Evaluation and treatment of back pain begins with a detailed description of your problem. We call this a medical history. This is when we take the time to listen to you. It is important that we gather some basic information. Put simply: When did your problem start? How did it start? What makes it worse? What makes it better? Is your pain confined to your back or does it go down your leg or into the front of your body?
This information tells us how to proceed. If there is any indication that your back pain is due to a medical condition such as kidney problems, intestinal problems, disease, or infection, then we will arrange for an appropriate medical evaluation. If your pain is clearly musculoskeletal, that is to say, mechanical in nature, then we carefully evaluate for the various causes of back pain. There are many. They include: conditions such as scoliosis, short leg syndrome, congenital conditions; injured muscles, called strains of the back; stretched ligaments, called sprains of the back, spinal contusions such as after a sports injury, work injury, fall, or auto injury; disc problems; degenerative changes such as degenerated discs and spinal arthritis; and pain from the joints of the spine which we refer to as facet syndrome.
The specific cause of your problem is determined by a careful, methodical examination, paying close attention to an array of orthopedic and neurologic tests. Basically this means that we use various positions and movements to ask your body questions, and the answers tell a story which leads to an understanding of your problem, which we call a diagnosis. The goal is to develop as high a level of understanding of your condition as possible. X-rays can be a helpful tool when appropriate.
Depending on your particular diagnosis, treatment can consist of one or more of the following:
- Advice on how you perform activities
- Instruction in specific stretches and exercises, or changes to your exercise routines
- Spinal manipulation, also known as a spinal adjustment
- Spinal decompression, also known as Cox flexion-distraction manipulation
- Electrical stimulation
Goals of treatment vary with the individual, but, in general, we want to see noticeable improvement in one week, and significant improvement in two.