BACK PAIN

A back doctor finds possible causes of pain. 

Although some patients are concerned about a severe cause of back pain, such as cancer, most causes are mechanical, such as disc or joint wear and tear. It is well recognised that treatment consisting of rehabilitation to get your back moving better in combination with changes to the way you think about your pain works. A back doctor will assess you to find the cause. 

What investigations and treatments does a back doctor use to help relieve low back pain?

Causes of your low back symptoms require a detailed investigation, such as an MRI scan and blood test. Getting a proper diagnosis from a specialised back doctor can help with treatment. For example, pain in young people is sometimes due to stress fractures, such as a pars stress fracture. Pars stress fractures require a different approach and rehab progra . In a new blog, Dr. Masci discusses the specific treatment of pars stress fractures in young athletes. 

Some patients develop back and leg pain due to a condition known as ‘Sciatica.’ Sciatica occurs when a small part of a disc presses on a nerve, causing sharp, shooting pain down one leg. Occasionally, patients may experience other symptoms, such as tingling, numbness, and weakness. In such cases, further imaging with an MRI scan helps confirm the diagnosis. Your back doctor will refer you for this scan. Moreover, specific treatments such as medications and injections are often beneficial.   These back injections are relatively safe but must be performed by a back doctor who specialises in this area. Sometimes, patients have seen surgeons who have said that surgery is required and there are no other options. However, it may be prudent in some instances to get a second opinion from a back doctor to discuss non-surgical options.

Another less common cause of low back pain is inflammatory arthritis. This condition is an autoimmune disease where the immune system attacks the structures in the back, causing pain and restricted movement. Often, patients report experiencing inflammatory back pain, which worsens in the morning and improves as the day progresses. Exercise frequently makes the pain worse. Night pain is sometimes common. Often, we use a combination of MRI and rheumatoid blood tests to confirm the diagnosis. Effective treatments are now available to treat inflammatory arthritis. 

Another source of low back pain is the sacroiliac joint. Problems with the sacroiliac joint include osteoarthritis, sacroiliitis and sacral stress fracture. 

Sometimes, back pain is not caused by a problem in the back.

The cause of low back pain may be entirely unrelated to a spinal problem. For example, runners may develop a condition known as hamstring tendinopathy. Hamstring tendonitis occurs due to the overload of the large hamstring tendon that attaches to the pelvis. Patients often describe their symptoms as worse with running and sitting, and better with standing. Unfortunately, hamstring tendonitis can frequently be misdiagnosed as ‘sciatica’ and requires a different exercise program, supported by additional treatments such as tendonitis injections. Usually, a back doctor will perform an ultrasound or MRI scan to confirm a diagnosis of hamstring tendonitis.

Specific low back conditions:

• Pars stress fractures
• Hamstring tendonitis
• Seronegative inflammatory arthritis 
• Sacral stress fracture 

Dr Masci assesses back pain in central London.

If you wish to speak to our team about injection therapy, please contact us.