Mention back or neck pain, and chances are, someone you know suffers from it. Causes can range from age-related wear and tear, to ruptured or slipped discs from falls or accidents. Arthritis, fibromyalgia, spinal stenosis and degenerative disc disease can also be sources of pain, as can lifting, stretching the wrong way or being sedentary and overweight.
TYPES OF PAIN AND FINDING THE CAUSE
Acute pain comes on suddenly, can last up to six weeks, and may be caused by falls, trauma, sports or improper lifting. Pain is considered chronic when it lasts for more than three months. It can be more difficult to pinpoint because the pain can vary from a dull ache to tingling and burning, and is often not preceded by an abrupt event.
Dennis E. Cramer, DO, Board- Certified Neurosurgeon with the Spine Program at Corona Regional Medical Center, explains normal aging, wear and tear, also referred to as degenerative disc damage, can be a source of both acute and chronic pain. “Sometimes the pain doesn’t appear unless an injury occurs, and we can’t tell if the degenerative damage was there before the trauma. Occasionally, the injury makes it worse,” he says.
Orthopedic Spine Surgeon Richard Lin, DO, starts with X-rays to look for the source of pain. “Shooting pain down the leg often relates to an issue in the lower back. If we find something in the X-ray, we know where to start,” he says. “I also learn how long the patient has had the pain.”
In addition to X-rays, MRIs, CT scans or nerve conduction tests may be required. “Ninety-five percent of the time, only an X-ray and MRI are needed. But if there is nerve pain, a nerve conduction study tells us if the nerve is damaged,” says Dr. Cramer.
WILL I NEED SURGERY?
Depending on the type and cause of pain, we recommend that patients start with conservative and non-invasive treatment, such as anti-inflammatories, chiropractic care, massage or physical therapy.
Neurosurgeon Sean Armin, MD, says surgery is not something that should be rushed. “That decision is made on an individual basis and depends on test results and patient history. It should only be considered if all conservative measures have been exhausted,” he says.
Orthopedic Spine Surgeon Babak Khamsi, MD, agrees and says the majority of people never need surgery. “It is usually recommended for herniated discs, degenerative disc disease, spinal stenosis or weakness.”
“We talk to our patients about all treatment options – is there a clearcut indication for surgery, or are there a lot of variables? We educate them so they can make an informed decision and know what the expectations are,” says Dr. Cramer.
Doctors at the Spine Program each have different specialty backgrounds, states Dr. Cramer. “This provides a broader range of knowledge and experience that can lead to better patient outcomes,” he says.