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Back Pain: When Should You See a Doctor?

June 4, 2015 10:59 AM with Dr. Srdjan Mirkovic

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Back pain symptoms are obvious--pain can come on suddenly or it can manifest as a chronic dull ache--but do you know when it’s time to seek the advice of a physician? Dr. Srdjan Mirkovic, Spine Surgeon at NorthShore, will answer questions on back pain, from symptoms and possible causes of back pain to treatment options, including surgical and non-surgical.

Brenna (Moderator) - 10:52 AM:
This chat is scheduled to begin at 11. You can submit questions now or at any point during the chat.

  Ankit (Round Lake, IL) - 11:06 AM:
I have a back pain, I feel sharp pain or burning in my buttocks. Question is will I ever get better from this back pain? because I have seen that once people get back pain they will have life long back problems, repeating doctors visits and multiple back surgeries. If I get remanded pain management injection then they only work for one or two years then surgery and most back surgeries are fail? I don't know what to do? It feels like a dead end? What do you suggest Dr. Mirkovic. Thank you !!
Dr. Srdjan Mirkovic (NorthShore)
Dear Ankit, I would recommend that you undergo a comprehensive evaluation of your lumbar spine to assist in diagnosing possible causes for your back pain. This would entail a visit with a spine surgeon as well as completion of necessary imaging studies, i.e., x-rays and possible MRI, to assist in determining your diagnosis. Once a formal diagnosis has been made, appropriate treatment recommendations can be offered, which may include oral medications, physical therapy, spinal injections, and possible surgery. I would advise you undergo an evaluation to ensure that prompt attention is not required to address the possibility of more serious conditions, that could account for your symptoms. The above treatment options can go a long way in alleviating your symptoms, though at times, low back pain cannot fully cured. Please feel free to contact my office at 312/664-6848 if you are desirous of proceeding with a formal evaluation. Thank you, Srdjan Mirkovic, MD

Brenna (Moderator) - 11:08 AM:
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  M.Harazin (Evanston,IL) - 11:16 AM:
Which over the counter pain medication do you suggest as the most effective and safe for lower back pain and at what dosage? Thank you.
Dr. Srdjan Mirkovic (NorthShore)
Dear M. Harazin: Over the counter medications fall into two categories, anti inflammatories and Extra Strength Tylenol. Non-steroidal anti-inflammatories include Advil, ibuprofen, Aleve, and Naprosyn, amongst others. One is not more efficacious than others, however, this can vary from person to person. I prefer Aleve given the less frequent dosing required. The recommended dosages on the medication bottle should be followed. One should not take more than the recommended doses. It is recommended that you take a medication such as Prilosec, Prevacid or Nexium to decrease the possibility of developing stomach issues while taking an anti-inflammatory medication. It is also recommended that you take these medications with food. Two anti-inflammatories MUST not be taken at the same time. Tylenol may be taken in addition to the anti-inflammatory, according to the recommended dosage on the medication bottle. One should not exceed 3 gm of Tylenol daily. Thank you

  Alee (Chicago,IL) - 11:25 AM:
Good day Dr. Mirkovic, I would like to ask about my lumbar pain it's been going on for let's say few years, it's on/off but there are times it lasts for 1-2 weeks with intense pain. the pain is annoying/constant like, 3-7/10, has been frequent than before. I feel it in the middle of my lumbar or sacral area, when I press on it, it hurts but with some relief. I had a slip/fall ~3 years ago where xray was fine. What would you recommend for it, I don't want/like surgery. Thank you so much!
Dr. Srdjan Mirkovic (NorthShore)
Dear Alee: I would recommend that you undergo a formal evaluation of your lumbar spine by a spine specialist, in order to make a diagnosis and rule out any serious condition. Based on your evaluation and imaging studies, treatment recommendations can be made, to include observation, oral medications, physical therapy, and surgery less frequently. Around 1 in 20 patients, are given a surgical option. The majority of patients can manage their symptoms through non-operative care. Thank you, Srdjan Mirkovic, MD

  Mike - 11:32 AM:
Are there minimally invasive options now for surgery for back pain? And can you expect to recover to the point of no pain?
Dr. Srdjan Mirkovic (NorthShore)
Dear Mike: There are minimally invasive options, depending on your condition and extent of surgery required. A reasonable expectation for pain relief, depending on the condition, is 75-90% improvement. Some patients can experience complete relief in their back pain, however, the extent of pain relief is multifactorial. Thank you, Srdjan Mirkovic, MD

