Milwaukee Back Pain Specialists

The back and spine are finely coordinated units made up of many small joints, muscles, ligaments and nerve tissues. The pelvis is designed to connect the upper and lower bodies. It must support the upper body while still providing mobility and flexibility to the lower extremities. When used improperly or injured, symptoms develop. Back pain can be intense and limit your mobility. Dr. Neal Pollack, Milwaukee’s pain specialist, offers several non-surgical treatment options for patients with back pain.

There are many causes of back and spine pain. Finding the source of your chronic pain will make treatment easier. Common conditions include:

  • Chronic low back pain
  • Degenerative disc disease
  • Disc herniation
  • Sacroiliac pain
  • Spinal stenosis
  • Piriformis syndrome

Chronic Low Back Pain

Acute pain is usually due to strains and sprains that frequently resolve on their own. If pain continues, it is classified as chronic and may sensitize the nervous system which increases pain intensity.


  • Mild to severe pain anywhere along the back
  • Radiating pain into the arms or legs
  • Weakness

In addition to sprains and strains these additional issues can cause pain:

  • Disc degeneration
  • Osteoarthritis
  • Myofascial pain
  • Fracture
  • Scoliosis
  • Radiculopathy

Degenerative Disc Disease

As we age, degeneration occurs. The spine contains discs which have padding between them.  Disc water dries up and leads to changes in our bones, ligaments, nerves and muscles. This process is intensified by trauma, genetic predisposition and smoking.

Symptoms & signs include:

  • Pain
  • Loss of flexibility
  • Muscle spasm
  • Extremity numbness

Disc Herniation (Slipped Disc)

Bulging and herniated discs are common occurrences with varying degrees of symptoms. They are caused when the soft ring between the spinal discs tears. These injuries are exacerbated by poor mechanics, repetitive strains and trauma. The resulting pain is due to nerve compression from discs colliding.

Symptoms & signs include:

  • Pain in spine, arm or leg
  • Increased pain from neck & leg movements
  • Numbness in the extremities
  • Reflex changes

Other diseases that can mimic a disc herniation include:

  • Fracture
  • Infection
  • Neoplasm
  • Stenosis
  • Shoulder osteoarthritis
  • Hip osteoarthritis
  • Sacroiliac joint dysfunction
  • Spinal stenosis
  • Spondylosis

Sacroiliac Pain and Sciatica

The sacroiliac joint links the spine to the lower extremities. The joint is stabilized by the ligaments which connect to the pelvic bone. It is thought to be the cause of up to 30% of chronic low back pain cases but it is often not considered in the assessment.  Unfortunately, one third of lumbosacral spinal fusion patients also develop sacroiliac joint pain.


  • Pain may be felt in the buttocks, lower back, groin, abdomen, lower leg and foot
  • The pain is often on one side
  • The pain is often worsened with entering or exiting a car
  • Often a pop is heard that results in pain relief



Other diseases that are in the differential diagnosis include:

  • Ankylosing spondylitis
  • Lumbar disc pain
  • Hip osteoarthritis
  • Malignancy
  • Myofascial pain
  • Radiculopathy
  • Referred visceral pain
  • Rheumatoid arthritis
  • Trochanteric bursitis
  • Facet joint pain

Spinal Stenosis

Spinal stenosis is a narrowing of the central spinal canal. It often presents with radiating pain and mild back pain. It can be due to arthritic changes or genetic predisposition. The chance of this condition occurring can increase with age, often presenting after age 50. The natural course of stenosis is often stable symptoms with no deterioration based on a 4 year prospective trial. Unfortunately, exacerbations can be very painful. The symptoms of stenosis are thought to be related to mechanical compression of the neural fibers or reduced blood flow to the nerves.


  • Progressive weakness
  • Progressive numbness and tingling
  • Pseudoclaudication (neurogenic claudication) describes buttock, thigh, and leg pain that is worsened by walking or standing and improved with sitting

Other conditions that mimic stenosis:

  • Lateral recess stenosis
  • Radiculopathy
  • Malignancy
  • Trauma
  • Piriformis

Piriformis Syndrome

Piriformis syndrome is sciatica-like pain due to impingement of the sciatic nerve as it courses through the piriformis muscle. The incidence is thought to be 6% to 8% of all low back pain cases and is most often noted in the 30 to 40 year old age group. The piriformis muscle is the largest of the short external rotators of the hip. It originates from the second to fourth sacral vertebrae, travels through the sciatic notch before inserting on the upper portion of the greater trochanter the sciatic nerve courses differently through the piriformis muscle and contraction of the muscle causes sciatica. Activities that can worsen the pain include arising from a chair, walking up the stairs or standing for a long period of time. Any activity that increases hip external rotation can increase the pain. The main symptom produce is buttock and leg pain.

There are other diseases that can mimic piriformis syndrome:

  • Endometriosis
  • Herniated disc
  • Hip joint pain
  • Pelvic tumors
  • Sacroiliac joint dysfunction
  • Spinal stenosis
  • Spondylosis

Back Pain Treatment

Your specific condition will be determined by a detailed medical history, extensive medical examination and appropriate diagnostic studies. Combinations of conventional and alternative therapies will be used to relieve your pain. Call us at 414-453-7780.

For back pain relief, contact our Milwaukee pain treatment center today to find a non-surgical and effective treatment for you.

See also “How Spinal Decompression Can Relieve Your Back Pain

For back pain relief, contact our Milwaukee pain treatment center today at 414-453-7780.

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