Back At The Start

The reason for back pain can often be a mystery; the place to start finding answers is primary care

If you raked the leaves, weeded your garden and washed the car in one day and then that evening you have back pain, you can probably guess the reason why. If you spent most of the day watching ESPN but then got back pain, it may not be so clear.

Unfortunately, there is a long list of possibilities including a herniated disk, inflammatory arthritis, even gastrointestinal disease. But most often, it is simply a non-specific musculoskeletal pain that goes away on its own.

Bottom line: if your back pain is interfering with your life, it’s worth having your primary care physician take a look.

“Back pain is a very common complaint,” explains Thomas Falace, MD, of St. Joseph’s/Candler Primary Care on the Islands. “I see people with it every day. It can be very nonspecific, meaning that it doesn’t necessarily have an identifiable cause.”

A medical history and physical exam are the critical first steps for treating back pain. Then Dr. Falace follows with a series of basic questions.

“With your answers, I can start to formulate what we call a differential diagnosis, which involves distinguishing a particular cause from other common causes,” Dr. Falace says. “When we specifically think about who the patient is, what their medical history is, what their specific symptoms are and what the physical exam shows us, we can tailor that down to things that are much more likely to be in play.”

There are some very serious conditions that can cause back pain, including infection of the spine or cancer that has spread to the spine. Part of the process involves ruling those scarier possibilities out.

“I go through a logical series of steps to get the clinical picture,” Dr. Falace says. “And the majority of the time, it points to a non-specific, self-limiting musculoskeletal back pain.”

In those common cases, Dr. Falace will treat the pain or other symptoms until it resolves on its own, usually in a few weeks. He knows just as well as anyone how intense back pain can be.

“After recently moving here with all those boxes and furniture, I had to deal with some back pain of my own,” he says. “And it doesn’t necessarily have to be something serious to really hurt. Through the physical exam, medical history and the right set of questions, we can hopefully rule out the big, scary things, give you reassurance and get you back to your life.”