Back pain has multiple possible causes. Evaluation by a skilled pain management provider is key to finding the source of your pain. Once the source is identified or narrowed down, we may recommend one or more of the treatments described on this page.

What Causes Back Pain?
Many different things can cause back pain. What it is important to note, is that back pain is usually the symptom of a greater problem. Back pain can be grouped into categories which include:

• Mechanical – this involves a mechanical issue with the way the spine moves. This can include issues which affect the discs and cause them to deteriorate. The large joints which connect the joints to each other can also be affected.
• Injuries – fractures and sprains to the bones and muscles in the back can cause a great deal of pain. This can occur from trauma such as a fall or impact.
• Conditions and diseases – Scoliosis, different types of arthritis, spinal stenosis, osteoporosis, and ankylosing spondylitis are all diseases which can cause back pain and affect the muscles in the back or the spine. Conditions such as pregnancy and fibromyalgia can also cause back pain.
• Infections and tumors – these are not as common, but they do occur. Osteomyelitis is an infection which involves the vertebrae. Tumors can also put pressure on the spine and cause pain.

Emotional and stress related pain is also common in the back and neck areas.

What Happens During an Initial Visit to a Pain Specialist?
Since many different types of conditions can affect a person’s back and cause pain, the doctor will perform an evaluation of your physical health to help determine the cause. The doctor will collect your medical and family history to identify any possible conditions or patterns. The doctor will also ask questions, such as “when did the pain begin.” This can help determine the most likely cause of the pain. The doctor may also ask about any recent symptoms or illnesses you have dealt with. There will also be a physical examination. The doctor may also want to order images of your spine. X-rays and are the usual starting place, though some presentations may warrant an MRI. If the pain is chronic and severe, the doctor may also order nerve testing, called an EMG/electromyogram and/or NCV/nerve conduction velocity. These help determine if there is nerve damage present.

What Can the Doctor Do to Help?
 Pain management is critical for ongoing pain control, especially when patients are dealing with long-term or chronic pain. After the evaluation, the doctor will help you determine what the best treatment plan entails. The doctor can prescribe pain medications, physical therapy, and self-care techniques.