Back pain is extremely common. More than 90% of people will suffer from back problems at some point. For most patients, after a little rest and massage, the pain goes away and they are able to resume their normal lives.
However, sometimes the pain just won’t go away. If that’s the case for you, you might be referred for a surgical consultation.
As part of a spine consultation, a variety of tests are often done. This might include an MRI, myelogram, CT, X-rays, or nerve conduction studies, among others.
Sometimes, no specific lesion can be found as a source of the pain. Current examination techniques and investigations aren’t able to find every problem. This is not really surprising. The spine is extremely complex. It is made up of many bones, joints, ligaments, discs, tendons, and muscles – any of which can cause pain if inflamed or injured.
In other patients, abnormalities may be found, but they are not sufficiently severe or they are not amenable to treatment. And in still others, a lesion was found, but surgery was unsuccessful or didn’t resolve the pain.
Unfortunately, many of these problems cause similar types of pain, so it is not possible to determine the source of the problem based upon the pain itself. Unless the specific source of your pain can be identified, surgery is not likely to improve your pain. It would be like randomly replacing a part on a car and hoping that it will start running again.
This is a long way of saying that surgery is not a good option for some patients. For these patients, non-surgical treatments are the best options.
So if surgery doesn’t work, what options do you have? A recent study group analyzed the available evidence and published a set of guidelines. These new guidelines can be seen here. The results are similar to a recent review from Europe. But, if you don’t want to read the whole articles, here’s a summary:
Heat, exercise, massage, therapy, acupuncture, and stress reduction seem to be the most effective treatments. Anti-inflammatory medications (ibuprofen, naproxen, diclofenac, etc.) are also helpful.
Finally, a little word about spinal cord stimulation (SCS) is worthwhile here. A spinal cord stimulator (SCS) is a newer device which is placed over the nerves in the spine. It “stimulates” the nerves to block pain. It can be effective for back pain, particularly in patients who have failed prior back surgery. For more information, look here.