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.

What our Patients Say

When business owner and consultant Dawn Pirthauer first came to the Weill Cornell Medicine Center for Comprehensive Spine Care, she thought her back pain would be a fairly straightforward case. Life intervened to make things unexpectedly complicated...
Ser una figura pública tiene sus ventajas y privilegios, y la periodista de investigación ganadora del Emmy Alicia Ortega siempre los había apreciado. Sin embargo, cuando necesitó una cirugía en la columna vertebral, descubrió que la fama...
There are perks and privileges that come with being a public figure, and Emmy award-winning investigative journalist Alicia Ortega had always appreciated them. But as she discovered when she needed spine surgery, fame has its down sides as well.
Alex Hornig, of Ridgefield, Connecticut, is no slouch. He’s a professional firefighter for the nearby Milford Fire Department as well as a flight paramedic for North Country Life Flight in Saranac Lake, New York, and a per diem paramedic with...
Before 2012 Dr. Jeff Linden was leading a glamorous life as one of the premier endodontists in New York City. A leading expert in his field, Jeff cared for his patients, mentored young dentistry residents at top teaching hospitals, and was often...
By Alfred Tosto I know I’m a pretty complicated case – I had a liver transplant in 2008 after being diagnosed with cancer and I take a basketful of drugs every day, immunosuppressants, prednisone, a lot of meds. But I’m a project manager and I treat...
A new 3D navigation system allowed Dr. Härtl to get Kathy back on her feet -- and back to her life -- in record time
Sara Kearns had always loved to travel, and she built her career around it. So when back pain interrupted her ability to travel, she knew she needed help. Dr. Hartl was there to get her back to her travels.
By Stefano Kaslowski Mountain climbing is a hobby I inherited first from my Grandmother Cici and later from my mother — they both grew up in Torino near the Alps. I was born in Italy but live now in Istanbul, in Turkey, and I have been trekking and...

Our Care Team

  • Hansen-MacDonald Professor of Neurological Surgery
  • Director of Spinal Surgery
Phone: 212-746-2152
  • Assistant Professor of Radiology in Neurological Surgery (Manhattan and Queens)
Phone: 212-746-2821 (Manhattan) or 718-303-3739 (Queens)
  • Associate Professor of Neurological Surgery, Spinal Surgery
  • Co-Director, Spinal Deformity and Scoliosis Program
  • Chief of Neurological Surgery, NYP Lower Manhattan
Phone: 212-746-2260
  • Assistant Professor, Neurosurgery 
Phone: (888) 922-2257
  • Assistant Professor of Neurological Surgery, Spine Surgery
Phone: 718-670-1837 (Queens) / 888-922-2257 (Manhattan)
  • Chief of Neurological Surgery, NewYork-Presbyterian Queens
Phone: (718) 670-1837
  • Orthopedic Surgeon
  • Director, Orthopedic Spine Surgery
Phone: 212-746-1164
  • Clinical Associate Professor of Neurosurgery
  • Attending Neurosurgeon
Phone: 888-922-2257
  • Assistant Professor of Neurological Surgery
Phone: 646-962-3388
  • Associate Professor of Clinical Neurological Surgery
Phone: 718-780-5176
  • Assistant Professor of Neurological Surgery
Phone: 866-426-7787 (Manhattan) / 646-967-2020 (Brooklyn)

Reviewed by: Eric Elowitz, MD
Last reviewed/last updated: September 2020

Weill Cornell Medicine Brain & Spine Center 525 East 68 Street, Box 99 New York, NY 10065 Phone: 866-426-7787