Chronic Back Pain Management

“Chronic back pain is defined as persistent or recurring pain that lasts for weeks or months, often affecting daily function and quality of life. It can result from a variety of underlying conditions involving the spine, nerves, or musculoskeletal system. With proper evaluation and a comprehensive treatment approach, chronic back pain can often be managed effectively without surgery. I can help guide you toward long-term relief and improved function.”

-Dr. Anatoly Pisman, MD

What is Chronic Back Pain?

Chronic back pain refers to pain that persists beyond the normal healing period, typically lasting longer than 12 weeks. Unlike acute pain, which is often caused by injury or strain, chronic pain may be ongoing and influenced by structural, neurological, or systemic conditions. It can affect the lower back, upper back, or both, and may vary in intensity over time.

Common Causes of Chronic Back Pain

Chronic back pain can develop from a wide range of underlying conditions. Inflammatory disorders such as ankylosing spondylitis may affect the spine over time, while widespread pain conditions like fibromyalgia can lead to persistent discomfort and sensitivity.

Structural issues, including osteoporosis-related compression fractures, are another common cause, particularly with aging. Lifestyle factors such as poor posture, repetitive strain, and lack of physical activity can also contribute to long-term pain and reduced mobility.

Symptoms of Chronic Back Pain

Chronic back pain can present in different ways depending on the underlying condition. Some patients experience constant discomfort, while others have periods of flare-ups and relief.

Symptoms may include persistent aching or stiffness, sharp or burning pain, muscle tightness, and reduced flexibility. In some cases, nerve involvement can lead to radiating pain, numbness, or tingling. These symptoms can interfere with daily activities, sleep, and overall quality of life.

When to See a Doctor

Medical evaluation is recommended if back pain lasts longer than a few weeks, worsens over time, or begins to interfere with daily activities. Pain associated with stiffness, fatigue, or systemic symptoms should also be assessed. Early diagnosis helps identify the underlying cause and supports more effective long-term management.

Diagnosis & Testing

Diagnosis begins with a comprehensive review of your symptoms, medical history, and lifestyle factors. A physical examination evaluates mobility, strength, and areas of tenderness. Imaging such as X-rays or MRI may be used to assess structural conditions, while specialized testing like EMG/NCV testing may be recommended if nerve involvement is suspected.

Non-Surgical Treatment Options

Chronic back pain is often best managed with a multidisciplinary approach. Treatment may include physical therapy to improve strength and flexibility, medications to control pain and inflammation, and lifestyle modifications to reduce strain on the spine.

In some cases, targeted treatments such as trigger point injections or epidural steroid injections may be used to relieve pain and improve function. A personalized treatment plan focuses on long-term relief and preventing recurrence.

What to Expect at Your Visit

During your visit, your pain history, lifestyle, and symptoms will be carefully evaluated. A physical examination will assess movement, posture, and any signs of nerve or systemic involvement. Based on your evaluation, a customized treatment plan will be created to help manage pain, improve mobility, and enhance your overall quality of life.