Most back pain is not dangerous, does not need an MRI, and gets better. The clinical work is separating that majority from the small number of cases that need something more — and then actually treating the pain rather than waiting it out. At Remix Medical in Houston, our board-certified pain physicians do both.
What is Back Pain?
Back pain is among the leading causes of doctor visits and disability worldwide. It can be sharp and short-lived or dull and persistent, and it can arise from muscle, disc, joint, nerve, or bone.
Most cases are what clinicians call non-specific: no single structure can be confidently blamed, and the pain improves with conservative care. That is genuinely good news, but it is not a reason to leave pain unmanaged for months.
What Causes Back Pain
1. Muscle and Ligament Strain
Heavy lifting, awkward movement, or sustained poor posture strains the soft tissue supporting the spine.
2. Disc Problems
A bulging or herniated disc can press on a nerve root, producing pain that radiates into the buttock or leg.
3. Facet Joint Arthritis
The small paired joints at the back of each spinal level develop arthritis with age, causing pain that worsens with extension and twisting.
4. Spinal Stenosis
Age-related narrowing of the spinal canal compresses nerves, classically producing leg pain that eases when you sit or lean forward.
5. Sacroiliac Joint Dysfunction
The joint where the spine meets the pelvis can refer pain into the low back and buttock.
6. Osteoporotic Fracture
Weakened bone can fracture in the spine with minimal trauma, particularly in older adults.
Obesity, smoking, deconditioning, workplace ergonomics, and stress-related muscle tension all raise the risk and slow recovery.
How Remix Medical Can Help
Evaluation begins with history and examination aimed at two questions: is there a red flag, and is there a nerve involved. Routine imaging is deliberately avoided for non-specific back pain without red flags, because degenerative findings are common in people with no pain at all and can send treatment in the wrong direction.
Treatment is then matched to what the examination actually found.
| Approach | What it involves |
|---|---|
| Staying active + physical therapy | Core stabilization and movement retraining — first-line, and more effective than rest |
| Medication management | Anti-inflammatories or a short course of muscle relaxant, preferred over opioids for back pain |
| Epidural steroid injections | Image-guided, for pain with a clear nerve-related component that hasn't settled with conservative care |
| Medial branch blocks and radiofrequency ablation | Diagnostic blocks confirm the facet joints as the source, and ablation provides durable relief when they do |
| Chiropractic and soft-tissue therapy | Available in-house alongside the therapy program |
| Surgical referral | Reserved for nerve compression causing weakness, or pain that fails everything else |