Back pain is the most common cause of pain and disability and some estimate that close to 84% of the general population will experience back pain at some point in their life. However, I think it is often important to remember that most back pain is not serious and will resolve on its own. The majority of back pain typically falls under the category of muscular or ligamentous sprain/strain. These conditions will typically resolve on their own with conservative therapy. In fact, current guidelines do not even recommend imaging within the first 4 weeks unless there are warning signs present. Back pain is not considered chronic unless it has been present for greater than 12 weeks.

Conservative therapy can consist of many different modalities to include massage, physical therapy, a structured home exercise or stretching program (please see our blog on stretching for some excellent pointers), spinal manipulation, acupuncture, yoga, and even tai chi. Depending on the study, all of these techniques have been shown to be of some benefit. Medications such as Tylenol and anti-inflammatories are considered first line therapy and some cases, muscle relaxers. Long term, the goal is to strengthen your core muscles which can lessen the load on the structures of the spine and to help maintain flexibility of the muscles surrounding the spine. Current guidelines also recommend against bedrest as this prolongs the time until full recovery. Instead, activity should be done as tolerated and then gradually increased.

There are certain situations in which back pain is felt to be more serious and would need a more immediate work up. These can manifest as symptoms of numbness/weakness that goes into the legs (sometimes just pain that goes all the way down the leg), loss of control of the bowel or bladder, unexplained weight loss, and fevers/chills that go along with severe back pain. You should immediately seek out medical care if any of those conditions should occur.

Unfortunately, sometimes back pain does not improve on its own or it is accompanied by shooting leg pain that is sometimes more difficult to treat. That is where Southeast Pain & Spine Care can offer many more advanced therapies. We offer a multitude of interventional therapies that can used to address back pain and please feel free to continue to browse our website for the therapies that we offer…. or better yet, schedule your consultation today.


Kevin Costello, MD