Back pain affects a large number of adults at some time in their lives. In most instances the episodes are short-lived and resolve on their own. However some individuals may develop chronic back pain (pain that lasts for more than 12 weeks). Back pain is rarely a sign of serious medical illness. Serious causes of chronic back pain may include spinal cord compression, metastatic cancer, and infection such as a spinal epidural abscess or vertebral osteomyelitis. Other less serious causes may include vertebral compression fracture, spinal nerve root compression, lumbar spinal stenosis, spondyloarthritis, osteoarthritis, and scoliosis.
The clinical evaluation of chronic back pain requires a history and examination for symptoms or signs that may help direct the need for laboratory testing and imaging. Patients with chronic back pain usually require imaging with a plain radiograph. Imaging findings often show abnormal findings, even in adults without back pain. This makes it difficult to determine which imaging findings are clinically important. Osteoarthritic changes are commonly seen on imaging but do not necessarily correlate with back pain and even when changes are consistent with the clinical presentation, the extent of radiographic changes do not always correlate with clinical severity.
The goal of treating chronic back pain is to minimize pain, maintain function, maximize coping and prevent disability. Treatment is individualized based on the cause of back pain. Conservative options may include psychological and mind-body therapies, spinal manipulation, supervised physical therapy, acupuncture and massage therapy. For more severe symptoms pharmacologic options may include topical analgesic gels or patches, acetaminophen, NSAIDS, muscle relaxants, and selective-serotonin reuptake inhibitors. Opioids may be used for short term improvement in pain or function but should not be used routinely for the management of chronic back pain due to their modest efficacy and the potential for harm. For patients in whom medical management is ineffective or inadequate, surgery may be an option.
Dr. Marc Phillpotts
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I've been going to Dr. Mehta for several years and have been extremely happy with the care and treatment he's provided. He's helped me get my lupus under control and I have been feeling great. I appreciate Dr. Mehta listening to what I need and making sure everything is in check.
Dr. Philpotts is very attentive, thorough caring and listens to all my mom's concerns. If it wasn’t for him we wouldn’t have found the diagnoses for my mom and get her the care she needs. The office is always clean and the staff is always friendly and welcoming. I’ve heard horror stories from people about their Rheumatologist. But, I will definitely say going to Southland Arthritis and seeing Dr. Philpotts is a breath of fresh air and we’ll continue to get treatment here for the foreseeable future. Thank you for all that you do for your patients.
Everyone here was wonderful – from the front desk, to Dr. Bravo and her assistant. They all put me at ease. Dr. Bravo explained my lab results in both technical terms and in terms a lay person would understand. Wait times were short. This doctor visit was a very pleasant experience all round.
Dr. Trivedi is the best doctor I've been to since as long as I can remember. She is so kind, informative, thorough and most importantly genuine and caring. Unfortunately, finding a doctor this amazing is so rare and I am extremely happy to have found her! I feel so comfortable and taken care of. Thank you for being awesome Dr. Trivedi. You most definitely change lives for the better.
Dr Panikkath and staff are very friendly and professional. Dr Panikkath dedicated time and answered all my questions and explained thoroughly. Had a pleasant experience. Would recommend this specialist to anyone.
Southland Arthritis is a great office. Dr Ramaswamy is great! He really listens to you and does whatever is needed to treat your symptoms. His staff is wonderful! Always so helpful and professional. I would recommend them to everyone!
Dr Colburn is amazing and very thorough. He knows his stuff and is always helpful. Definitely listens to his patients.
I absolutely recommend this clinic to everyone suffering from RA. My husband started seeing Dr Chavez in April of this year and I can honestly say I see a 75% improvement in his health. Dr Chavez is very proactive with her treatment plan, she is compassionate, professional and knowledgeable. Staff is very nice and professional as well.
The girls at the front desk are friendly and so helpful. Come to the back, and the medical assistants are also friendly. I have seen Angel Bustamante and he explains everything so well, answers any questions I may have. There is also minimal wait time! Definitely recommend!
Today I saw Lisa Asfahani. I was very impressed by her such a good listener and answered my questions and very informative. I look forward to being your patient. Thank you so much.
The Southland Arthritis medical group has been very good and professional to me. The doctors are very caring and knowledgeable. They really care and listen to your personal needs. I highly recommend this facility.
Dr. Marc Phillpotts is a board certified physician in Internal Medicine and Rheumatology. Dr. Phillpotts earned his medical degree at The University of the West Indies in Jamaica. He moved to Washington, DC where he completed Residency training in Internal Medicine at Howard University Hospital, then Fellowship training at the George Washington University. He has held an academic position as an Assistant Professor of Medicine at the GW SMHS. He is a member of several professional societies including the American Medical Association, International Society of Clinical Densitometry and American College of Rheumatology. Dr. Phillpotts has expertise in musculoskeletal ultrasound and bone densitometry. In his spare time, Dr. Phillpotts enjoys running, swimming and tennis.
Dr Amal Mehta is a very compassionate and professional doctor. He takes the time to listen to you. He also takes the time to explain things in a way you can understand. I've never felt rushed during a visit. It's been my experience in California that good drs are hard to come by. Dr Mehta is an exception. I highly recommend him.