20 Jun

Why does my back hurt?

Almost everyone has had back pain at some point in their life. Sports injuries, car accidents, heavy lifting, long car rides, sitting at a desk all day–there’s no shortage of causes. Most of the time, the pain is manageable; sufferers pop a few painkillers, maybe throw on some ice, and assume a little back pain’s bound to act up every now and then.

But what if it isn’t? What if, by taking those painkillers, we’re really just masking a symptom of a greater problem? Charles Gambino, D.O., of Northcoast Internal Medicine in Sea Cliff, New York, worries this might be the case.

“The risk of taking any analgesia for an extended period of time to help with back problems is covering up a potentially life-threatening problem,” he says, adding that painkillers like ibuprofen should be taken only for 48-72 hours at most. “Any recurring pain needs to be evaluated.”

This is especially true for older people, for whom non-musculoskeletal causes of back pain are much more common. According to Dr. Gambino, “In general, under the age of 50, back pain would be associated with job-related injuries, trauma, etc. and the cause would be a little bit more obvious…but as [the patients] get older, the diagnosis requires…more attention.” He estimates that, for individuals over the age of 60, pain in the back has a 50-50 chance of being caused by something unrelated to the spine or muscles.

The list of back pain culprits he’s seen is extensive: Metastatic disease, cancer, Lyme disease, infection, pneumonia, pleurisy, pulmonary issues, Pott’s disease (tuberculosis of the spine), multiple myeloma, gall bladder disease—just to name a few. Appropriate testing needs to be done to determine where the real issue lies.

Often, Gambino will send back pain patients to physical therapy when a more typical injury is suspected, in order to both ease their pain and prevent re-injury. “[Physical therapy] will handle all of the acute musculoskeletal problems, as well as the chronic,” he says. But “if [patients] undergo a course of physical therapy and they’re not getting better, then there might be something else underlying.”

Either way, by ignoring their pain or simply suppressing it with medication, people aren’t doing themselves any favors.

“Through my years of practice, I’ve noticed that back pain should not necessarily be brushed off,” Dr. Gambino insists. “It could be an indicator of something more serious.”

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20 Jun

How Can An Epidural Steroid Injection Help Back Pain?

When a herniated disc causes pain, what can be done to help? One of the options is an epidural steroid injection. Dr. Matthew Kalter, a pain management physician in Long Island, tells us how.

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08 Jun

Radicular Arm Pain

Have you ever felt a pain radiating down your arm? An ache that seems to shoot through your shoulder? Have you wondered if you have a pinched nerve? Actually, the cause is more likely musculoskeletal.

In my office, I often see patients who complain of pain which travels down the arm,” says Dr. Joseph Carfi, MD, who has a practice in New Hyde Park, New York. “It may start in the neck; it may start in the shouder; or it just may be isolated in the arm.” Generally, he finds that discomfort of this sort is caused, not by some neurological issue (like a pinched nerve), but by a musculoskeletal problem. Since the body’s internal sensory map is imprecise, your body can misconstrue pain from int

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08 Jun

What Is A Pinched Nerve?

Pinched nerve: We’ve all heard the term, and most of us have probably thought we had one at some point. But what is a pinched nerve, really?

Dr. Joseph Carfi, a doctor of physical medicine in New Hyde Park, NY, sees a lot of patients who come in with this complaint. A pinched nerve, he says, is just what it sounds like. “Quite literally, the nerve is being pressed” within the spine. This could be the result of a condition like arthritis or a herniated disc, or simply from poor posture.

Nerves travel through the spine, making their way through tiny passages in the discs and vertebrae. When swelling occurs, these passages narrow and press against the nerve, often causing pain or numbness. “It hurts because the nerve is being irritated from this pinch and it becomes inflamed,” says Dr. Carfi. “Inflammation is painful.”

“The first order of business is to reduce the swelling and the inflammation by medications, physical therapy, activity modifications, position modifications, things of that nature,” he explains. “The other way to [unpinch a nerve] is to improve posture and positioning so that the little holes where the nerve has to pass…are slightly larger.”

Sometimes, the pinched nerve can even correct itself with time due to natural changes and restrictions in the discs. It usually doesn’t take a drastic approach to fix the problem, since the spaces being dealt with are so miniscule that the smallest bit of movement makes a difference. “Even a little bit helps.”

Written by Danielle Poupore

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