A Careful Approach to Back & Spine Pain

Ian Wattenmaker, MD, an orthopedic doctor and spine surgeon at Inova Loudoun Hospital, emphasizes the hospital’s evidence-based approach to spine pain management.

“I am very thoughtful and deliberate in my approach to figuring out exactly why a person is in pain,” he says. “When a person has symptoms, such as pain, numbness or weakness, what we do is carefully correlate their symptoms with physical examination findings, imaging studies and their personal history. These components are assembled like a puzzle to find the cause.”

Dr. Wattenmaker avoids prescribing or suggesting one treatment to fit all circumstances. Often physicians will ascribe symptoms to a non-problematic, incidental imaging finding and treat with oral narcotics, injections or surgery. Even when a disc herniation is causing back pain or lower extremity pain, he notes, a doctor must be careful not to overtreat it, as in 85 percent of cases, the pain will be gone within three months with no treatment whatsoever.

“The average adult is not going to have a ‘normal’ spine on an MRI,” he says. “When it comes to routine back pain, it’s important to know how common it is. It affects close to 90 percent of people in their lifetime. You have to be careful not to overtreat it.”

This is why Dr. Wattenmaker stresses coming to an evidence-based diagnosis. That way he knows that whatever treatment he prescribes — whether it is surgery, responsible use of narcotics, or other medications or injections — it is the right treatment for that patient.

Learn more about Inova’s back pain and spine services at inova.org/spine