Pain Center
Back Pain
The most common reason patients come to us — and where we have the most to offer.
Overview
Understanding back pain.
Back pain is the most common reason patients come to us, and the least useful diagnosis they arrive with. "Low back pain" names a location, not a cause. The lumbar spine has several structures that can generate pain independently — the disc and its vertebral endplates, the facet joints at the back of each segment, the sacroiliac joints at the base, and the nerve roots that exit between them. Each produces a recognizable pattern, and each responds to a different treatment.
That is why the first appointment is spent narrowing the field rather than reaching for a prescription. Where the pain sits, what provokes it, what relieves it, and what your imaging shows will usually shortlist one or two candidates. A diagnostic block then confirms which one is doing the talking. Only after that do we recommend a procedure — because a facet-mediated back is treated very differently from a vertebrogenic one, and the wrong procedure is not a small mistake.
Common Symptoms
- Localized low-back pain
- Pain radiating to the buttock or leg
- Pain with bending, twisting, or sitting
- Morning stiffness or pain after prolonged standing
Common Causes
- Disc herniation or degenerative disc disease
- Facet joint arthropathy
- Sacroiliac joint dysfunction
- Vertebrogenic pain (Modic changes)
- Compression fractures
How we approach back pain.
Radiofrequency Ablation
Durable relief for confirmed facet- or SI-mediated pain.
Learn moreIntracept Procedure
Implant-free relief for vertebrogenic low-back pain.
Learn moreSpinal Cord Stimulation
For persistent axial back pain, post-surgical pain, or radicular pain.
Learn moreSI Joint Fusion
When diagnostic blocks confirm the sacroiliac joint as the pain source.
Learn moreMinuteman Lumbar Fusion
Posterior, minimally invasive stabilization when imaging shows a lumbar segment that would benefit from it.
Learn moreKyphoplasty
Stabilizes a painful vertebral compression fracture.
Learn moreDiagnosis & workup
- Detailed history — where the pain sits, what provokes it, and whether it radiates below the knee.
- Physical exam including range of motion, provocative facet and SI maneuvers, and a neurologic screen.
- Review of existing imaging; MRI when the pattern suggests disc, nerve, or endplate involvement.
- Diagnostic medial branch blocks when facet-mediated pain is suspected — two separate blocks are required before radiofrequency ablation.
- Diagnostic sacroiliac injection when pain localizes to the buttock and provocative testing is positive.
When to see a specialist
- Back pain past 6 weeks despite physical therapy, activity modification, and oral medication.
- Pain radiating into the leg, or numbness and weakness anywhere below the waist.
- Pain that wakes you at night or prevents a full day of work.
- A prior spine surgery that helped less than expected, or not at all.
- Back pain with fever, unexplained weight loss, or bowel or bladder change — seek care immediately.
What to expect over time.
Timelines depend entirely on the source. Facet-mediated pain confirmed on two diagnostic blocks is treated with radiofrequency ablation: the procedure itself takes about 15 minutes, most patients return to light activity the next day, and full benefit is reached at about the 6-week mark, commonly lasting 6 to 18 months and repeatable. Vertebrogenic pain treated with Intracept follows a different arc — light activity within a day or two, and most patients back to work inside two weeks. Sacroiliac pain that has failed conservative care may lead to SI joint fusion, where most patients walk unassisted the same day and reach full activity between 6 and 12 weeks. We give you the timeline for your diagnosis, not an average.
Ready when you are.
Same-week consultations are typically available, and most major insurance is accepted.
Direct answers — no jargon.
If your question isn’t here, ask us at your consultation.
- No. Bring whatever imaging you already have and we will tell you whether more is needed. Imaging findings are common in people without pain, so an MRI is most useful once the exam has given us a specific question to ask of it.
How we treat back pain, differently.
There is no single back pain procedure, and any practice offering one is guessing. Dr. Baumgartner's approach is to name the pain generator before treating it — history, exam, imaging, and where needed a diagnostic block that has to actually confirm the hypothesis. It sometimes takes an extra visit. It also avoids the far more expensive mistake of a well-executed procedure on the wrong structure.
Other conditions we treat.
See all conditionsSciatica
Radiating leg pain from compression or irritation of the sciatic nerve.Learn moreHerniated Discs
When the soft inner disc material pushes through the outer wall and irritates a nerve.Learn moreSpinal Stenosis
Narrowing of the spinal canal that compresses nerves and limits walking.Learn moreNeck Pain
Precision care for the cervical spine — without rushing to surgery.Learn morePost-Surgical Pain
When surgery resolved the issue but pain remained — interventional options that can help.Learn moreMedically Reviewed
Reviewed by Edward Baumgartner Jr., MD · Last reviewed . Information on this page is not medical advice. Always consult your physician.
Ready When You Are
Get the care you deserve. Schedule your consultation today.
Two Houston-area locations. Same-week consults available. Most insurance accepted.