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A Better Approach to Lower Back Pain

Back pain is common. Unfortunately, successful evidence-based treatment is not.

"Those with acute back pain often end up seeing multiple doctors, waiting for imaging that offers little or no useful information, and pursuing solutions with no proven benefit—all of which delays recovery," explains Natalia Covarrubias, MD, board-certified physical medicine and rehabilitation physician at St. Jude Centers for Rehabilitation.

The St. Jude Back Pain Program was created by a multidisciplinary team of clinicians to offer patients evidence-based care that avoids the delays and wrong-turns that often characterize treatment.

"For patients without neurological symptoms or other red flags, imaging is often not useful," she explains, pointing out that even among patients reporting no back pain, 80 percent of imaging is positive—leading to unnecessary and often unhelpful interventions. "By using research-based best practices, the program is creating high-value care that not only improves outcomes but increases patient satisfaction."

Getting the right diagnosis—quickly

Patients are first evaluated by a physical therapist who specializes in neck and back pain, often within 48 hours of referral. "Through a comprehensive spine exam we can identify the musculoskeletal dysfunction," explains Michael Heaton, MSPT, who says the program's team has developed and refined 15 distinct pathways for lumbar and cervical issues. "Treatment begins during the patient's first appointment."

The vast majority of patients, especially those with lower back pain, see their symptoms resolve through noninvasive therapies, which often go beyond traditional therapeutic exercise to include biofeedback, aquatic therapy, neuropsychology support, and a biomechanics class.

Making the next step the right one

If a patient doesn't respond or an underlying issue is identified, Dr. Covarrubias directs and coordinates the next steps, including a referral to a specialist or surgeon, advanced pain interventions, or additional testing.

"Having a board-certified rehabilitation physician oversee and 'quarter back' treatment offers a huge advantage to our patients," says Michael. "Her expertise allows patients to sidestep common mistakes, such as waiting for weeks to see the wrong specialty."

The program is located inside the St. Jude Centers for Rehabilitation and Wellness in Brea and as soon as a physician referral is sent, patients can call (714) 578-8720 to schedule an appointment. Services are covered by most insurance plans.

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