Back Pain SmartSite ^TM

Questions to ask your doctor about back pain

About back pain

What is the likely cause of my back pain?

When is an x-ray or MRI scan needed? Do I need other tests?

What should I expect to happen with my type of back pain? Will it go away? If so, how soon? Will I have chronic (long-term) low back pain?

Taking care of your back at home and work

What over-the-counter pain medicines can I take?

What else can I do to relieve the pain while sleeping, sitting, driving, or working at a desk? Is it better to stay active while I am resting?

What can I do to prevent injuries doing sports?

What types of activities are more likely to cause back pain? Is it okay to continue doing the sports that I am doing?
How much sports activity is too much?
What sports activities may be easier on my back?
Can certain exercises help prevent sports injuries?

What type of changes do I need to make at work?

Are there limits to how much I should lift? What is the best way to lift heavier objects?
How can I have my desk, chair, or computer set up differently?
Are there stretches or exercises I can do during the day?

What should I do about feeling stressed or sad?

Treatments for back pain

What type of doctors or other health care providers should I see about my back pain?

How can my primary care provider help?
Should I see a physical therapist?
What is a sports medicine doctor? A physical medicine and rehabilitation doctor?
When do I need to see a spine surgeon?

What other medicines are available to help relieve my back pain?

What other treatments besides surgery can I try:

Injections?
Exercise?
Acupuncture?
Massage therapy?

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Review Date: 4/3/2018

Reviewed By: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

View References:

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Cohen SP, Hanling S, Bicket MC, et al. Epidural steroid injections compared with gabapentin for lumbosacral radicular pain: multicenter randomized double blind comparative efficacy study. BMJ. 2015;350:h1748. PMID: 25883095 www.ncbi.nlm.nih.gov/pubmed/25883095.

Chou R, Hashimoto R, Friedly J, et al. Epidural corticosteroid injections for radiculopathy and spinal stenosis: a systematic review and meta-analysis. Ann Intern Med. 2015;163(5):373-381. PMID: 26302454 www.ncbi.nlm.nih.gov/pubmed/26302454.

Chou R. In the clinic. Low back pain. Ann Intern Med. 2014;160(11):ITC6-1. PMID: 25009837 www.ncbi.nlm.nih.gov/pubmed/25009837.

Deyo RA, Von Korff M, Duhrkoop D. Opioids for low back pain. BMJ. 2015;350:g6380. PMID: 25561513 www.ncbi.nlm.nih.gov/pubmed/25561513.

Eismont FJ, Norton RP, Hirsch BP. Surgical management of lumbar degenerative spondylolisthesis. J Am Acad Orthop Surg. 2014;22(4):203-213. PMID: 24668350 www.ncbi.nlm.nih.gov/pubmed/24668350.

Fritz JM, Magel JS, McFadden M, et al. Early physical therapy vs usual care in patients with recent-onset low back pain: a randomized clinical trial. JAMA. 2015;314(14):1459-1467. PMID: 26461996 www.ncbi.nlm.nih.gov/pubmed/26461996.

Furlan AD, Giraldo M, Baskwill A, Irvin E, Imamura M. Massage for low-back pain. Cochrane Database Syst Rev. 2015;(9):CD001929. PMID: 26329399 www.ncbi.nlm.nih.gov/pubmed/26329399.

Gardocki RJ, Park AL. Degenerative disorders of the thoracic and lumbar spine. In: Azar FM, Beaty JH, Canale ST, eds. Campbell's Operative Orthopaedics. 13th ed. Philadelphia, PA: Elsevier; 2017:chap 39.

Hooten WM, Cohen SP. Evaluation and treatment of low back pain: a clinically focused review for primary care specialists. Mayo Clin Proc. 2015;90(12):1699-1718. PMID: 26653300 www.ncbi.nlm.nih.gov/pubmed/26653300.

Maas ET, Ostelo RW, Niemisto L, et al. Radiofrequency denervation for chronic low back pain. Cochrane Database Syst Rev. 2015;(10):CD008572. PMID: 26495910 www.ncbi.nlm.nih.gov/pubmed/26495910.

Manchikanti L, Cash KA, Pampati V, Falco FJ. Transforaminal epidural injections in chronic lumbar disc herniation: a randomized, double-blind, active-control trial. Pain Physician. 2014;17(4):E489-E501. PMID: 25054399 www.ncbi.nlm.nih.gov/pubmed/25054399.

Mayer EAK, Maddela R. Interventional nonoperative management of neck and back pain. In: Steinmetz MP, Benzel EC, eds. Benzel's Spine Surgery: Techniques, Complication Avoidance, and Management. 4th ed. Philadelphia, PA: Elsevier; 2017:chap 107.

Mazanec DJ, DeMicco RC. Medical management of neck and low back pain. In: Steinmetz MP, Benzel EC, eds. Benzel's Spine Surgery: Techniques, Complication Avoidance, and Management. 4th ed. Philadelphia, PA: Elsevier; 2017:chap 106.

Peul WC, Bredenoord AL, Jacobs WC. Avoid surgery as first line treatment for non-specific low back pain. BMJ. 2014;349:g4214. PMID: 25030631 www.ncbi.nlm.nih.gov/pubmed/25030631.

Rasouli MR, Rahimi-Movaghar V, Shokraneh F, Moradi-Lakeh M, Chou R. Minimally invasive discectomy versus microdiscectomy/open discectomy for symptomatic lumbar disc herniation. Cochrane Database Syst Rev. 2014;(9):CD010328. PMID: 25184502 www.ncbi.nlm.nih.gov/pubmed/25184502.

Schneider M, Haas M, Glick R, Stevans J, Landsittel D. Comparison of spinal manipulation methods and usual medical care for acute and subacute low back pain: a randomized clinical trial. Spine (Phila Pa 1976). 2015;40(4):209-217. PMID: 25423308 www.ncbi.nlm.nih.gov/pubmed/25423308.

Steiger F, Becker HJ, Standaert CJ, et al. Surgery in lumbar degenerative spondylolisthesis: indications, outcomes and complications. A systematic review. Eur Spine J. 2014;23(5):945-973. PMID: 24402446 www.ncbi.nlm.nih.gov/pubmed/24402446.

Vaccaro AR, Fisher CG, Whang PG, et al. Evidence-based recommendations for spine surgery. Spine (Phila Pa 1976). 2014;39(19):E1183-E1189. PMID: 25166476 www.ncbi.nlm.nih.gov/pubmed/25166476.

Yavin D, Hurlbert RJ. Nonsurgical and postsurgical management of low back pain. In: Winn HR, ed. Youmans and Winn Neurological Surgery. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 281.

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Back Pain SmartSite TM

Questions to ask your doctor about back pain

About back pain

Taking care of your back at home and work

Treatments for back pain

Back Pain SmartSite ^TM