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Back Pain

Pain in the lower back or spine can impact every facet of life. In severe cases, pain is chronic, and can be lifelong.

Back pain can be the direct result of the accident or a preexisting condition. Back pain can occur during a cascade of events like a preexisting sprain, made worse in a car accident, not properly treated, or the result of a recovery plan that is not carried out.

A Medical Expert Witness who is Board-Certified in Pain Medicine (ABPMR) is the right physician to assess the presence and degree of pain in a litigant.

What causes back pain?

Back pain develops for many reasons, from trauma and overuse to disease and the consequences of aging. If back pain starts suddenly, it may be due to an injury from moving awkwardly or lifting something too heavy. Sprains, strains, and whiplash from sports injuries and motor vehicle accidents are also common causes of back pain.

Back pain that develops slowly could be due to a degenerative condition such as:

  • Disc herniation
  • Vertebral compression fractures
  • Spondylosis (popping and crunching in the spine)
  • Degenerative disc disease
  • Spinal stenosis
  • Osteoarthritis
  • Spondylolisthesis
  • Spondylolysis

These conditions might affect the cervical spine (neck) or lumbar spine (lower back) but are less common in the upper back (thoracic spine).

In many cases, the pain these conditions cause is due to radiculopathy: compression or damage to the spinal nerves. Sciatica, for instance, is lumbar radiculopathy, which is most often due to a herniated disc pressing on the sciatic nerve.

What treatments ease back pain?

Treatment for back pain could include several therapies, which are likely to be conservative to begin with. They are not always effective.

A medical treatment plan may use impairment-based classification, which involves designing treatments based on a diagnosis in combination with the symptoms being experienced.

Physical therapy techniques can help with back pain, such as stretching and strengthening, core exercises, and neuromuscular reeducation and stabilization, which activates the deep muscles in the lower back.

However, in some cases, Physical Therapy can make recovery worse. Depending on the source of the pain, a course of treatment will differ.

Medication may be necessary to ease severe back pain and enable a person to take part in a physical therapy program. Ice and heat can also be helpful.

Is pain treatment safe?

Pain treatments are varied and come with distinct dangers, risks and benefits. E.g., pain-relief medication run the gamut from anti-inflammatories to highly addictive medications like oxycodone.

Non-invasive procedures like a steroid injection are less risky than surgery. Read more about Pain Management Procedures.

What if back pain doesn’t improve?

If conservative approaches like physical therapy aren’t relieving back pain, common non-surgical treatments include:

  • Epidural steroid injections
  • Facet joint injections
  • Medial branch blocks
  • Facet joint blocks
  • Radiofrequency ablation
  • Spinal cord stimulation

For specific problems like vertebral compression fractures, other treatments include vertebroplasty and kyphoplasty to stabilize the spine. An orthopedic specialist may be part of a treatment team to restore function and improve back and neck pain. Orthopedic surgery is the most invasive treatment for back pain but may be the indicated approach.