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Stand Tall With Expert Spine Care

A Senior Patient Points Out to His Doctor where on His Back the Pain is

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Your spine is truly at the center of your health, so taking care of the backbone of everything you do is always important. You don’t need to limit yourself from doing the things you love because of back pain. You can find relief right now with our spine care experts at Rothman Orthopaedics at AdventHealth Winter Garden.

With insight from our experts at Rothman Orthopaedics, orthopedic spine surgeon Daniel Fassett, MD, and physical medicine and rehabilitation specialist Brian Goldberg, MD, provide information on how to best care for your back pain, common causes of back pain and treatment options.

Common Causes of Back Pain

Spinal problems are a painful and, unfortunately, common occurrence. Many adults experience back pain at some point in their lives, and it can cause many people to miss work, too.

With back pain being such a common occurrence, you might be wondering about its underlying causes. According to Dr. Fassett, “Back pain can have many causes, including arthritis or muscle strains, or it may also be a symptom of another medical condition. Our goal is to alleviate your pain, whatever the source.”

Some of the most common causes of back pain include:

  • Disc herniation
  • Muscle strain or tendinitis
  • Spinal arthritis
  • Other medical conditions like kidney stones and ovarian cysts

Conditions that worsen back pain include:

Standing Tall: Steps for Better Back and Spine Health

“While spine-related pain is common, that doesn’t mean you have to live with it. In addition to staying connected with your health care provider, there are many steps you can take to improve your daily and long-term spine health,” says Dr. Goldberg.

Some important strategies to prevent back and neck pain from Drs. Fassett and Goldberg include:

  • Adjusting the height of your desk, computer and chair
  • Avoiding lifting anything that’s too heavy, or twisting when lifting items
  • Avoiding slouching to prevent strain on your neck and shoulders
  • Avoiding smoking, which lessens normal blood flow and damages bone density, discs and connective tissue
  • Eating healthy foods and maintaining a healthful weight
  • Going to physical therapy to improve balance, reduce pain and control the progression of osteoporosis and osteoarthritis
  • Managing stress
  • Practicing good posture by sitting or standing with your head up and your back straight
  • Sleeping on your side with a pillow placed between your legs or sleeping on your back with placing a pillow under your knees. Using a firm mattress can also help.
  • Staying active to keep muscles strong and flexible

Treatments for Back Pain

Most back pain resolves within a month of home treatment, especially for people younger than age 60. Pain relievers and using heat and ice may be all that you need. However, for many, the pain lasts several months or more.

Continue your activities as much as you can with back pain. Dr. Fassett recommends, “Try light activities, such as walking. Stop activity that increases pain, but don't avoid it because you fear pain. In fact, it is more helpful to continue light activity than to stay on bed rest.”

If home treatments aren't working after several weeks, your health care provider might recommend stronger medications or other therapies.

Medications for Back Pain

Medications depend on the type of back pain. They might include:

  • Pain relievers: Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve), might help. Take these medications only as directed. Overuse can cause serious stomach, bleeding or kidney side effects. If pain relievers you can buy without a prescription don't help, your health care provider might suggest prescription NSAIDs
  • Muscle relaxants: If mild to moderate back pain doesn't improve with pain relievers, a muscle relaxant might help for more acute conditions. Muscle relaxants can cause dizziness and sleepiness, though
  • Topical pain relievers: These products, including creams, salves, ointments and patches, deliver pain-relieving substances through the skin
  • Antidepressants: Some types of antidepressants — particularly duloxetine (Cymbalta) and tricyclic antidepressants, such as amitriptyline — have been shown to relieve chronic back pain
  • Neuropathic agents: Seizure medications such as Gabapentin and Lyrica (pregabalin) can stabilize irritable nerves and help control nerve pain in a leg or arm.
  • Narcotics: Drugs containing opioids, such as oxycodone or hydrocodone, are a last resort and may be used for a short time only, with close medical supervision

Physical Therapy

A physical therapist can teach exercises to increase flexibility, strengthen the back and abdominal muscles, and improve posture. “Regular use of physical therapy techniques can help keep pain from returning,” says Dr. Goldberg.

He continues, “Physical therapists will also provide education about how to modify daily work and leisure movements during an episode of back pain. This way, you can avoid flaring pain symptoms while continuing to be active.”

Surgery and Other Procedures

Procedures used to treat back pain may include:

  • Cortisone injections: If other measures don't relieve pain that radiates down the leg, an injection of cortisone plus a numbing medication into the epidural space around the spinal nerve roots might help. A cortisone injection helps decrease inflammation and can last anywhere from weeks to months or even years. These injections are performed in a safe manner using a sterile technique under live X-ray guidance
  • Radiofrequency ablation: In this procedure, a specialized needle is inserted through the skin, targeting the most painful arthritic spinal joints. Radio waves are passed through the needle to lesion the nerve branches within the painful joints. Disrupting these nerve branches interferes with some of the lumbar pain signals to the brain
  • Implanted nerve stimulators: Devices implanted under the skin can deliver electrical impulses to the spine to block spinal back and leg pain


In most cases, surgery is last resort option for the treatment of back pain, or may not be an option at all. In some patients with spinal deformities or tumors, surgery can be considered. But for most patients, surgery isn’t a first-line treatment for back pain.

What Is Sciatica?

Sciatica is the term for pain that often radiates from the buttocks down the leg. It’s caused by nerve compression or inflammation in the spine.

Treatment options for sciatica:

  • Non-operative treatments may include anti-inflammatory medications, physical therapy and epidural cortisone injections
  • Surgery is often considered for sciatica when non-operative treatments fail or when a patient has a weakness. Surgery typically involves creating more room for the nerves to relieve irritation and pain. Many of these surgeries are minimally invasive, with immediate pain relief from sciatica

Healthy Spine, Healthy Life

Our spine care specialists are ready to listen, answer your questions and explain spinal disorder treatment options. Then, we’ll offer you the latest technology and diagnostic tests. If you need an expert physician, nutritionist, physical therapist or pain management specialist, we’ll connect you with our experts to care for your specific needs.

The Backbone to Heal, the Heart to Care

Whether you need treatment for scoliosis, spinal cancer or another spinal condition, we’re here for you, from the emergency room to the physical therapy gym.

You can find all the experts you need for back pain relief, all in one place. AdventHealth has created a comprehensive program that brings together clinical leaders from AdventHealth Spine Center, Orlando Neurosurgery and Rothman Orthopaedics. Nationally recognized expertise and a local legacy of exceptional treatment ensures our patients have the very best care close to home, with several convenient locations across Central Florida.

Our team of spine experts at Rothman Orthopaedics at AdventHealth Winter Garden is ready to help. You can learn more about how we can support your spine health at

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