Back Pain Explained

There are many causes to chronic upper back pain, low back pain or neck pain. Commonly, a patient will tell us that her low back pain happened once or twice before, and went away with over the counter medications or some chiropractic adjustment after a month or so. Then after lifting something in an uncomfortable position, the back began to hurt again, but now will not go away. Back pain can start out with a muscle strain. As we get older, the joints between the bones of the neck and back narrow and show wear and tear. We call this degenerative arthritis. The bones of the spine, called vertebrae, are separated by thin rubbery pads with a soft center called discs. Think of the back bones as coffee cups, and the discs as jelly donuts stacked on either side. If pieces of the donut break off, we call that a disc fragment. If the disc squishes out, we call it a herniated disc. If the donut gets squished enough, the coffee cups or their handles can rub on each other, and we call that degenerative disc disease. Cracks in the cups can occur, and we call that a compression fracture. If the cups or vertebrae do not line up as they should, we call that a slipped disc or spondylolisthesis. If the squished donut (disc), or even a part of the coffee cup (vertebrae) touches a nerve, we say you have a pinched nerve. A pinched nerve in the neck may cause numbness or tingling in the arm, especially when you move your neck. It is less common to have upper back pain, and pain here is usually due to trauma or severe arthritis or scoliosis.
 
Sciatica
The term "Sciatica" refers to a pinched sciatic nerve, and sciatic pain that goes down the back of the thigh and calf, sometimes into the foot. While most of the time the sciatic pain comes from an pinched nerve in the low back, the sciatic nerve can also be pinched by the buttock muscles, and is called piriformis syndrome if that occurs. 

Spinal Stenosis
Spinal stenosis is when the spinal cord itself is pinched, usually by degeneration of the discs and arthritis of the vertebrae. Patients with spinal stenosis will have little back pain when resting, but when they walk the severe back pain and leg pain builds up.  The pain will usually get better after resting 10-15 minutes. Some people call spinal stenosis "Shopping Cart Disease" as people with spinal stenosis can walk much farther when pushing a shopping cart.

Lower Back Pain Treatment

Neck or lower back pain treatment takes an individualized plan. We have been treating low back pain at our Newport Beach location in Fashion Island since 1995, and know what it takes to start you on the road to lower back pain relief. Many pain specialists only do pain blocks like epidural steroids, others only give pain medications. We offer both, along with specific exercise for lower back pain and physical therapy.  Our goal is to improve your life, and that may mean using a variety of pain therapies. We know you prefer topical pain relievers and creams to minimize side effects. We know you want back pain relief, but prefer to stay off of narcotics if you can, understanding you may need something strong if nothing else helps.  When you can't sleep because of the pain, we can help. Our goal is to do this without giving you a drugged feeling. 

Epidural Steroid Block
If needed, Dr. Scott can help with an epidural steroid block, or specific nerve block.  Epidural blocks are a type of injection where a powerful anti-inflammatory like cortisone is injected just outside the spinal canal to help reduce local swelling around the pinched nerve of the neck or low back.  Epidural steroid blocks are most effective for pain going down the leg. They can be effective at helping you start exercise for lower back pain, and jump start your lower back pain relief.   

Cortisone Blocks
For lower back pain, neck pain, or upper back pain due to arthritis, a pain doctor may recommend facet blocks.  Facet blocks are injections that treat back pain, they do not usually help with leg pain.  They do have a role in helping to get you exercising with less pain and can provide some back pain relief.

Epidural steroid injections, facet blocks and nerve blocks are less painful than you think, but are delicate procedures and should be done after careful consideration of the risks and benefits. Last, we work to keep your primary doctor informed of your progress with your pain therapy. 



We are happy to provide a second opinion for any low back pain problem.  Pain doctors have many different backgrounds-they may be physiatrists, neurologists, internists, orthopedists, or like Dr. Scott, anesthesiologists. Thus opinions about your best therapeutic course may differ from doctor to doctor.

Don't waste one minute more!

Why suffer with ongoing neck pain, lower back pain, sleeplessness and feeling blue.  Make the commitment to be healthy. We'll be your partner in treating your neck or back pain every step of the way. Dr. Scott accepts Work Comp patients and Medicare. Call Newport Pain Management at 949 759-8400 for a consultation today.