Internal Medicine Doctors of
Mill Basin & Bergen Beach, Brooklyn

How I Can Help Treat Your Back Pain (Lumbar Pain, Sore Back)

Posted by admin on August 7th, 2013

“If you are experiencing back pain, you are in good company. Back pain is one of the most common reasons that people visit their doctor. Back pain may be acute or chronic and is treated in a variety of ways, depending on the cause of the back pain. Back pain can affect your ability to work and your ability to enjoy life, particularly if it becomes chronic. If you injure your back or suffer from chronic back pain, come in and see me so that we can assess the problem and determine how best to treat your pain”.

-Dr. Anatoly Pisman, MD

What is back pain?

Back pain can affect virtually any area of the back, including the neck, the upper back, the mid-back, the lower back or the tailbone area (the sacrum). It is caused by a problem with the bones or joints of the spine, the nerves that lead  away from the spine to the rest of the body, or the muscles and ligaments that support the spine.

Back pain may be dull, burning or sharp and may radiate to other areas, including the the hands, the arms, the buttocks, the groin, the legs and the feet. In addition to pain, you may experience numbness or tingling. You may also experience weakness of the extremities.

What causes back pain?

In most cases, no specific cause can be found for back pain. Back pain may be caused by muscle strain. Other potential causes of back pain include:

• disc herniation– a tiny tear in the outer covering of the intervertebral disc which allows the jelly-like cushion to bulge out
• degenerative disc disease– degeneration (wearing down) of one (or more than one) of the intervertebral discs of the spine
• osteoarthritis– wearing down of the discs of the spine caused by wear and tear associated with the aging process
• spinal stenosis– narrowing of the spinal cord causing compression
• trauma– accident or acute injury affecting the back
• inflammatory disease-such as rheumatoid arthritis or ankylosing spondylitis
• infection
• fracture– osteoporosis, in which the bones become brittle and weak and are prone to fracture, may cause compression fractures of the spine
• cancer (rarely)

How do I know whether to seek care for my back pain?

Most back pain will subside with time and rest. You may still need to see me to rule out a serious cause of your back pain, especially if the pain is severe or does not get better after a few days. There are some absolute red flags that should prompt you to make an appointment to see me urgently. These include:

• bowel/bladder problems (inability to urinate, loss of bladder or bowel control)
• numbness, pins and needles in the genitals, buttocks, inner thigh (what we refer to as the “saddle area”)
• sexual dysfunction (such as sudden impotence with back pain)
• back pain associated with fever, weight loss or night sweats
• history of previous cancer
• progressively or rapidly worsening weakness, pins and needles, or numbness

What can I expect when I come in to see you?

If you come to see me complaining about back pain, I will need to know if you know what caused your pain (for example, back pain occurred at work while you were lifting a heavy object). I will also need to know how long you have had the pain, what remedies you have tried (and if they have worked) and what makes your pain worse.

If you are a new patient, I will need to know about your past medical history, whether you have had any surgeries and whether you are allergic to any medications. I may also ask you about your family history. I will want to know if you have ever had back pain before and what transpired over the course of your previous back pain. Did it get better on its own? Did you require treatment and, if so, what treatment did you receive?

I will then need to examine you. I may ask you to change into a gown, as it will be easier for me to see your back and watch how you move. I will likely ask you to perform different movements and bend in certain ways so that I can try to determine precisely where your pain is located. If necessary, I may order diagnostic testing, but generally this is not necessary if I suspect you have strained your back. Based on my examination and your history, I may suggest:

• antiinflammatory medications to reduce pain and swelling
• ice or heat to relieve pain and reduce inflammation (ice is best for the first 48 hours; after that, a heating pad or hot pack can be used)
• gentle stretching exercises
• physiotherapy
• massage therapy
• avoidance of certain activities for a period of time

If you need a note for work, I can provide you with one. If I feel that your back problem is something that I cannot manage, I will refer you to other specialists; however, I am a physical medicine and rehabilitation physician and can therefore manage most common back pain issues.

If you are suffering with back pain for longer than 3 to 4 days that is not relieved with home remedies, make an appointment to see me in the clinic so that I can rule out any serious causes of your back pain.

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