Back Pain

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Diagnosing and Treating Back Pain

To determine the cause of your back pain, your doctor will gather history and symptoms and conduct a thorough physical examination. He or she may also order the following diagnostic tests:

  • X-rays can show which areas of the back are involved, and how.
  • Computerized tomography (CT) is a noninvasive procedure that uses X-rays to produce a three-dimensional image of the spine. A CT shows more details than an X-ray and can show the nerves, spinal cord, and any possible damage to them.
  • Magnetic resonance imaging (MRI) uses magnetic fields and radio-frequency waves to create an image of the spine that reveals the discs, nerves, spinal canal, and other details that can’t normally be seen on an X-ray. Sometimes a contrast agent is injected into a vein in the hand or arm during the test, which highlights certain tissues and structures to make details even clearer.
  • Myelogram uses a dye that is injected directly into the spinal column and is used in conjunction with an X-ray or CT scan.
  • Electromyogram and nerve conduction studies (EMG/NCS) measures the electrical activity in the nerves and muscles. It may identify nerve damage or nerve compression.
  • Blood tests: Blood may be tested for the HLA-B27 gene, which is carried by more than 95 percent of those with ankylosing spondylitis, a form of arthritis in which chronic inflammation causes stiffness and pain in the spine.

 

Treatment Options
Treatment for back pain will vary depending on its cause and the severity of pain. Treatment options should be conservative at first, starting with home remedies and medical therapies, before surgery is considered. The Weill Cornell Medicine Center for Comprehensive Spine Care offers a full range of nonsurgical treatment options before surgery is considered, including:

Home Remedies: Back pain that’s due to muscle or ligament strain will often get better on its own with time, self-care, and home remedies such as:

  • Hot or cold compresses
  • Reduced activity
  • Over-the-counter pain medication such as ibuprofen and acetaminophen

 

Medical Therapy: In cases where there is structural damage to the spine, the following medical therapies can help:

  • Prescription medications for pain, including non-steroidal anti-inflammatory medications (NSAIDs) and opioids
  • Bracing to stabilize the spine and reduce pain
  • Physical therapy to strengthen the core muscles surrounding the spine and encourage newer pain-free ways of moving.
  • Steroids
  • Muscle relaxants
  • Injections of anti-inflammatory medication
  • Alternative treatment like acupuncture and massage

 

Surgical Treatment: If back pain persists, then surgery may be required. The goal of surgery is to relieve pain, stabilize the spine, and increase a person’s ability to move. The neurosurgeons of the Weill Cornell Medicine Center for Comprehensive Spine Care may recommend surgery if:

  • conservative treatments prove ineffective
  • the pain is so severe that it is debilitating
  • It is difficult to stand or walk

Because the causes of back pain are sometimes hard to identify, it is important to be seen by a specialist in order to be properly diagnosed and treated. At the Weill Cornell Medicine Center for Comprehensive Spine Care, our specialists have advanced training in diagnosing and treating conditions of the spine. They believe in an interdisciplinary approach to treating back pain, including physiatry, pain management, physical therapy and – only when necessary – minimally invasive surgery.

Learn more about surgery for back pain.

Reviewed by: Eric Elowitz, MD
Last reviewed/last updated: October 2016