Dr. Vikas Garg practices Pain Medicine in Logan and Murray, Utah. Pain medicine is concerned with the prevention of pain, and the evaluation, treatment, and rehabilitation of patients experiencing pain. Pain medicine physicians use a broad-based approach to treat all pain disorders, ranging from pain as a symptom of disease... more
Some pain is manageable, lasting for only a short period of time, but when lingering, it can cause significant impact physically and emotionally. It can affect different organ systems, and cause issues such as increasing heart rate, decreased lung volumes, nausea, vomiting, muscle spasm, sleep deprivation, hindered healing, fatigue, depression, and anxiety. Treating pain can improve quality of life.
A number of things can be done to prevent back pain, including regular exercise, using proper body ergonomics and posture, and lifting heavy objects properly. Usually, back pain problems tend to resolve themselves. Talk to your doctor or a pain doctor if pain does not improve, pain begins radiating down the legs, or if you notice weakness of legs or any bladder or bowel incontinence.
There can be different generators of pain in the lower back area. It can be a disc, which is a soft cushion type of material in between the vertebra, joints in between the vertebra called facet joints, or z joints (zygopophysial joints). Different structures can cause pain in different areas and may also be caused by trauma, auto accidents, falls, or normal wear and tear, which is called degeneration.
Making a correct diagnosis is a key component in treating lower back pain. Diagnosis is made with a detailed history, physical examination, and imaging like MRI or diagnostic injections; however, an MRI is not always needed.
A number of studies have shown that a herniated disc does not always tell whether it causing the pain or not. Pain can sometimes be coming from a different area, so the first step is to make a firm diagnosis in order to ensure targeted treatment.
A multi-disciplinary approach is needed to reduce pain and improve quality of life. This may include combination of physical therapy, psycho-therapy, non-surgical Interventional techniques, and medications. Interventional injections include epidural injections, nerve blocks, facet joint injections, and radiofrequency ablation or rhizotomy, where a nerve can be killed to help with pain. Newer techniques like spinal cord stimulators can be tried if other techniques have failed to relieve pain. Fluoroscope is also used to do all interventional procedures. Some people believe that injection therapy is a “pain cover up.” This is simply not true. Research has shown that injection therapy can improve pain and quality of life.