<>Depending on what the doctor suspects is wrong with you, the doctor may perform an abdominal examination, a pelvic examination, or a rectal examination. These exams look for diseases that can cause pain referred to your back. The lowest nerves in your spinal cord serve the sensory area and muscles of the rectum, and damage to these nerves can result in inability to control urination and defecation. Thus, a rectal examination is essential to make sure that you do not have nerve damage in this area of your body. >
<>Dr. Stieber strongly believes that a personalized treatment approach delivers optimal relief and a superior patient experience. As such, your back pain treatment regimen will be tailored based on the severity, duration and underlying cause of your symptoms. For most of our NYC patients, the solution will involve a blend of approaches, including medication, physical therapy and, in rare cases, surgery. >
<>Can inversion therapy help with back pain? Inversion therapy, where a person is held upside down for several minutes, is an alternative therapy for back pain. They may use gravity boots or an inversion table or chair to reduce the pressure on their spine. Evidence for the effectiveness of this technique is mixed. Learn more about the benefits and risks here. Read now >
<>COX-2 inhibitors, such as celecoxib (Celebrex), are more selective members of NSAIDs. Although increased cost can be a negative factor, the incidence of costly and potentially fatal bleeding in the gastrointestinal tract is clearly less with COX-2 inhibitors than with traditional NSAIDs. Long-term safety (possible increased risk for heart attack or stroke) is currently being evaluated for COX-2 inhibitors and NSAIDs. >
<>Lumbar radiculopathy: Lumbar radiculopathy is nerve irritation that is caused by damage to the discs between the vertebrae. Damage to the disc occurs because of degeneration ("wear and tear") of the outer ring of the disc, traumatic injury, or both. As a result, the central softer portion of the disc can rupture (herniate) through the outer ring of the disc and abut the spinal cord or its nerves as they exit the bony spinal column. This rupture is what causes the commonly recognized "sciatica" pain of a herniated disc that shoots from the low back and buttock down the leg. Sciatica can be preceded by a history of localized low-back aching or it can follow a "popping" sensation and be accompanied by numbness and tingling. The pain commonly increases with movements at the waist and can increase with coughing or sneezing. In more severe instances, sciatica can be accompanied by incontinence of the bladder and/or bowels. The sciatica of lumbar radiculopathy typically affects only one side of the body, such as the left side or right side, and not both. Lumbar radiculopathy is suspected based on the above symptoms. Increased radiating pain when the lower extremity is lifted supports the diagnosis. Nerve testing (EMG/electromyogramspina bifida >
<>Surgery for nonspecific back pain is a last resort as spinal problems are unlikely to be the cause of chronic non-specific back pain in the absence of loss of movement and sensation or other findings such as loss of muscle bulk and reflexes. In cases where the pain spreads into the extremities and imaging studies reveal compression or damage to nerve tissue in the spine, surgery remains a consideration if loss of function as well as pain continues after a trial of conservative treatment with medications and activity modification including a home exercise program and physical therapy. >
<>The diagnosis of low back pain involves a review of the history of the illness and underlying medical conditions as well as a physical examination. It is essential that a complete story of the back pain be reviewed including injury history, aggravating and alleviating conditions, associated symptoms (fever, numbness, tingling, incontinence, etc.), as well as the duration and progression of symptoms. Aside from routine abdomen and extremity evaluations, rectal and pelvic examinations may eventually be required as well. Further tests for diagnosis of low back pain can be required including blood and urine tests, plain film X-ray tests, CAT scanning, MRI scanning, bone scanning, and tests of the nerves such as electromyograms (EMG) and nerve conduction velocities (NCV). >
<>To ensure a thorough examination, you will be asked to put on a gown. The doctor will watch for signs of nerve damage while you walk on your heels, toes, and soles of the feet. Reflexes are usually tested using a reflex hammer. This is done at the knee and behind the ankle. As you lie flat on your back, one leg at a time is elevated, both with and without the assistance of the doctor. This is done to test the nerves, muscle strength, and assess the presence of tension on the sciatic nerve. Sensation is usually tested using a pin, paper clip, broken tongue depressor, or other sharp object to assess any loss of sensation in your legs. >
<>It may be tempting to quit exercising when you're suffering from back pain, but it's essential to keep yourself moving. Pilates is one great option. In a 2014 European Journal of Physical Rehabilitation Medicine study, researchers found an improvement in pain, disability, and psychological health in chronic low-back pain patients who took five hourlong Pilates classes a week for six months. Meanwhile, people who remained inactive experienced further worsening of their pain. Similarly, a Medicine and Science in Sport and Exercise study revealed that taking either Pilates or a general exercise class twice a week for six weeks both improved pain and quality of life. >
<>A doctor may recommend a spinal injection to help reduce your back pain. There are different types of injections that doctors specializing in pain relief may use. For example, an injection of a corticosteroid can help relieve inflammation that is causing the pain. Depending on the kind of injection, your doctor may limit your number of doses per year to avoid possible side effects. >
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