Common causes of lower back pain
- Muscle or ligament strain from lifting, twisting or sudden movement
- Degenerative disc disease and facet joint arthritis
- Herniated disc, especially when pain travels down the leg
- Spinal stenosis and spondylolisthesis
- Vertebral compression fractures, especially with osteoporosis
- Adult scoliosis and spinal deformity
When to see a spine specialist
Make an appointment if your back pain:
- Lasts longer than six weeks despite rest and over-the-counter care
- Travels below the knee or comes with numbness, tingling or weakness
- Follows a fall, car accident or other trauma
- Wakes you at night or comes with fever or unexplained weight loss
Our approach
Dr. Ferachi's evaluation focuses on finding a specific, treatable cause. That means a careful history, a hands-on exam, and imaging only when it will change the plan. Treatment is matched to the diagnosis:
- Active care: education, activity guidance and a physical therapy program focused on core strength and mobility.
- Medication: short-term anti-inflammatories or muscle relaxants when appropriate.
- Targeted injections: epidural, facet or medial branch injections to both diagnose and treat pain generators.
- Surgery only when there is a clear structural problem, such as nerve compression or instability, that matches your symptoms and hasn't responded to conservative care.
Surgery for back pain alone, without nerve compression or instability, has more modest results, and Dr. Ferachi will be direct with you about whether an operation is likely to help.
Common questions
Do I need an MRI for back pain?
Not usually at first. Guidelines recommend imaging when pain persists beyond about six weeks, when there are nerve symptoms or red flags, or when injections or surgery are being considered.
Will I need surgery for my back pain?
Most patients do not. The majority of people Dr. Ferachi sees for back pain are treated with therapy, medication or injections. Surgery is an option when a specific structural problem is confirmed and conservative care hasn't worked.