Scott Webb (Host): If you're like me, you suffer from back pain and wonder if there's anything you can do to get some relief from your pain and improve your quality of life. I'm joined today by Dr. Mayank Patel. He's a Primary Care Physician with Emerson Health Primary Care Concord, and he's here today to discuss back pain and how we can help. This is the HealthWorks Here podcast from Emerson Health. I'm Scott Webb. Doctor, thanks so much for being here.

Mayank Patel, MD: Thanks, Scott. Great to be here.

Host: When should I worry about back pain? Like, should I be worried right now that my back hurts even though I'm not doing anything? Like, give us your expert opinion here. When should we worry?

Mayank Patel, MD: There are several factors that we tend to look into when we are dealing with back pain. It's what we call red flag symptoms. Some of these red flag symptoms include like if you have history of cancer, let's say, if you've had significant weight loss in the last few weeks or a few months or so, if you were dealing with any recent infections, changes in bowel or bladder functions, like for instance, are you having urinary incontinence, are you not able to hold in your urine or hold in your poop?

Well, that's a problem in conjunction with this back pain. If you're having neurological symptoms where the pain is shooting down your legs, that's something where you should talk to your primary care doctor and get this further checked out.

Host: Okay, so reading between the lines here, some back pain is quote unquote normal, right? And some of it may be more concerning. That's maybe a time to reach out to our provider. Is there anything that we can do? Like, I know, doctor, if I have to cut the grass and weed whack and do my house chores, I just know that I'm going to suffer for it afterwards, but it's got to get done. What are you going to do, right? But in general, what can we do to reduce back pain?

Mayank Patel, MD: In general, exercising, stretching, maintaining good posture. You see how I'm sitting right here? Um, trying to maintain my posture. That's part of the work, but that we put in for uh, managing back pain and having good health, long healthy life, minimizing pain, chronic pain, physical therapy, pain meds, mindfulness, relaxation techniques.

All of these tend to help. And then also sleeping in a good position. We don't value that as much, but that is also one of the important factors that I feel helps manage long term back pain and a quicker onset of recovery.

Host: You mentioned physical therapy there. What about physical therapy, spine injections, things like that? Do those help?

Mayank Patel, MD: They do, but it's more like, we start off conservative and then we start going into more specifics and more tailored treatment plans for patients. Cause one size doesn't fit all. So, some people who are not able to do well with physical therapy, that's where we start discussing other options for pain management, whether you need pain medicine, whether we need to do spinal injections, whether we need to do cognitive behavior therapy et cetera, or even discuss surgery as a last option.

Host: Just want to get a sense of your personal experiences with back pain and how that then helps you relate to patients.

Mayank Patel, MD: I've had chronic back pain, as well, and this was during my med school years. It was devastating trying to sit through an eight hour licensing exam, multiple licensing exams, and being in pain from sitting; so that was an eye opener for me. Just being able to go through this whole process of physical therapy, diagnosis, seeing specialists, spinal injections, chiropractor, acupuncture, all of that, having been through it myself; this helps me connect better with my patients at a deeper level, and when we connect at that deeper level, it helps build the foundation and be able to guide them through their journey to their recovery.

Host: Yeah, one of my best friends, Doctor, I hate to admit this publicly, but one of my best friends is my heating pad. You know, sort of the nature of being in our fifties and everything hurts, you know, just watching our daughter play basketball for two hours. My back will hurt because I'm sitting in the stands, you know? So, I'm sure that's a comfort to patients to speak with somebody who's like, yeah, been there, done that. Here's what I've tried. These things might work for you. Maybe this is the 64,000 dollar question, Doctor, but does back pain ever really go away? Do we ever get to a point, you know, I'm 56. Will I get to a point where at some point in my life where I'm like, yep, I feel great, my back doesn't hurt. Does that ever happen?

Mayank Patel, MD: It certainly can.

Host: Okay.

Mayank Patel, MD: But the thing is that it takes work. Nothing goes away completely. At least that's what I feel with the chronic back pains. Chronic back pains takes work. It takes a lot of effort from a person, like for me, for instance, I stretch regularly every single day, working on my hamstrings, working on my core strength, working on my posture, working on different sets of exercises.

And this has kept me pain free for the last eight years. Now, would I say that the back pain is completely gone? I know it comes back, unfortunately. Like, for instance, if I take a vacation where I am not doing any of those above things that I just mentioned, I will start having some pain shooting down my leg.

And then I realize that as soon as I start stretching again, within two to three days, the pain goes away. So, that's what I would say, that all of this requires work. Being pain free, also requires work and that's something that I would highly encourage and set the expectation for all my chronic pain patients. And setting those expectations early on also helps understand how the recovery process will go.

Host: Right. In other words, there's no magic pill. You know, you are an expert, but not a magician. We have to do some of this work ourselves, right? Just want to give you a chance here at the end. This has been good stuff. Just, talk about yourself a little bit. Like, what do you enjoy about the work that you do and working with patients?

Mayank Patel, MD: I enjoy the success stories. Like, every doctor yes, we want to help patients. We want our patients to feel better. But then um, the one that gives me the highest kick is when I've helped a patient and they come back and tell me how whatever we discussed, approaches that we took, the specialists that we saw; helped them make a complete recovery and are now leading very healthy lives and are happier with their current diagnosis and current treatment plans.

That's essentially what I look for in everyday relationships with my patients.

Host: Yeah, it does seem, and I hear that a lot from providers, especially at Emerson Health, that smiles on faces, people walking around pain free, hugging you doctors, saying thank you so much, you've changed my life. I'm sure you've had a few of those, right?

Mayank Patel, MD: Yes.

Host: Yes of course. Well, it's been a pleasure having you here, learning from you, thank you so much.

Mayank Patel, MD: You're welcome.

Host: And visit EmersonDocs.org or call 978-287-7495 to make an appointment with Dr. Patel. And thanks for listening to Emerson's HealthWorks Here podcast. I'm Scott Webb, and make sure to catch the next episode by subscribing to the HealthWorks Here podcast on Apple, Google, Spotify, or wherever podcasts can be heard.