What’s Causing My Back Pain, and How Can I Treat It?

Stiff or aching back? Sharp or piercing pain in your spine? A tingling sensation that shoots down your arms or legs? Back and neck pain comes in a variety of flavors, but all of them can be disruptive to your daily life. If you have chronic back or neck pain, it might feel like you’re living your life in slow motion, just trying to wade through the pain or holding your breath waiting for it to come back.

The good news is that there are many different back pain treatments that can help you get back to your normal routine with less pain and greater function. Life is for living, and you don’t have to let debilitating spine pain prevent you from doing the things you love. There are a wide range treatment options, from medications and injections to innovative therapies and surgery.  Ultimately, the best treatment for you is one tailored to the origin and type of pain you have, as well as your goals.
​

Understanding your spine anatomy.

The spine is a complex part of the body, made of 33 small bones stacked on top of one another.  These bones, or vertebrae, can be divided into five segments:
​

• The cervical spine is made up of 7 small, stacked bones (vertebrae) at the neck
• The thoracic spine is located in the middle of the back, comprised of 12 vertebrae
• The lumbar spine typically includes 5 stacked vertebrae, making up your lower back
• The sacrum is below the lumbar spine, consisting of 5 fused vertebrae connected to your hips
• The coccyx (tailbone) is made of 3 to 5 fused vertebrae found at the bottom of the spine

In addition, connective tissue, discs, nerves, and ligaments surround the vertebrae to help you move around safely. When any one of these parts become damaged or worn out, you could experience pain. Understanding the anatomy of your spine can help you to better recognize exactly where you’re feeling pain and what potentially could be causing the discomfort. 
​

Common causes of chronic back or neck pain.

More than eight out of ten Americans will experience back pain at some point in their life, so when does it become a problem? Chronic back pain is generally defined as discomfort that remains or worsens for more than six weeks. Lower back pain is perhaps the most common type of pain, but back pain can be felt anywhere in the spine or neck. 

There are several underlying causes of back or neck pain:

• Aging: The body generally experiences wear and tear in the spine and other bony structures, making spine arthritis especially common
• Posture: Poor positioning of the spine while sitting or moving about can add stress or strain to your back over time.
• Trauma or injury: An accident or unexpected fall can trigger chronic back pain.
• Other chronic back conditions: Herniated discs, pinched nerves, spinal stenosis, and other conditions can develop and cause pain.

Not all back pain requires treatment, as sometimes it will go away on its own within a few weeks. However, when pain prevents you from participating in your favorite hobbies or disrupts your daily life, it’s time to seek care from a spine expert. 
​

A menu of treatment options.

There are a variety of different specialists who can evaluate your back pain. Orthopedists, spine surgeons, and physiatrists are just a few specialized physicians who are trained to diagnose and treat back pain with different, but effective approaches. At MedStar Health, our colleagues in different specialties collaborate to determine the best options for our patients, working closely to ensure seamless coordination between clinics when a referral to a different specialist might be helpful.

The first step in evaluating your back pain is to understand where you are feeling pain and what the pain feels like. By localizing where the pain is coming from, we can often determine what part of your spine’s structure is affected and address that pain. Sometimes advanced imaging can help us to definitively identify what’s causing the pain so we can address any underlying causes. In other instances, we can target treatment where the pain is happening without imaging evidence.

Conservative treatment options for back pain.

Once we’ve diagnosed the cause of your pain, we can consider a wide range of treatment options. Typically, we aim to try the least invasive, most conservative treatment options that we think will be the most effective for your unique situation. For some, this could be as simple as taking ibuprofen or tylenol before certain activities. For others, your doctor may recommend one or more of the following interventions:
​

• Physical therapy (Including manual therapy, dry needling, or other techniques)
• Medications (e.g., anti-inflammatory medications)
• Injections (e.g., epidural steroid injections and nerve blocks) 
• Neuromodulation (Nerve stimulation that lessen or prevents pain signals from traveling to the brain)

Ultimately, the treatment your spine specialist recommends will vary based on your particular condition, what other treatments you’ve tried, and other factors. 
​

When to consider spine surgery.

When you decide you’ve had enough of the pain, it might be time to explore surgery. If you’ve exhausted all conservative options and your quality of life has become so disrupted that you can’t think about anything else but your pain, back surgery might be the most effective treatment option for providing pain relief and improved function. 

While spine surgery may seem intimidating at first, your care team is focused on making sure you understand your options and what to expect at each step of the process. As one of few hospitals in the country with a spine robotic surgical system, we’re experienced in performing spine surgery with exceptional precision and efficiency. There are many different spine procedures, but typically surgery can be categorized as one of the following:

• Decompression: We remove any arthritis or compression on nerve roots  
• Fusion: We attempt to fuse segments of bones so there’s no instability in the spine

Recovery will look different depending on the type of procedure you have. Some patients are eligible for same-day discharge, while others can expect to be discharged within two to three days of surgery. 
​

Targeted and tailored treatment.

If back pain is interfering with your life, you’re not alone. But you don’t have to accept it as part of your new normal. There are a wide range of back pain treatment options that can help to provide relief so you can get back to the things you enjoy. And, what works for someone else might not necessarily be the best option for you. At MedStar Health, our spine experts will evaluate the underlying cause of your pain so we can develop an effective treatment plan tailored to you using the most conservative approaches, whenever possible. 

Don’t let back pain keep you from missing out on picking up your kids or grandkids or playing pickleball with your friends. Our spine experts can help you find relief and get moving again.