Doctor finds success in relieving back pain

Dr. Frank Jordan explains how pain affects the back.

Dr. Frank Jordan recalls a patient whose back pain was so severe her goal was to be able to get up and fix lunch. On a recent visit, she told him how she had spent three hours cooking dinner for her family.

“That’s a big improvement,” says Dr. Jordan. “She was in so much pain earlier, she couldn’t stand up.”

Treating back pain is a major part of Dr. Jordan’s pain management practice. This particular patient had severe spinal stenosis, a narrowing of the spinal column that can occur as people age. To help relieve her pain and improve her ability to function, Dr. Jordan inserted a spinal cord stimulator, a medical device that generates an electric impulse to produce a tingling sensation and alter the perception of the pain. It is just one of the techniques he has to treat severe chronic back pain.

He defines chronic back pain as sustained pain for three months. “A lot of my patients have had pain for years.”

There isn’t a magic cure for back pain, he says. It is a complex issue; the cause could be one of many factors, and even with the arsenal of treatment options he has, the realistic expectation is to reduce the patient’s pain by 50 percent.

“Reducing pain by 50 percent, however, can have a big improvement on a patient’s function and quality of life,” Dr. Jordan explained.

Most of his patients are referred to him because other options haven’t worked. Some patients refer themselves. “Many of my patients haven’t had much relief from the pain,” he said. “They’re hurting.”

The back pain could result from different problems, including disks, nerves, joints and muscles. “The difficult part of this whole job is evaluating and diagnosing the cause of the pain,” Dr. Jordan said. “It’s a diagnostic problem to figure out the cause of discomfort.”

Besides diagnostic tests like bone scans, CT scans and MRIs, Dr. Jordan relies on a physical diagnosis and his years of experience in treating back pain.

After several years as an anesthesiologist, Dr. Jordan did additional study in a pain management fellowship at Baylor Medical Center in Houston, Texas, to change the focus of his career. Today, he is board certified in internal medicine, anesthesiology and pain management.

In treating back pain, Dr. Jordan prescribes physical therapy; manual manipulation; exercise; lifestyle changes, such as losing weight or stopping smoking; pain medications; injections for joint, disk and nerve pain; and medical implants that mask pain, such as the one that helped the woman at the beginning of this story. An epidural injection in the spine, for example, delivers steroids that decrease lower back inflammation and thus reduce pain. A facet block can help to diagnose the specific source of nerve root pain and also reduce inflammation around the nerve root.

“Pain is a very personal issue,” he says. “Some tolerate it well, some don’t.” His goal, he adds, “is to try to give each patient substantial improvement in pain control.”