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Chronic back pain is often highly subjective and difficult to diagnosis, especially if there’s not a clear cause. Even when back pain is due to a herniated disc or fractured vertebra, two people with the same condition may report very different symptoms. For this reason, the management of chronic back pain needs to be highly personalized. Determining an appropriate treatment plan requires consideration of several important factors.

When Is Pain Experienced?

Defined as pain lasting six months or more, chronic pain can present itself in many different ways. Some people will have back pain that’s worse in the morning, which is sometimes related to sleeping positions. Other people will have periods of relief followed by back pain that lasts for days before going away again without any clear reason. Patients are encouraged to be as descriptive as possible so possible sources of discomfort can be identified based on pain patterns.

Where Is Pain Felt?

Chronic back pain isn’t always relegated to the affected area of the back. Since lingering discomfort often affects nerves, radiating pain is frequently experienced. With sciatic nerve pain, for instance, some degree of discomfort may be felt in the hips, thighs, or lower legs. If the upper or middle parts of the back are affected, pain may extend to the shoulders, neck, or arms. Radiating pain is often effectively managed once the actual source of nerve compression is discovered.

What’s Making It Worse or Better?

Diagnosing and managing chronic back pain is often a process of elimination. Patients can play an important role in determining what treatments will likely be effective by discussing what seems to make their pain worse and what makes it better. Symptoms associated with spinal stenosis, for instance, often go away when sitting or lying down or leaning forward.

Are There Any Underlying Conditions?

Chronic back pain can be affected by any number of conditions that existed before back pain became a problem. High blood pressure and diabetes, in particular, can contribute to inflammation and affect blood flow to tissues in and around the spine. This is why keeping underlying conditions under control often helps with pain management.

Successful management of chronic back pain usually involves a combination of treatments, techniques, and therapies. Some patients benefit from injections that immediately minimize pain to allow for active participation in physical therapy while others experience meaningful results from muscle strengthening exercises and taking steps to improve posture and modify activities that often trigger pain.

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