Back pain is one of the most common conditions affecting adults. There are many causes of back pain including muscle strain, herniated disc, lumbar spinal stenosis, and osteoarthritis. Evaluation of back pain is based on the patient's symptoms, history of injury, physical examination and any diagnostic studies.
Any patient with neurological symptoms such as numbness, weakness, or bowel or bladder dysfunction, should seek medical care immediately. Otherwise, pain medications such as ibuprofen or naproxen are good first line home treatments. Back pain lasting more than 2-3 days should be evaluated by a physician.
Some patients undergo conservative treatment for back pain such as physical therapy, weight reduction, steroid injections or medications. Doctors may choose to have patients undergo further evaluation with other diagnostic tests such as: CT scan, discography, electromyography, MRI, myelogram, or x-rays. Surgery is reserved for those individuals who experience debilitating back and leg pain, worsening neurological deficits, bowel or bladder dysfunction, difficulty standing or walking, or who fail to benefit from medications or physical therapy. Neurosurgeons decide the best surgical approach based on each patient's individual condition. For some, this means spinal fusion, meaning fusing the vertebrae together and stabilizing the spinal column with screws and rods. The goal of this procedure is to prevent the disc from herniating again. As with most surgeries, patients may require physical therapy during the recovery period to regain their mobility.