How do we diagnose back pain?

Close to one-half of all working Americans admit to having back pain symptoms each year, which accounts for more than 250 million lost work days per year. Experts estimate that up to 80% of the population will experience back pain at some points in their lives. X-ray and CT scan are very proficient at diagnosing fractures and degenerative disc disease, while MRI is the gold standard for imaging the spine as it provides valuable information about not only the bones, but the soft tissues as well.

What are some of the main causes of back pain?

The most common cause or lower back pain is degenerative disc disease, or age-related degeneration of the intervertebral discs, and spinal stenosis (narrowing of the spinal canal). Disc herniations and compression fractures following trauma are also common. Other pathology includes nerve impingement (sciatica), stress fractures, arthritis of the facet joints, ligament tears, muscle tears, and muscle spasm.

What can someone do to be preventative?
There are many proactive steps one can take to avoid recurrent symptoms. Stretching before and after strenuous physical activity and making back stretches or yoga a part of your daily routine is one way to prevent problems. Likewise, having an active life-style and keeping off excess body weight is also very important. Certain foods and dietary supplements such as turmeric may have anti-inflammatory properties. Other things to keep in mind include developing a strong core, using appropriate footwear, following a non-inflammatory diet, and getting adequate sleep which includes finding a mattress and pillow that suit your biomechanics and allow for restful, comfortable sleep.

How often is surgery needed & what are some other options?
I always tell patients that back surgery should be a last resort after all other treatment options have failed. There are many cases of “failed back surgery” or persistent pain despite surgery and invasive interventions can lead to complications and future problems. Sometimes however, it is unavoidable. There are many other treatments you should try first including anti-inflammatory medications, physical therapy, chiropractic adjustments, epidural injections, kyphoplasty for compression fractures, facet rhizotomy, and nerve ablations.

Brett Helfner, M.D. is a Musculoskeletal & Body Imaging Radiologist here at Zwanger-Pesiri Radiology.

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