Frequently Asked Questions
Commonly asked questions by patients looking for treatment from a Physiatrist.
Q: Why do I have back pain?
A: Back and neck pain can be caused by muscular strain, arthritis, and/or disc degeneration.
Q: When should I see a doctor about my back or neck pain?
A: If there is fever associated with your pain, you have any bowel or bladder changes, the pain continues to increase, or there are progressive changes in strength or sensation, you should see a doctor at a medical office.
Q: Am I too young to have back problems?
A: By age 50, 90% of us have some back or neck degeneration. It can strike insidiously in our earlier years, with or without any seeming cause or slowly build up as we age.
Q: How delicate is my spine? Do I need to baby it?
A: The spine tends to break down despite what you do. The research shows that degeneration is exercise neutral i.e. you can exercise or not exercise and your back will break down at the same rate.
Q: How do I prevent back/neck pain?
A: The best thing you can do is stay active, flexible and mobile. Engage in activities that improve your back and neck range of motion and strength.
Q: Why doesn’t my doctor prescribe bed rest?
A:Extended bed rest can lead to muscle atrophy and an increased risk of blood clots.
Q: Does the severity of my back or neck pain correlate with the amount of damage?
A: There is no great correlation between back pain and degeneration. A recent study confirmed this and found that the CT’s of people with and without back pain have no difference in terms of degeneration.
Q: What is an MRI and when do I need it?
A: An MRI is an advanced form of imaging the spine that allows visualization of both bones, muscles, intervertebral discs, ligaments, tendons, nerves, and fluid. An MRI is indicated if your physician is interested in performing an injection or surgery or if you physician is concerned that you might have cancer. MRI’s are also indicated for back pain that does not respond to more conservative modalities.
Q: Why doesn’t my doctor order an MRI immediately?
A: Early MRI’s can lead to increased advanced interventions and poorer outcomes. This is why we wait to see whether the pain resolves with more conservative care.
Q: Why doesn’t my doctor focus on the worst are on MRI?
A: There is a negative correlation with increased degeneration. i.e., the areas of your back with the most degeneration may not be the areas that are responsible for your pain, hence, a physical examination and story about where your pain came from is integral in establishing a diagnosis.
Q: Why don’t you just operate on me or send me to a surgeon?
A: Often, conservative therapy including oral medications, physical therapy and/or interventional spinal procedures like back injections can provide long lasting relief precluding the need for surgery. If such procedures don’t allow for relief, a surgical evaluation may be indicated.