What is pain management?

Often when many people think of pain management, they only think about which medications can be taken to help their pain. However, pain management is more than just medication management. The most effective treatment for chronic pain is performed by a multidisciplinary team. That team usually consists of physical medicine and rehabilitation specialists, interventional pain-management specialists, chiropractors, physical therapists and often pain-management counselors. Dr. Barry Bakst, founding partner at Delaware Back Pain & Sports Rehabilitation Centers, has been helping patients get better faster for over 30 years in Delaware. He works with a multidisciplinary team, and a limited use of opioid medications, to reduce and manage both acute and chronic pain.

What is the difference between acute, subacute and chronic low back pain?

Both men and women are most frequently affected by acute low back pain. This pain can last from several days up to four weeks. It tends to resolve on its own, allowing you to return to your normal daily activities. Most people who have acute low back pain suffer from a mechanical problem. This means that there is a disruption in the anatomy of the back (the spine, vertebrae, discs, muscles and nerves) that affects movement. 

Subacute low back pain can last between four and 12 weeks. Low back pain that persists for 12 weeks or longer, despite appropriate treatment, is defined as chronic low back pain. One of the most difficult issues related to treating low back pain is that only you truly know how severe your pain is and how much you are suffering. Your level of pain cannot be determined by any special scientific test; however, using a scale to describe your pain at regular doctor visits can help your doctor to monitor your pain over time. 

According to the National Institute of Neurological Disorders and Stroke, 80 percent of adults have low back pain at some time in their life. Of those adults, approximately 20 percent develop chronic low back pain with continued symptoms one year later.

How is low back pain diagnosed?

Any serious condition of low back pain can usually be identified by a physical exam and a complete review of medical history. This can be performed by a physiatrist. (A physiatrist is a doctor who is trained to treat a range of conditions affecting the brain, spine, peripheral nervous system and musculoskeletal system.) However, the source of chronic low back pain is often difficult to determine, even after a thorough medical examination. Imaging studies such as X-rays, CT scans and MRIs may be needed to identify the source of the pain. Electromyography (EMG) and Nerve Conduction Studies (NCS) are used to help determine whether a person has nerve damage; they also aid in discovering the pain source and in determining a prognosis.

Should you take medication for low back pain?   

Discussing medication use with your healthcare provider(s) is recommended. Certain medications, even over-the-counter medications, may be unsafe depending upon individual pre-existing conditions, current medications and medical history. Adverse reactions or other serious medical conditions may occur. Another great concern is that opioids can be addictive; patients can also develop a tolerance to them, or experience side effects from prolonged usage. There are opioid alternatives that can be prescribed, including non-steroidal anti-inflammatory drugs (NSAIDS), anticonvulsants, antidepressants and topical analgesics. These medications should only be used under a doctor’s supervision. For those who do not want to take medication, there are several other options available. Delaware Back Pain & Sports Rehabilitation Centers offers many innovative alternative solutions to reduce your pain and get you back to your daily activities.

Delaware Back Pain & Sports Rehabilitation Centers offers low back pain treatments to reduce pain and improve functional activities of daily living.

Other innovative techniques such as myofascial release, soft-tissue immobilization, active release, 3D ActiveTrac and osteopathic manipulation can be combined with more traditional treatments to get you back to your everyday life.

The AlterG is a state-of-the-art treadmill that can reduce your body weight, which can reduce pain during rehabilitation therapy.

What are some alternative treatments that can help with pain?  

Alternative treatment methods may be recommended by your treating physician to help reduce your pain and get you back to your normal daily activities. Most patients have positive outcomes with a combination of rehabilitation therapy, physical therapy and chiropractic care. Complementary and alternative medicine (CAM) approaches can provide additional relief for chronic low back pain. Acupuncture, meditation, yoga and tai chi are just a few of the alternative treatments available. Exercise programs that strengthen core muscles—which support the low back and improve flexibility, proper posture and positioning—are recommended as well.

Other innovative techniques such as myofascial release, soft-tissue immobilization, active release, 3D ActiveTrac and osteopathic manipulation can be combined with more traditional treatments to get you back to your everyday life. Delaware Back Pain has cutting-edge equipment—like Class III and Class IV cold-laser therapies, and an anti-gravity treadmill called the AlterG. This state-of-the-art treadmill can reduce your body weight, which in turn can reduce pain during rehabilitation therapy.

Treatment goals are to reduce pain and improve functional activities of daily living. It is important to realize that many patients with chronic pain may not be cured, but that they may be able to better manage their pain.

Are injections a good alternative treatment?

Injections may be an effective treatment for lower back pain, especially if more conservative treatments have not been successful. The use of fluoroscopic or ultrasound guidance helps localize the injection to the source of the pain. There are many different types of injections that can help relieve pain. Some injections, such as trigger-point injections and joint injections, can be performed in a doctor’s office. Other procedures, such as epidural steroid injections and facet joint injections, are frequently performed in an outpatient surgical center. Epidural steroid injections are frequently used to treat radiating low back pain. A spinal cord stimulator can also be an alternative solution to your chronic low back pain.

Can a multidisciplinary approach to pain management help people who live with daily pain?

A multidisciplinary team with different areas of expertise may be beneficial for patients with low back pain. In many cases, patients have not only physical pain but also psychological and/or social issues that need to be addressed as part of the healing process. Pain-management counseling, including behavior modification and relaxation techniques, may be an effective treatment for pain. Self-management programs, which educate patients to employ alternative ways of thinking about and reacting to pain, have also been effective. Still, despite the many non-surgical and surgical options available, those who suffer from chronic pain may not experience a complete elimination of pain. The goals of the treatment plans are to help patients manage and reduce chronic pain, and improve daily functions.

Dr. Barry L. Bakst, D.O., FAAPMR, FAOCPMR

Dr. Barry Bakst has been a leader in the specialty of physical medicine and rehabilitation for over thirty years in Delaware. Dr. Bakst works with a team of predominantly board-certified doctors, including physical medicine and rehabilitation specialists, interventional pain-management specialists, chiropractors and a psychologist. Personalized care and treatment plans are tailored to each patient. Delaware Back Pain & Sports Rehabilitation Centers provides multidisciplinary approaches to pain management under one roof.

With over 30 years of combined experience, the team members at Delaware Back Pain & Sports Rehabilitation Centers are the experts in getting you better faster!

Locations:
87 Omega Drive, Building B, Newark • 733-0980
2600 Glasgow Avenue, Suite 210, Newark • 832-8894
2006 Foulk Road, Suite B, Wilmington • 529-8783
700 Lea Blvd., Suite 102, Wilmington • 764-2615
124 Sleepy Hollow Drive, Suite 204, Middletown • 376-8080
29 N. East St., Smyrna • 389-2225
200 Banning Street, Suite 350, Dover • 730-8848

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