Chronic Back Pain: Finding the Source Before Chasing Symptoms

Back pain is rarely explained by a single injury, and imaging findings don’t always match the pain. The first step toward lasting relief is identifying what is actually generating it.

Back pain is one of the most common reasons people seek care, and it is rarely the result of a single injury. Herniated and bulging discs, along with other “abnormal” spinal findings, appear on imaging in large numbers of people who have never had significant back pain. The practical takeaway is one Dr. Borys returns to often: a scan finding is not the same as a pain generator.

Why the Diagnosis Comes First

Because a disc bulge on an MRI may or may not be the actual source of pain, effective treatment depends on identifying which structure is driving the symptoms — a facet joint, a disc, a ligament, an irritated nerve, or a muscular pattern. Dr. Borys uses history, a focused exam, and diagnostic ultrasound where appropriate to find the pain generator rather than treating an imaging report. Matching the treatment to that diagnosis is what separates lasting relief from a temporary fix.

Supporting Recovery at Home

Once a clear diagnosis is in place, day-to-day habits can meaningfully support recovery. The nervous system plays a real role in how spinal pain is experienced, so the goal is to keep the back moving and the system calm — these measures complement a diagnosis, they don’t replace one.

• Keep moving: spines that stay still become stiff and more pain-prone. Short, frequent walks restore movement and bring blood flow to the tissues.
• Stay hydrated: spinal discs are largely water, and good hydration supports both disc health and muscle recovery.
• Calm the nervous system: sleep, stress management, and mindfulness measurably help chronic low back pain — a JAMA trial found mindfulness-based stress reduction outperformed usual medical care alone.

When to Get Evaluated

Pain that persists beyond a few weeks, keeps returning, or limits daily life is worth evaluating rather than guessing at. An assessment with Dr. Borys can pinpoint the source and clarify which options — from targeted rehab to regenerative injections — actually fit the problem.