Article featured on Brigham Health Hub
Managing back pain can be challenging, because it’s often non-specific and may be the result of many different conditions. In this post, Dr. Jason Yong, an anesthesiologist and Medical Director of the Pain Management Center at Brigham and Women’s Faulkner Hospital, offers some guidance for people suffering from back pain.
Not all back pain requires treatment from a physician. Patients with acute low back pain (lasting less than three weeks), for example, can often get sufficient relief by using over-the-counter anti-inflammatory pain medications, physical therapy exercises, and temporary restrictions on lifting while the body heals itself. Generally, treatment by a physician is advised when pain is limiting a patient’s ability to walk, sit, or stand for prolonged periods of time, or if pain is greater than a 6 (on a scale from 0 to 10). Spinal surgery is usually considered for patients with intense, unrelenting pain (10 on a scale from 0 to 10), weakness, incontinence, or structural instability.
Role of Injections
Steroid injections typically provide short-term pain relief and can be combined with other forms of therapy. An injection may be provided, for example, prior to physical therapy to help a patient complete a regimen of important exercises.
Implantable Devices for Pain Management
Patients now have access to a wide range of implantable pain management devices. These include intrathecal pumps that infuse medication into the spinal fluid and use much lower doses of medications when compared with oral therapies. Spinal cord and peripheral nerve stimulators are other devices that can decrease the patient’s sensation of pain.
Importance of Multidisciplinary Care
Patients who have persistent back pain, including those considering spinal surgery, should work with a multidisciplinary team of specialists with expertise in treating back pain, because it may be caused by many conditions, including spinal stenosis, disc herniation, or instability. A multidisciplinary team is best suited to advise on the many modalities available to treat back pain, including benefits and risks associated with each approach.
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