The Back Story

Start here

NASS Tweets


Back Pain 101

Anand Joshi, MD

Realistic notebook template. Blank cover design. Mock up noteboo

Eight in 10 people will experience back pain at some point in their lives. In most cases, the pain is harmless and goes away over time. Let’s discuss some common concerns about back pain:

Why does my back hurt?

There are various reasons why the back can hurt, including muscle pain, disc pain, joint pain, or nerve pain. In most cases, these are not harmful or dangerous. Of course, there are some instances when pain can be a symptom of a more serious problem, such as a fracture, infection, or cancer affecting the spine. Thankfully though, these conditions are very rare, and usually only affect people with special risk factors.


My back has been bothering me for days. What should I do?

First off, don’t be alarmed! Remember that back pain is extremely common, and usually not associated with anything harmful or dangerous. An over-the-counter anti-inflammatory, combined with some ice may be very helpful. Although you may need to take it easy for a while, it is best to stay as active as possible, and to generally avoid bed-rest. Your symptoms will often improve over time.


When should I see a doctor for back pain?

Pain that is severe, lasts several weeks, and keeps you from participating in normal, daily activities, should not be ignored. Even if you have not had pain for several weeks, you should seek medical care sooner if you have special risk factors for cancer, infection, or fractures that may affect the spine. Finally, remember to contact a doctor immediately if you notice fever, chills, or new neurological symptoms. These could include new numbness, weakness or changes in urination or bowel movements.


A Field Guide to Foam Rollers

Justin Goehl, DC, MS

A green foam roller isolated on white with natural shadows. Foam

Any regular gym goer has come to encounter the dreaded “stretching area,” filled with mats, bands, machines, and those odd cylindrical objects that mimic modern torture devices. Those cylindrical objects are foam rollers, coming in different shapes, sizes, textures, and materials. Let’s learn a little bit more about these devices and how they fit into your current exercise routine:

Types: Foam rollers can be made of foam, PVC piping, or hard rubber material and offer various textures. Different levels of firmness determine the intensity and type of therapy one receives.

Benefits: Best performed post physical activity as flexibility training and cool-down, foam rolling can decrease muscle soreness, including Delayed-Onset Muscle Soreness (DOMS) which can occur 24-72 hours post strenuous physical activity.

How it works: Foam rolling is a soft tissue treatment for trigger points (painful spots in the muscle) and tight muscles using a release technique similar to that of massage. Rolling targets fascia, the connective covering of your muscles, to break up any adhesions and increase blood flow to the area, decreasing pain while improving flexibility and overall function.

Best Practices: The intensity of the exercise is completely controlled by the amount of weight you apply to the area while rolling. Use upper and lower body strength to regulate. When rolling, focus on slow controlled movements that reach the entire length or width of the muscle.

With these tips and a little bit of practice, you are ready to navigate the once scary stretching area with ease.

Multi-Society Pain Workgroup Successfully Preserves Popular Treatment

Last month The Multi-Society Pain Workgroup, a coalition of 15 societies, attended hearings held by the Washington State Health Care Authority’s Health Technology Clinical Committee. The Workgroup successfully argued that coverage should continue for spinal injections, a common back pain treatment. This decision is being praised as a win for back pain patients. For full coverage, visit Pain Medicine News.

SI Joint Pain

medically accurate illustration - painful sacroiliac jointRachel Cengia, PA-C

The sacroiliac (SI) joint can be a source of back pain for many patients. The joint is composed of the sacrum (bottom portion of the spine) and the iliac crest (part of your pelvis). The joint does not have a broad range of motion like other joints in the body. It does, however, use its limited motion to act as a shock absorber for stresses moving from your back to your pelvis.

It is believed that pain is most often caused by either increased motion or increased stress through the joint. This typically presents as low back pain localized to one or both sides. It can also cause pain into the buttock or even mimic “sciatic” pain shooting down the back of the leg. It often hurts to sit or stand for long periods with weight shifted to the affected side, and sleeping on the involved side can be painful as well.


How one orthopedic surgeon succeeded in Chicago’s most impoverished neighborhoods


Dr. Daniel Ivankovich has been named one of CNN’s Top 10 Heroes of the Year for his work in treating under-served low income Chicago patients. Dr. Ivankovich treats patients regardless of their ability to pay and cofounded the OnePatient Global Health Initiative, a nonprofit organization that has benefited more than 100,000 people.

For more information, visit:

Doctors Facing Higher Levels of Burnout

The New York Post published an article on findings from the Mayo Clinic that show physicians are increasingly stressed out. Between 2011 and 2014, the percentage of physicians who reported at least one symptom of professional burnout rose from 45% to 54%. To read the full study, visit Mayo Clinic Proceedings. To read an overview, visit the New York Post.

Majority of patients believe spine surgeons are fairly compensated, study finds: 5 things to know

In a University of Michigan study of patients’ understanding of their spine care providers’ compensation, patients got some right and some wrong. Patients accurately determined the procedures for which their surgeons received the highest reimbursement; however, they overestimated the amount of the reimbursements. Most patients also believed physicians received additional reimbursements for postoperative care. For an overview of the study, visit Beckers Spine.

Follow The Back Story on