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Your First Clinic Visit for Spinal Pain

Spinal pain is one of the most common reasons for doctor visits. It can be a challenge to diagnose and treat because it is often a non-specific pain. During your first clinic visit for spinal pain, your Allina Medical Clinic provider will talk with you about a number of things related to your condition and its treatment. Here is what to expect:

• Your provider will try to rule out what isn’t causing your spinal pain.
  The cause of non-specific spinal pain can be very hard to pinpoint. Your provider will look at your medical history and do a physical exam. He or she will want to rule out such sources of pain as:
  - tumors
  - infections
  - fractures or dislocations
  - surgical problems
  - serious illnesses.
  
  
• Your provider will give you information (a theory) about your spinal pain rather than a diagnosis for it.
  This will help prevent confusion if you should see another provider. Otherwise you could end up with more than one “diagnosis” for the same thing. 
  
  
• Your provider will explain how he or she treats spinal pain.
  Most spinal pain cases resolve themselves in a short time (a few weeks) naturally or with active treatment. Sometimes passive treatments or physical therapy are also helpful to relieve pain.
  - Active treatment: your provider will help you continue your daily routine as much as possible (be mobile). Research shows:
  • People who are mobile heal much faster than people who are inactive.
  • People with other situations such as heart surgery or joint replacement exercise as soon as possible. Normally they are active the first or second day after surgery.
  • Body parts that are inactive lose mobility and function rapidly. This results in more pain. The cycle can lead to chronic (long-term) pain.
  • If mobility hurts, it doesn’t mean it is harmful.
  - Passive treatment: your provider may prescribe some kind of treatment to relieve your spinal pain or other symptoms. There are several kinds of passive treatments:
  • heat, ultrasound, massage
  • spinal manipulation or adjustment
  • medicines – pills or injections
  • acupressure or acupuncture
  • TENS units, muscle stimulation, traction

Passive treatment does not heal or cure your back problem. If you have physical therapy appointments, you may receive some passive treatments during those appointments. 

• Your provider will talk about medicines to relieve your pain.
  - The over-the-counter medicine acetaminophen (such as Tylenol®) seems to work as well as anything to reduce spinal pain.
  - If your provider prescribes a mood-altering drug , it will be for a specific length of time. Examples of mood-altering drugs include muscle relaxants, narcotic pain medicine and codeine. 
  
  
• Your provider will explain when diagnostic imaging would be helpful in treating non-specific spinal pain.
  Diagnostic imaging in normally used only if:
  - You have signs or symptoms of a serious medical condition besides your spinal pain.
  - You are younger than age 20 and your condition has not responded to treatment or it gets worse.
  - You have either chronic spinal pain that reduces your quality of life or a herniated disc that has not responded to treatment and you agree to surgery if imaging shows a need for it.
  
  
• Your provider will talk with you about activity levels for home and work.
  He or she will determine what level of activity is safe for you by:
  - giving you a physical exam
  - reviewing your medical history and any prior treatments you’ve had for spinal pain.
  
  
• If you are a worker’s compensation patient, your provider will explain the return-to-work policy if your pain is related to work activities.
  - An early return to activities will help you heal faster.
  - You may be recommended for return to work before you are pain-free.
  - Returning to work is safe, even if you still feel some pain.