When Back Pain Won’t Go Away: Why an Expert Evaluation Matters
Dec 16, 2025
Back pain is one of the most common reasons people seek medical care, and nearly everyone experiences it at some point in life. For many, the pain improves with rest, activity modification, or basic treatment.
But when back pain doesn’t go away — or keeps coming back — it’s often a sign that a specific structure in the spine is irritated or damaged.
At Palm Beach Pain Institute in Delray Beach, Florida, board-certified pain management physician Marcie Merson, MD, specializes in identifying the exact source of persistent back pain and treating it with targeted, nonsurgical solutions.
Understanding why your back hurts is the first step toward lasting relief.
The spine is a complex structure composed of bones, discs, joints, nerves, ligaments, and muscles, all of which work together to support movement and stability.
Pain can arise from any one of these components, and many spinal conditions produce overlapping symptoms. This makes it easy to misidentify the cause and pursue treatments that don’t fully address the problem.
An expert evaluation focuses on determining which structure is responsible for your pain and how best to treat it.
Discs act as cushions between the vertebrae. When they bulge, herniate, or degenerate, they can irritate nearby nerves, causing localized back pain or pain that radiates into the arms or legs.
These small joints connect the vertebrae and guide spinal movement. Arthritis or inflammation in the facet joints can cause stiffness, aching pain, and discomfort that worsens with twisting or bending.
Compressed or irritated nerves can result from disc problems, bone spurs, or spinal stenosis. Nerve pain often feels sharp, burning, tingling, or shooting and may travel down the arms or legs.
Strains, overuse injuries, and poor posture can stress the muscles and ligaments that support the spine. While many muscle-related issues heal on their own, ongoing strain can contribute to chronic pain patterns.
Located where the spine meets the pelvis, the SI joints absorb force during walking and lifting. Dysfunction here can cause lower back pain that radiates into the hips or buttocks and is often mistaken for disc-related pain.
Persistent back pain rarely responds to a one-size-fits-all approach. An accurate diagnosis allows your pain specialist to tailor treatment to the specific structure causing your symptoms.
During an evaluation, Dr. Merson considers:
This detailed assessment helps rule out less serious causes while identifying conditions that benefit from targeted intervention.
Many chronic back pain conditions can be treated without surgery. Depending on your diagnosis, treatment options may include:
Corticosteroid or anesthetic injections can reduce inflammation and calm irritated nerves or joints. These may include facet joint injections, SI joint injections, or trigger point injections.
Epidurals deliver anti-inflammatory medication directly around spinal nerves, helping relieve pain caused by disc herniation, spinal stenosis, or nerve compression.
For patients who don’t respond to conservative care, advanced interventional techniques — such as radiofrequency ablation — may provide longer-lasting pain relief by interrupting pain signals.
Strengthening, flexibility, and movement-based therapies often complement interventional treatments, helping improve function and reduce future flare-ups.
You should consider a professional evaluation if your back pain:
Ignoring ongoing pain can allow inflammation or nerve irritation to progress, making treatment more complex later.
Back pain that won’t go away isn’t something you have to live with. With the right diagnosis and a personalized treatment plan, many patients experience meaningful improvement without surgery.
Dr. Marcie Merson brings years of experience treating complex spinal pain conditions using evidence-based, minimally invasive techniques.
To find out what’s really causing your back pain, call Palm Beach Pain Institute at 561-499-7020, or schedule an appointment online. An expert evaluation could be the key to getting your life and movement back.