Informative Website on Back Pain

A very informative website on back pain. Topics covered include: prevention of back pain, back and neck pain treatment options, back exercises (in the tutorials section), videos. The website is a service of the U.S. National Library of Medicine and the National Institutes of Health. Visitors can click on the "español" tab at the top left of the screen to view the contents in Spanish.

The website is MedlinePlus.

Lower Back Pain Generators - The Origin of Lower Back Pain

There are many reasons for lower back pain. The lower back is defined by the lumbar region of the spine. There are five lumbar vertebral levels and back pain can come from any of those levels. Studies have shown that there are approximately twenty pain generators at each level of the spine. So, twenty generators at five lumbar levels would make it one hundred pain generators.

The sources of lower back pain include, just to name a few:

• The skin
• The different muscles
• Different ligaments of the spine
• The vertebral bones
• Facet joints
• Nerve roots
• Lumbar disc herniations / herniated discs

Most of the time, back pain does not come from one single source, but rather from several sources. For example, when an elderly individual twists his/her back. He/she may be getting the back pain from arthritis from the facet joints, degeneration of the discs and the pulled muscle. Typically, a lumbar strain will resolve on its own within a few weeks and up to three month (even if one doesn't do anything about it). However, if the pain persists for longer than that, the individual should get evaluation and treatment from a pain doctor / pain physician who specializes in spinal injuries. These pain specialists can frequently help in determining the source of back pain by conducting the necessary workup and provide the appropriate pain relief treatments. These pain relief treatments can range from physical therapy, pain medications, trigger point injections, epidural injections, facet joint injections, acupuncture (accupuncture), and even surgery. Obviously, this is not a complete list of pain treatment options. I would recommend individuals with persistent back pain to seek treatment from a qualified Pain Management / Pain Medicine / Interventional Pain Management / Physical Medicine and Rehabilitation (Physiatry) doctor. One can find a pain specialist in the local phone book, through an online search, or talk to one's treating doctor.

Jackie Chan, MD, Modesto California
Board Certified in Pain Medicine
Board Certified in Physical Medicine and Rehabilitation
Board Certified in Electrodiagnostic Medicine


Reposted Dec 1,2019

Pain Management Specialty

The specialty of Pain Management is usually practiced by physicians with special training. Physicians who are board certified in Pain Management or Pain Medicine have to undergo additional training and testing. Actually, Pain Management or Pain Medicine is a sub-specialty; the doctor's primary specialty can be that of Physical Medicine and Rehabilitation (Physiatry), Neurology, or Anesthesiology. The doctor with board certification recognized by the American Board of Medical Specialties has the most stringent qualifications and requirements.

Some physicians may practice general pain management as well as interventional pain management. I, Jackie Chan MD, is board certified by the American Board of Physical Medicine and Rehabilitation (ABPM&R) and has a sub-specialty board certification in Pain Management / Pain Medicine granted by the ABPM&R which is recognized by the American Board of Medical Specialties. I currently practice both non-interventional and interventional Pain Management in Modesto, Califonia. I utilize both standard western approaches such as physical therapy, medications, soft tissue and spinal injections as well as alternative medicine such as acupuncture to manage pain. So make sure your doctor is board certified in Pain Management or Pain Medicine that is recognized by the American Board of Medical Specialties.

Please refer to pain management wikipedia link for more general information about pain.

Pain Management Conditions and Techniques

Pain conditions most frequently seen at my office include the followings:

• Industrial injuries
• Disk herniation and other spinal disorders
• Back and neck pain
• Radiculopathy (pinched nerves)
• Carpel Tunnel Syndrome
• Cumulative Stress Injury
• Joint Injuries (ankle, elbow, knee, shoulder)
• Sprains or Strains
• Arthritis
• Bursitis / Tendonitis
• Tennis Elbow
• Sciatica

As a pain doctor, pain management techniques used to treat some of the conditions listed above would include:

• Local injections
• Epidural injections
• Facet joint injections
• SI joint injections
• Medical acupuncture
• Physical therapies
• Medications
• BOTOX injections
• Nerve blocks
• Radiofrequency nerve lesioning
• Surgeries