What to expect in the initial phases of back pain management

The first step toward successful back pain management is properly diagnosing its source. There are many conditions that can cause similar symptoms, and knowing what you are dealing with can help you — and your physician — determine the best approach to treatment.

Tests used for diagnosing neck and back pain

The diagnostic process can involve several different tests and exams. You can expect your physician to ask about your symptoms and overall health, then perform several simple nerve and muscle evaluations in his or her office.

From there, your physician will likely order one or more imaging scans. These may include:

• X-rays. These imaging scans can show the composition of the spinal bones in detail. They are primarily used to check for instability caused by fractures, spondylolisthesis and other similar conditions.
• CT (computed tomography) scans. These images are slightly more detailed than X-rays in that they provide cross-sectional views of the spine. They can be particularly helpful for diagnosing herniated discs, spinal stenosis and other similar conditions.
• MRI (magnetic resonance imaging) scans. These imaging scans can provide detailed images of the spinal discs and nerve roots. Most commonly, they are used when a physician is looking for a specific condition, such as degenerative disc disease, or attempting to rule out the presence of a tumor or spinal infection.
• Bone scans. These scans use small radioactive materials to highlight areas with high bone turnover, which may indicate the presence of a tumor, infection or small fracture. However, because these scans cannot differentiate among these conditions, a CT scan or MRI is typically required as a follow-up.

Diagnostic injections can also be used in the initial stages of back pain management. For instance, a physician might administer a selective nerve root block to determine if a specific spinal nerve is the source of your pain, or a facet or medial block to determine if a specific joint is the site of your discomfort.

Medications, injections and other types of treatment

Once an official diagnosis is made, you can begin working through your treatment options. Your physician may recommend prescription or over-the-counter medications to alleviate inflammation or block pain signals from traveling throughout your body. Physical therapy and various at-home exercises are other conservative options for back pain management. Epidural steroid injections, selective nerve root blocks (SNRB), facet joint injections and trigger point injections can also be useful, with the first three injections focused on alleviating nerve pain and the latter primarily used for muscle pain.

Usually, a combination of two or more of these treatments proves to be most effective. Working with a trusted orthopedic spine specialist is crucial, as this type of medical professional can help you evaluate all appropriate therapies and find a back pain management plan that adequately meets your needs.

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