For persistent pain, assistance from a rheumatologist should be obtained. Treatment should be directed at the specific cause of pain. Management techniques include analgesics, anti-inflammatories, antidepressants, muscle relaxants and rehabilitation exercises. Mechanical back supports are usually recommended for limited periods of time in certain situations, such as post-operative patients. If these techniques fail within a reasonable time, injections with local anesthetics and steroids can be helpful.
Surgery can be very helpful when comprehensive nonoperative therapy fails.
Physical and occupational therapy are important forms of treatment. Since surgery is indicated for only a small percentage of patients, it is likely that a rheumatologist can significantly reduce the cost of back pain by reducing hospitalization, expensive imaging procedures, excessive physical therapy visits and surgery. If you want to find a rheumatologist in your area, check the American College of Rheumatology membership directory .