When your back pain lingers…

Oh, my aching back! We’ve all been there — when it hurts to stand up after a long day at work. What can you do to reduce the ache?

Most of the time, you can take basic steps to eliminate or reduce back pain. But occasionally, the pain may not go away, and the underlying cause of your back pain will require more care. Let’s take a look at what to do when the pain does not improve.

When “minor” back pain seems more serious

Back pain impacts nearly 80 percent of Americans at some point in their lifetime. How can you know when your back pain requires a physician’s care?

If your pain is significant and interfering with your daily activities — or if it lingers for longer than a week — it’s a good idea to check in with your doctor. He or she will offer suggestions on how to reduce your pain.

If your pain still doesn’t go away with lifestyle changes and basic care, you may need more aggressive treatment.

“If you’ve had back or leg pain that doesn’t improve after six weeks, we typically recommend conservative medical management, including physical therapy, weight loss, smoking cessation and the use of non-steroidal pain medications,” says Joseph Miller, MD, neurosurgeon with UT Erlanger Neurosurgery Group. “85 percent of patients typically improve if they follow those four recommendations. But if a patient fails to improve, then we’ll order an MRI to check for underlying causes of the pain.” Dr. Miller does recommend an urgent MRI “if the pain is especially debilitating, causes weakness, numbness, or bowel/bladder dysfunction.”

Determining if surgery is needed

Physicians will almost always recommend less invasive treatment for back pain before recommending surgery. If your back pain doesn’t respond to treatment, your doctor will use MRI and other diagnostic tests to uncover the cause of the pain and determine how to best treat it.

“When we order an MRI, we’re looking for issues like stenosis and nerve root impingement that could be causing back pain that radiates down the leg,” Dr. Miller says. “Once we review the MRI, we’ll determine whether surgery is necessary.

“Not everyone needs surgery — or at least not back surgery. The MRI might reveal that the source of the pain is related to the hips, shoulders or other areas of the body. From there, we might order a nerve conduction study to test for herniated discs, sciatic nerve issues or nerve impingement, among other issues.”

When surgery is needed

When doctors determine that the best option for a patient is back surgery, they’ll first look to minimally invasive surgical options.

“While not everyone is a candidate for a minimally invasive procedure, many people are,” Dr. Miller says. “These procedures have many benefits, including smaller incisions, shorter recovery times, a reduced risk of infection and higher overall patient satisfaction.”

Have back pain that isn’t responding to at-home treatment? Schedule an appointment with the providers at UT Erlanger Neurosurgery Group by calling (423) 265-2233. Learn about one woman’s experience with the collaborative care they offer.