  Jim (Gurnee, IL) - 11:35 AM:
I have a back issue related to tennis injury due to muscle strain or spasms. This is chronic and ongoing for last 2 years. What is the best way to alleviate and prevent this problem ? Is there any exercise or massage technique that will help this problem ?
Dr. Srdjan Mirkovic (NorthShore)
Dear Jim: Chronic muscle strain and spasm is an unlikely diagnosis for your ongoing back pain for more than 2 years. I would recommend that you undergo a formal evaluation of your lumbar spine by a spine specialist, in order to make a diagnosis and rule out any serious condition. Based on your evaluation and imaging studies, treatment recommendations can be made, to include observation, oral medications, physical therapy, and surgery less frequently. Likely, the most efficacious exercise regimen for you would include a core strengthening program performed at least two times weekly, preferaby three times weekly. It should be varied and consideration should be given to a group setting, to prevent boredom and enhance compliance with the exercise program. Thank you, Srdjan Mirkovic, M.D.

  michael (mount prospect,IL) - 11:41 AM:
I have had 3 cortisone injections for the arthritis in the facets with no relief. Also have herniated disks. Do you suggest radiofrequency ablation or Minimally invasive surgery?
Dr. Srdjan Mirkovic (NorthShore)
Dear Michael: It is unlikely that radiofrequency ablation would be of help, if you did not receieve any relief with the facet injections. Surgical options including minimally invasive surgery may be a treatment option, depending on the extent of your symptoms and the absence of other possible causes for your pain. Thank you, Srdjan Mirkovic, MD

  M.Harazin (Evanston) - 11:45 AM:
Thanks for your advice. Does aspirin fall into the same anti-inflammatory category? or do you just not recommend it? Would taking prilosec or Nexium also decrease stomach issues with aspirin? Also, what is Tylenol's mechanism and if anti-inflammatory not helping much would I take Tylenol at the same time or stagger the doses?
Dr. Srdjan Mirkovic (NorthShore)
Dear M. Harazin: Aspirin does fall into the anti-inflammatory category and should be taken with Prilosec or Nexium, to decrease stomach issues. Aspirin should not be taken with other anti-inflammatories (i.e., Advil, Aleve, ibuprofen). Tylenol is strickly an analgesic, pain medication, and has no anti-inflammatory properties. You may take Tylenol at the same time, alternate, or stagger doses. Thank you, Srdjan Mirkovic, MD

Brenna (Moderator) - 11:45 AM:
There are 15 minutes left in this chat. We apologize in advance that we won't be able to get to every question.

  Scott (Batavia, Illinois) - 11:49 AM:
I have been diagnosed with DISH in my cervical spine region. Is there treatment for DISH and is surgery an option to regain motion to this segment of my spine.
Dr. Srdjan Mirkovic (NorthShore)
Dear Scott: Treatment for DISH includes rheumatological pain management. Surgical options are limited to restoring alignment of the spine (to straighten the spine and correct horizontal gaze) and addressing possible fractures if these occur. Unfortunately, there are no viable surgical options to increase mobility at this time. Thank you, Srdjan Mirkovic, MD

  Butch (Rockford) - 11:56 AM:
I've been having pain for about two weeks and had an MRI on my back. Results are a slipped disc pinching a nerve. What would you recommend to fix the problem? Thanks in advance!
Dr. Srdjan Mirkovic (NorthShore)
Dear Butch: If you have no weakness, consideration can be given to pain management including oral medications, physical therapy, and epidural steroid injections, depending on the severity of your pain. If you have weakness, depending on the evolution and extent of your weakness, surgery may be considered. Surgery is considered more promptly if you experince any bowel/bladder dysfunction, or numbness/tingling in your inner thighs, genital or anal region. If you have been bedridden for a prolonged period of time, one should also be aware of the possibility of blood clots. This can be associated with increased pain beyond the pain resulting from the disc hernation, and requires prompt evaluation and treatment. Thank you, Srdjan Mirkovic, MD

Brenna (Moderator) - 11:56 AM:
This will be the last question of our chat today.

Brenna (Moderator) - 12:03 PM:
Thank you for your participation today. We apologize that we were unable to answer every question. For more information on back pain and treatment options visit our NorthShore Spine Center page.

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Thank you very much for your participation.