Most every American will, at one time or another, have back pain. The Centers for Disease Control & Prevention reported that in 2019, 39 percent of adults had back pain within the last three months. That’s a lot of achy backs.
“One of the most chronic forms of pain we see in our society tends to be chronic back and neck pain — low back pain probably being the most common type of chronic pain that ails people,” said Neil Patel, MD, an anesthesiologist and interventional pain management physician at Endeavor Health Northwest Community Hospital.
Dr. Patel specializes in treating a wide variety of painful conditions and takes particular interest in treating painful spinal conditions. His practice focuses primarily on performing minimally invasive procedures with the goal of alleviating pain and avoiding surgery.
Causes
It starts with identifying the cause of the pain, such as:
- Muscle or ligament strains can occur from repeated heavy or improper lifting.
- Osteoarthritis commonly affects the lower back, usually occurring from age-related wear and tear of the small joints in the back.
- Osteoporosis (brittle bones) can lead to breaks in the vertebrae.
- An inflammatory disease called ankylosing spondylitis can cause some bones in the spine to fuse.
- Spinal stenosis is a condition when the spinal canal narrows, possibly putting pressure on the spinal canal and nerve roots which can be painful.
Pain that lasts for more than three months is viewed as chronic. It’s pain that doesn’t improve despite rest and modified activities. “That’s often when your primary care doctor may suggest this is a good time to get evaluated by a pain specialist … to see if there are other potential sources behind the pain,” Dr. Patel said.
Treatment
A pain doctor might initially prescribe advanced imaging like MRI scans and physical therapy to further evaluate and treat chronic back pain.
“Many, many people find that their pain improves on its own with conservative care — rest, activity as tolerated, over-the-counter analgesics such as Tylenol or ibuprofen,” he said. Some individuals may be good candidates for certain types of pain procedures including epidural steroid injections, nerve blocks and radiofrequency ablation to name a few.
Common spinal surgeries include laminectomies — when surgeons cut out a small portion of bone to decompress the spinal cord with the hope of reducing spinal stenosis, or tightening around the nerves. If the spine needs support, a spinal fusion might be appropriate, where the spine is aligned and held together with rods and screws. Discectomy is another common and fairly minimally invasive back surgery. It’s needed when a disc might rupture or bulge and press on a nerve.
People who are experiencing sudden severe new pain, weakness or numbness in the legs, or experiencing sudden loss of bowel or bladder functions, may be demonstrating “red-flag symptoms” and they should head to the emergency room immediately to be further evaluated, he said. This could be a sign that the spinal cord might be getting pinched in such a way that could require fairly urgent surgical intervention, he said.
Ways to strengthen your spine
So, how can you give your back a break? Dr. Patel offers some ways to strengthen your spine and reduce back pain:
- Exercise regularly. Unlike doing a bicep curl to make our arms stronger, the spine can’t get stronger per se. We can, however, stretch and strengthen the muscles and tissues around the spine. The best thing you can do for good back health is exercise — specifically, strength training, aerobic exercise and flexibility training, Dr. Patel said. “We think those folks tend to have reduced degenerative changes,” he said.
- Avoid sitting for too long. “There’s pretty good evidence in avoiding inactivity,” he said. Studies have shown that sitting for prolonged periods of time can lead to degenerative disc disease, he added. “Don’t sit for too long — get up, walk around, do other things,” he advised.
- Shed excess weight. Extra pounds can also lead to back pain. People who are overweight or obese are prone to back pain and degenerative spine conditions as well. “One of the best things we recommend to folks is weight management,” he said. “By reducing weight, that’s also reducing pressure on those joints and discs and in the long term, hopefully preventing further degeneration.”
- Refrain from tobacco use. Tobacco use can also lead to degenerative spine conditions, Dr. Patel said. People who use tobacco products have an increased risk of microvascular disease.
“We think the wear and tear might be accelerated in those folks who frequently use tobacco products,” he said. “We think that the small blood vessels that supply the spine and discs can become diseased with chronic tobacco use, and without a healthy blood supply, the spine may experience accelerated degenerative changes.” - Focus on mental health. Managing stress and mental health also plays an important role in treating chronic pain; specifically, our own body’s perception of it, he said. “The psychological component is very difficult for us to understand, but we know that for many people that focus on improving their mental health — stress management and pain coping strategies — a lot of those people when they’re in the right mindset, find themselves with reduced pain and improved ability to perform everyday tasks. We highly encourage people to focus on mental health as a preventative measure.”
Naturally, every person’s situation varies and that’s why it’s important to be evaluated by a specialist to see what the best course of treatment and pain management is for you.
If you are looking to be evaluated by Dr. Patel, you can contact the Endeavor Health Spine and Pain Center in Arlington Heights at (847) 618-9565, to schedule an appointment.
