Back in Action

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

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In addition to physical therapy, your doctor may prescribe electric nerve stimulation and heat therapy, Sureja says.

“From this point, either the patient will get better or the pain will continue to get worse and may require a consultation either with a neurologic surgeon or an orthopedic spine specialist,” he says.

If the pain doesn’t get better, your doctor may prescribe stronger pain medications such as narcotic pain medicine or topical anti-inflammatories as well as topical treatments to reduce pain. Sureja may refer patients to a chiropractor for additional treatment. He also may suggest a back brace to be worn several hours a day for a few weeks to a few months to support painful muscles and joints in the spine. Sureja may encourage patients to seek out alternative treatments such as biofeedback or acupuncture.

If after a few months these treatments bring no relief, your doctor may order a CT scan or MRI to evaluate for a pinched nerve, herniated disc, degenerative disc disease, or narrowing of the spinal canal (spinal stenosis), Sureja says.

The next step in treatment might be trigger point injections to break up muscle spasms, he says. If the joints between the vertebrae (called facet joints) are arthritic and inflamed, a doctor might order facet joint injections to relieve that pain.

If injections don’t provide long-term relief, your doctor might perform what’s called a diagnostic medial branch nerve block, blocking the pain for different facet joints to determine which one is causing your back pain, Sureja says. Once the problem joint has been identified, the doctor could perform a procedure called a radio frequency ablation to cauterize the nerve sending the pain signals and bring you relief.

For herniated/degenerate dics or pinched nerves, lumbar epidurals also can provide significant pain relief lasting from three months to up to three years, Sureja says.

Don’t suffer in silence. Get help for your back pain.