Almost everyone at some point deals with pain in the lower back and neck. Many people heal with time, while others may try to live with it. If left untreated, this pain can interfere with your quality of life.
In this Q&A, Gary Esses, MD, Assistant Professor, Anesthesiology, Perioperative, and Pain Medicine, at the Icahn School of Medicine at Mount Sinai, and leader of the Pain Management Service at Mount Sinai Brooklyn, explains how to manage low back, neck, and sciatic pain, and when to seek help from a pain management specialist.
To make an appointment with Gary Esses, MD, call 718-758-7072 or click here to book online.
“If you have seen a regular doctor and your pain isn’t healing, it may be time to see a pain management specialist,” he says.
Why does my lower back hurt, and how can it be treated?
Low back pain is frequently caused by arthritic joints in the back or nerves being pinched by discs, and can send shooting pain down the legs. A pain management specialist can help alleviate the pain through a variety of methods, including prescribing oral medications, an injection using numbing medication, or steroids to reduce inflammation. In addition, the pain specialist might use radio frequency ablation, which employs radio waves to heat an area of nerve tissue to silence those nerves and stops them from sending pain signals to your brain. In addition, they will advise you to strengthen your back muscles through home exercise or physical therapy, which can lessen and even eliminate spine pain over time.
What is sciatica, and can it be treated?
Sciatica is a type of low back pain with shooting pain down the leg, often in the back of the leg. Initial treatment for sciatica could include oral steroids, muscle relaxers, and physical therapy. Patients suffering from sciatica for more than a month without relief from initial therapy may need an epidural steroid injection to help decrease the inflammation in that area. Specialists may use X-rays to pinpoint the nerves and area causing the pain.
Can sciatica go away on its own?
Yes, if the swelling due to the inflammation subsides, then the pain will also diminish. However, if the pain persists for more than a month, you should visit a pain management specialist.
What is causing my neck pain, and how can it be treated?
Commonly, the joints in the neck or a slipped disc in the spine will cause neck pain, which sometimes will send shooting pain into the arms. Pain management specialist will perform a physical exam to determine the location and root cause of your neck pain, and may also perform X-rays.
Initial treatments often include the use of oral medications that decrease inflammation and relax tense muscles to see if they can help. If a slipped disc is the cause of the pain, your pain management doctor might prescribe an epidural steroid injection, which would silence the nerve activity in the area of the injection. If the joints in the neck are the source of your pain, the pain specialist might use radiofrequency ablation, a procedure that uses electricity to treat pain. This treatment heats up the nerves to silence those causing the pain.
Is my neck pain causing my headaches?
Often, neck pain triggers headaches. If oral medication does not alleviate the headache, the specialist might recommend treating your neck pain with an injection to silence the nerves. The decrease in neck pain is typically accompanied by a decrease in headaches. If headaches persist after treating neck pain, you may be referred to another specialist.
How can I tell if my neck pain is from trauma or injury, such as whiplash?
Pain caused by trauma or injury requires imaging and possible evaluation by a neurosurgeon. Because there might be physical damage to muscle tissue, typical pain management treatments would include muscle relaxants or anti-inflammatory medications.
Will I be prescribed pain medications? Should I be concerned about addictive medications?
Your pain management team will prescribe pain medications only if they think they will be beneficial. At Mount Sinai Brooklyn, our doctors are very conservative about the medications prescribed to help alleviate pain. The team will rarely, if ever, prescribe opioids, which are more addictive than typical pain medications.
When should I see a pain management specialist?
There are board certified medical specialists dedicated to diagnosing and treating pain-related disorders. Your pain management specialist will consider multidisciplinary approaches to treating your pain, and will discuss possible therapies and help coordinate your care with other health care professionals. If needed, they will perform interventional therapies, such as administering an epidural injection in the spine.
