Back in Action

Don’t suffer in silence—get relief from chronic pain

The Orthopaedic and Spine Center in Newport News

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Maybe it started with yard work. Or a bad move during a softball or basketball game. You don’t have to suffer with debilitating back pain. The goal of pain management is to correctly diagnose your pain and then treat it with the most conservative means possible, says Dr. Raj Sureja, interventional pain management specialist at the Orthopaedic and Spine Center in Newport News.

“One goal of pain management is to diagnose and treat the pain generator to improve the use of potentially harmful pain medications,” Sureja says. “Then we want to not only reduce pain but improve function. We want patients to be able to go back to work so they can support their families and return to a normal activity level with improvement in their quality of life.”

The first step will be to ensure the back pain is not neurological, Sureja says. If neurological issues are suspected, your doctor may obtain X-rays. Symptoms of nerve-related pain include bladder or bowel dysfunction (so don’t be too embarrassed to mention it) as well as sensory loss and/or weakness in the arms or legs. Once that possibility has been eliminated, your doctor will begin with the most conservative treatment, stepping up as needed if conservative treatment doesn’t bring you relief.

While your pain may make it tempting to stay in bed or on the couch, your physician will want you to continue with everyday activities. Years ago, the first treatment for back pain often was bed rest, Sureja says. But bed rest has been found not only to result in no improvement in function, but also to lead to weakening of muscles, he says.

But proceeding directly to invasive treatment such as surgery is not a good idea either. “We explain to patients the natural progression of back injuries and explain that the more conservative treatment efforts provide more long-lasting gain than jumping to more aggressive treatment right away,” he says. “In general, most acute back pain does get better within two to six weeks.”

Your physician might first prescribe muscle relaxers to lessen back spasms and prescribe anti-inflammatory medication to help reduce inflammation and pain, Sureja says. When your back is hurting, you’ll avoid certain movements—movements that might be essential in physical therapy. The goal is to get your pain sufficiently under control so you can tolerate physical therapy, which will further aid your recovery, he says.

“What you’re doing with physical therapy is not only restoring the range of motion, but also strengthening the muscles that support the spine,” he says. “More support takes the pressure off the soft tissues of the spine that could be contributing to the pain.”