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Johns Hopkins Bayview News - Ask the Expert: Back Pain

Summer 2015

Ask the Expert: Back Pain

Date: August 3, 2015


Portrait of physiatrist Akhil Chhatre, M.D.
Akhil Chhatre, M.D., physiatrist

If you have lower back pain, you are not alone. About 80 percent of adults experience lower back pain at some point in their lives. It is the most common cause of job-related disability and a leading contributor to missed work days.

Here, physiatrist Akhil Chhatre, M.D., answers frequently asked questions about back pain and explains when you should seek medical treatment.

What causes lower back pain?

Even with today’s technology, the exact cause of lower back pain can be difficult to determine. In most cases, back pain may be a symptom of many different causes, including any or several of the following:

  • Overuse or strenuous activity, such as repetitive or heavy lifting
  • Trauma, injury or fracture
  • Degeneration of vertebrae
  • Obesity
  • Muscle tension or spasm
  • Sprain or strain
  • Ligament or muscle tears
  • Joint problems, such as spinal stenosis
  • Protruding or herniated disk
  • Diseases, such as osteoarthritis or spondylitis

What type of self-management techniques can I use to alleviate back pain?

The best advice I can give someone is to let pain be your guiding factor. If a certain position or motion hurts, avoid it, as well as all moderate-level activities, until the pain subsides. To help with inflammation, take over-thecounter ibuprofen and ice the injured area for 20 minutes at a time. This will help relieve your pain and prevent further injury. Back pain is not a condition that should be “powered through.”

Can lower back pain be prevented?

For those with back pain caused by pre-existing conditions, it may be hard to prevent flare-ups. However, there are lifestyle habits that everyone can practice to reduce the risk of back injury or pain. These include:

  • Practicing proper lifting techniques (Lift with your knees, not your back!)
  • Maintaining correct posture when sitting, standing and sleeping
  • Exercising regularly with proper stretching before and after
  • Maintaining a healthy weight
  • Reducing emotional stress, which may cause muscle tension

How is lower back pain diagnosed?

Lower back pain is diagnosed with a complete medical history and physical exam. This includes identifying the location and severity of the pain, as well as any aggravating factors, positions or movements. Imaging studies such as an X-ray, CT scan or MRI also may be ordered to determine if the pain is muscular or skeletal.

What are some medical options for treating back pain?

If your back pain starts to affect your ability to perform your daily activities, you should seek medical attention. Depending on your diagnosis, treatment may include:

  • Physical therapy
  • Medications (over-the-counter or prescription) to support other treatments and therapy
  • Alternative therapy, such as acupuncture or chiropractic care
  • Injection therapy
  • Surgery

A physiatrist is a doctor who specializes in physical medicine and rehabilitation. He or she treats conditions, such as arthritis, back pain, work- and sports-related injuries, and brain or spinal cord injuries, to name a few. To schedule an appointment with a physiatrist, call 410-550-0414.

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