therapy is not limited to massage or stretches, though those may be included in your treatment plan along with exercises that are practiced at home under guidance from a physical therapist.

"We're movement experts," Gomez said. "Our job is to get you functioning again. So, if you're a runner, we want to help you get back to running. We want basketball players back on the court, moms to be able to comfortably hold their children-whatever your goal is, we can develop a plan to get you there."

Gomez has helped enthusiastic athletes as well as patients who try to avoid exercise.

"I've had people tell me they hate exercise and they hate to sweat," he said. "For them, I ask if they can just give me two minutes."

Then, he builds a routine with bite-size amounts of movement that can aid recovery from the pain-causing injury.

Select PT physical therapist Heather Seyfert said that busy schedules are a barrier to regular movement for too many people.

"The truth is, if we think we don't have time to take care of our bodies, our bodies will force us to pay attention," she said. "If you're stuck at your desk all day, set a timer and make a point to walk to the end of the hall and back a couple of times an hour. Little changes to habits make a big difference over time."

Read: Back Pain: Non-surgical Treatments

Medical Options for Pain

Medications also can be useful for addressing back pain. Bach said he recognizes the concerns shared by patients and health professionals alike about opioids. However, nonopioid medications and certain supplements can provide safer relief.

"Patients tell me they don't like to take medications or that they feel guilty taking them," Bach said. "We try to help people through that. It's OK to take over-the-counter medications as directed for a couple of weeks while you're in pain."

Bach works closely with the Cedars-Sinai Pain Center and refers patients if they need more advanced pain management. Pain specialists may administer injections that combine steroids and medications to reduce pain and inflammation. When the pain is emanating from the joints or spine itself, a nerve-blocking anesthetic medication is used and not steroids.

In cases where a nerve block is successful, patients may be candidates for radiofrequency ablation guided by imaging, which uses electromagnetic waves to disable the specific nerve carrying the pain impulse.

"No one needs to struggle alone with back pain," Bach said. "Whether the pain is new or it shows up in recurring episodes, we can tailor a plan based on your history, the cause of your pain, and your needs."