Medically Reviewed by Michael Warden, MD

According to the National Library of Medicine, back pain is one of the most common causes for which patients seek emergency care. Approximately 28% of US adults report having chronic lower back/sciatic pain. The symptoms tend to be persistent, causing some individuals significant disability. In this Q & A, Dr. Michael Warden of Florence Neurosurgery and Spine at McLeod Health provides insights on the most common causes and treatments for back pain.

Q. Back pain seems to afflict many Americans. What are some of the common causes of lower back pain?

Back pain affects both patients and their families. Some common causes of back pain include muscle strain, fractures of bones in the back, or a bulging disc that’s pushing on a nerve. Everyone’s heard about pinched nerves. It can cause pain in the back. It can also cause that pain to radiate down the legs.

Q. Are there things we can do at home to relieve back discomfort before it’s necessary to visit a doctor?

At home, people suffering from back pain can try adjusting their activities, taking it easy for a couple of weeks, and seeing if their back pain improves on its own. Many times back pain can be a self-limiting occurrence, where it can kind of get better on its own when the patient makes a concerted effort to take it easy. Trying some of the OTC (over the counter) medications like Tylenol and Ibuprofen can help, as well as applying ice and heat. Also, nowadays, you can Google lots of easy-to-do-at-home back exercises and stretches that may give patients relief before they see their primary care doctor or a pain specialist.

Q. When does a patient make the determination that their pain is persistent and it’s not going away – that they need to see a doctor?

I would say when the back pain has been around for about a month, it’s probably time to see a primary care provider. They may recommend trying some of those OTC medications and specific exercises or physical therapy. By the time patients see us, they’ve been dealing with back pain for about three months or so, and it’s transitioned from an injury that may get better on its own into a chronic, nagging pain that’s holding them back from doing the things they enjoy, like spending time with family, playing with grandkids, all those kind of things.

Q. At what point in the assessment would a patient be referred to a pain management specialist for lower back pain?

At Florence Neurosurgery, we can see patients at any time along the continuum of care. Many times that’s after they’ve already seen their primary care provider, who has already tried a variety of conservative measures. Our practice has physical therapy on site, and we can make recommendations on a treatment plan. We offer many different procedures that can help patients return to doing the things they enjoy in their life.

Q. What are some of the treatment options?

We have lots of treatment options for back pain. Many people have heard of epidural steroid injections. We also have other injections to target arthritis. Based on the patient and the specifics of their case, we offer a procedure that uses radiofrequency ablation, where we destroy the nerves that go to the joints in the back that have arthritis and cause severe pain. It can give people long-lasting relief from six to nine months (and sometimes to a year), and it’s a very simple in-office procedure. No hospital stay, no cutting, no surgery. Also, we have other advanced procedures like spinal cord stimulation, where we can interrupt the transmission of those painful signals from the back and from the legs through a simple outpatient procedure.

To learn more, speak with a pain management specialist near you.