Back Pain Defined

As much as 20% of Americans report that they experience back pain every year. Males and females experience back pain equally, and it can occur at any age, with the majority of initial episodes taking place between ages 20-40.

Causes / Predisposing Factors

Generally back pain has mechanical causes and most of which are relatively benign, although a small number of cases are due to more serious illness. Common causes of back pain include degeneration (osteoarthritis), muscle strain, mechanical problems (such as herniated disc), and vertebral fractures associated with osteoporosis. Rare, more serious causes include cancer, infection, vascular problems and damage to nervous tissues. Tobacco, alcohol and drugs, poor diet, and lack of regular physical activity have been implicated as risk factors for back pain.

Modifying these risk factors, avoiding certain repetitive motions such as bending and twisting or heavy lifting, and treating obesity and depression can help prevent back pain before it becomes debilitating.


Back pain is usually reported in the lower back but can occur in the upper back as well. The pain may be aggravated with movement, or may radiate into the upper or lower extremities. Patients may also experience limited range of motion and/or tenderness upon touch.



Diagnosis leading to effective back pain treatment is done by a doctor through a comprehensive history and physical examination.

Additionally, a full neurological review is often performed to accurately diagnose the back pain. Any extra imaging is usually reserved for symptoms that persist beyond several weeks despite conservative treatment, or if a physician suspects serious pathology.

Depending on your particular back pain, the doctor may order an imaging procedure. An x-ray will be conducted if a bone infection or tumor is suspected. A magnetic resonance imaging (MRI) or computed tomography (CT) scan is conducted if disc herniation is suspected.


The goals of back pain treatments are to relieve symptoms and improve function. Back pain treatments range from conservative management to surgery, depending on the cause and severity of the pain. Back pain typically resolves on its own within weeks with conservative treatment. More conservative back pain treatments include:

  • Physical therapy and exercise helps strengthen the back to avoid future injury and speed the recovery process
  • Lifestyle adjustments to avoid aggravating movements and reduce body weight
    Alternative therapies such as massage, yoga, and acupuncture may provide benefit to some patients
  • Interventional pain medicine, such as epidural steroid injections and spinal cord stimulation therapy
  • Pain-relieving medications may also be prescribed for back pain. These can include over-the-counter pain medicines such as acetaminophen (Tylenol™), ibuprofen (Advil™), muscle relaxants, or prescription pain medicine

Certain red flags indicate a more serious condition that may require emergency evaluation or surgery, including weakness, numbness or tingling, fever, weight loss or problems with bowel and/or bladder control.

When conservative measures suggested by your doctor for back pain are ineffective, local anesthetics, steroids or pain medicine can often be injected at the site of pain to block the pain signals from reaching the brain. Back pain due to disc herniation may require surgical intervention via spinal fusion or discectomy.

Dr. Skaribas prescribes pain medicine only when medically necessary and after certain conditions are met as part of a comprehensive treatment plan that reduces risks and maximizes benefits. We follow strict DEA recommendations and we prescribe these substances only if the patient has failed other therapeutic options, after they meet specific inclusion criteria and only if it is absolutely medically necessary.

If you suffer from back pain, it’s important to get help early. The pain can become more debilitating the longer it goes untreated, and can affect every aspect of your life, from daily productivity to emotional well being. Dr. Skaribas of the Greater Houston Pain Consultants wants to help you get well with expertise and nonjudgemental care. Call and book an appointment with Dr. Skaribas as your first step toward a better quality of life without pain.

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