Back Pain is clearly one of the number one complaints we see in both Emergency and Urgent care medicine. In some people it is a chronic issue and never ending; others it comes out of the blue and completely incapacitates them. Essentially there are two processes working against ease other: Inflammation and Muscle Spasm. The person who works too much in the yard or garage and wakes up the next morning unable to move; or the person who simply lifts the extremely small object and the back simply locks up.
Both are different sides of the same coin. In the first; inflammation eventually leads to spasm which now starts the cycle of inflammation causing more spasm which causes more inflammation. In the second scenario muscles become fatigued and the usual coordination of some muscles relaxing while others contract; both sets contract and cause instant spasm; which leads to the same cycle of inflammation causing spasm causing inflammation and on and on.

Regardless of the mechanism, the basis of healing involves powerful anti-inflammatories in conjunction with muscle relaxers. Now the key to muscle relaxers is that they do not work during the day, they are effective at night during sleep. Diazepam (Valium) is the most effective muscle relaxer and if narcotics are needed for pain relief they are prescribed and it is recommended that they be taken at night with the muscle relaxers. It may seem drastic but rest assured there was an oath we took as health care providers about not hurting anyone and while it may seem aggressive, I assure you it is safe and effective. But rest assured other options are available as well. Heat and massage with balms and patches are often effective and we are knowledgeable of all different modalities.

Some back pain may need further imaging to rule it a herniated disc and an MRI will be ordered and if necessary a referral to a Neurosurgeon if a herniated disc is the cause.

Regardless, we will find the source of the back pain and treat accordingly.