Back Pain is a common reason for consulting a physician. It ranks fifth as a reason for all physician visits. Here are a few statistics to be aware of: 80 percent of adults of working age get back pain at some time; 15-20 percent of the population has an episode of pain in any 12 month period in the United States; every year back pain occurs in 50 percent of working age adults; back pain disables two percent of the US population.

Mechanical low back pain can also be called discogenic pain. The discs are gel filled sacs between each of your vertebrae. The roles of the discs are to provide shock absorption.

Symptoms can be isolated to the low back, but can vary with referral to the buttock, thigh, calf or foot. The pain can be exacerbated by activities that load the disc, such as sitting, rising from a seated position, awaking in the morning, bending, sneezing or coughing. Symptoms in lieu of pain can be numbness, tingling or weakness in the extremity.

There are non-surgical medical specialties that focus on spine care, one being a Physiatrist.
A Physiatrist typically treats low back, neck, extremity, joint pain, tendonitis, arthritis, osteoporosis, compression fractures, and sports injuries. Their goal is to decrease pain and restore function without surgery. They work closely with your physical therapist, occupational therapist, primary care physician and spine surgeon, if required. Their ultimate goal is to allow patients to stay active as long as possible at any age.

Physiatrists attain a broad scope of expertise through four years of medical school plus a four-year hospital based residency training as a specialist in physical medicine and rehabilitation. Some physicians pursue additional advanced degrees in sub specialties, such as musculoskeletal rehabilitation, spinal cord injury, pain management, and sports medicine.

Physiatrists also have specialty training and diagnostic skills that help accurately pinpoint the source of ailments. They can design treatment programs that can be done by the patient themselves or with the help and guidance of their physical therapist. A few will have extensive knowledge of Mechanical Evaluation or the McKenzie Evaluation to determine appropriate reasonable diagnostic and treatment interventions.

Mechanical low back pain can be treated conservatively with physical therapy, education and exercises. If the symptoms are radiating into the buttock, leg or foot, the first goal is to centralize the symptoms, i.e. move them up towards the back. Often times, using the McKenzie Method to assist in diagnosing the source of the problem is an effective and less costly method to quickly identify who will  respond to conservative care and who may not and need more aggressive interventions.

When treating mechanical low back pain, it is important to recognize that the non-surgical approach, such as physical therapy or injections, can avoid less extreme interventions and costly procedures. If you have questions or concerns about your back pain, make sure to talk to your healthcare provider.

To locate a rehabilitation physician in your community, or to learn more about the specialty, visit the AAPM&R website at aapmr.org

 Ricardo A. Nieves M.D. recently moved to Fort Collins from New Mexico. He is Board Certified in Physical Medicine and Rehabilitation, Electrodiagnostic Medicine, Independent Medical Examiner and Pain Management. He also has sub-specialty Board Certifications in Sports Medicine and Pain Medicine (American Board of Medical Specialties.)

Ricardo A. Nieves, M.D., FAAPMR
1301 Riverside Ave. Suite 2,  Fort Collins, CO 80524
(970) 692-5550