Back pain: an occupational hazard
Dr. Armando Villarreal is a Pain Management Physician at Rehabilitation Medicine Center of New York. He completed his residency at Temple University and his fellowship at Thomas Jefferson University Hospital. His area of interest is neuropathic pain and the use of neuromodulation techniques. Dr. Villarreal is the former... more
Back pain is among the most common causes of disability in the world, with the highest incidence among middle age working people. The US spends about 100 billion dollars on the management of low back pain.
Back pain is caused by a variety of factors, including genetics, occupational (construction work, and other types of manual labor, job dissatisfaction), psychological, as well as lifestyle (i.e. obesity, smoking, etc).
It was thought that the great majority of acute onset back pain will resolved within 3 months, however recent studies have determined that up to 48% of acute back pain will transition into chronic pain. Same factors mentioned as causes of back pain could also contribute to make the condition chronic, specially, the psychological factors (i.e. depression), and the lifestyle (i.e. obesity and smoking)
Current recommendations for the treatment of acute back pain include maintaining activity level as tolerated, spinal manipulation, heat, massage and acupuncture. Only if patients have symptoms of pain radiating to the leg, accompany with numbness and weakness, or signs of infection, or neoplasm, will imaging be necessary.
As mentioned earlier, when symptoms persist despite above recommendations beyond 3 month, the condition is consider chronic, and in that case, subspecialty care may be recommended. A more exhausting workup will need to be performed to identify specifics causes for the back pain, in particular the presence of disc herniations.
Other conditions include spinal stenosis, myofascial pain, or osteoarthritis of the spine. An interventional pain physician has the tools to differentiate all these possible etiologies and recommend treatments that may avoid the need for surgical intervention, or the use of medications with high degree of habituation.
If you are among the thousands of patients suffering with intractable back pain, ask your provider to refer you to a pain specialist.
