Stop the Pain! Where is Your Back Pain Coming From?

Is it related to a work injury? Car accident? Other underlying medical condition?

By Dr. Ahmed Elborno

Back pain is not a diagnosis, it’s a symptom. Back pain affects 80% of Americans at some time in their lives. It is the number one cause of disability related to work accidents. It comes in many forms- from lower back to upper back pain to neck pain to sciatica.

The pain may be caused by a variety of medical conditions. Common back pain causes include nerve problems, disc problems, and muscular problems that are commonly related to back injuries. It could be an alerting symptom to other underlying medical conditions that may be serious.

Injuries are the most common cause of back pain, frequently occurring when the back is used in strenuous activities, aprticularly work related activities. Work related accidents that may cause back injury or pain include heavy lifting, tripping, falling, or excessive twisting of the spine, falls from significant heights, direct blows to the back or the top of the head, a high-energy fall onto the buttocks.

Occupations that are physically demanding and require repetitive lifting are at greatest risk for both non-accidental and accidental back injury. Severe back injuries may also result from car accidents .

Back injuries might cause physical limitations depending on the area of the back and the severity of the injury. Physical limitations may include and are not limited to standing, sitting, reaching, lifting, carrying, pushing, pulling, climbing, bending, stooping, crawling, kneeling, driving, and walking.

Back injuries may lead to acute and chronic pain which can seriously impact the quality of life, one’s ability to perform their daily living activities, and possibly leading to disability and wage loss.

Any employee who sustains an injury in the performance of duty can typically receive compensation, both medical and monetary, through Workers’ Compensation. It is important to follow the company’s reporting procedures to insure injured employees receive their benefits. Under the law, injured employees are entitled to immediate medical care at no cost to themselves, and they have the right to choose their own physicians.

Detailed history and comprehensive neurological evaluation is always the first step in the management of back pain. This may be combined with additional testing if indicated. It is very important to address and rule out other underlying medical conditions that may contribute in part or in total to the back pain. If there is an underlying medical condition causing the back pain, it should be treated appropriately.

After reaching the right diagnosis, there are many modalities of Pain management, which should always start with conservative management. If there is persistent leg or arm weakness, numbness or disturbance of bowl or bladder control that is related to pinched nerves, back surgery may be warranted. In most cases of back pain, however, back surgery may not be indicated. While surgery usually reduces the pain, sometimes the pain may become worse after surgery.

Every year, more than 15 million Americans go under the knife - and this may not always be necessary. As a matter of fact, it has been estimated that 2.4 million unnecessary surgeries are performed every year in the United States, with huge costs and subsequent morbidity and mortality (about 11,900 deaths).

So how do you know whether you need surgery? What can you do to avoid unnecessary surgeries? A reasonable first is to communicate with your physician. Ask questions and discuss all treatment options and alternatives. You should do your own search in addition to seeking a second opinion from other specialists who specialize in non-surgical Pain Management. Before surgeyr, ask questions and discuss all treatment options again. One study showed that when patients and doctors share the decision making, rates of surgery drop by as much as 44%.

If you sustained back or neck injury, there is no reason to suffer disabling pain that compromises the quality of your life. There are many FDA approved, non-surgical, minimally invasive procedures that could manage your back pain, pinched nerve pain and/or sciatica. Often patients can leave the hospital or surgical center the same day and can resume their normal activities i the next day.

Ahmed Elborno, M.D., is the Medical Director of the of Pain Management Center of Excellence at Hinsdale Hospital and was formerly the Medical Director of Rush Oak Park Hospital Anesthesiology Department and Pain Management. He is an Associate Professor of Anesthes and Pain Management at Rush-Presbyterian-St. Luke’s Medical Center teaching new practitioners.. Dr. Elborno offers many less-invasive procedures for amnagment of neck and back pain due to disc herniation. He is a Board Certified Pain Management Specialist.