Today’s Wall Street Journal talks about treatment of back pain. Whether people experience back pain because they are more active during the summertime or because the pain seemingly appears out of nowhere, most cases can be treated conservatively. Given time alone, most cases of back pain will resolve on their own with relative rest. In cases where the pain persists, most people can be treated conservatively. As the article correctly points out, imaging does little to change the course of treatment in most cases and is not typically recommended in acute cases of back pain. If symptoms persist for several weeks and to a significant degree, imaging may be warranted.
In patients whose pain persists and conservative treatments have not helped, spinal injections may provide significant relief. Such injections should be considered only if a patient’s level of pain warrants such treatment in the first place and, just as importantly, if diagnostic studies show an issue at a specific spinal level that is consistent with the patient’s pattern of symptoms. Furthermore, such procedures are not recommended to be performed under general sedation by the International Society of Interventional Spine (ISIS) and the American Society of Anesthesiologists (ASA).