Back Pain

At Nucellin Orthopedic Clinic in Seoul, Dr. Heejun Kim personally assesses back pain through your symptoms, physical and neurologic examination, daily loading pattern and imaging when necessary.

A scan shows structure. It does not always explain pain.

The goal is to identify the source of symptoms and choose the least invasive treatment that can reasonably restore function.

Common Back Problems

Back pain may come from:

• Muscle or soft-tissue strain
• Disc irritation or herniation
• Facet-joint pain
• Sacroiliac-region pain
• Nerve-root irritation
• Spinal stenosis
• Age-related degeneration
• Previous injury or surgery

Symptoms such as pain extending into the buttock or leg, numbness, tingling, weakness or difficulty walking can provide important clues.

Not all radiating leg pain is true sciatica. Pain may also be referred from the facet joints, sacroiliac region, gluteal muscles, hip or upper hamstring.

Two people with similar MRI or X-ray findings may have very different symptoms. Imaging should therefore be interpreted together with the examination.

Diagnosis

Diagnosis begins with your history and a hands-on examination.

Dr. Kim may assess:

• Location and pattern of pain
• Spinal range of motion
• Muscle strength
• Sensation and reflexes
• Nerve-tension signs
• Hip and pelvic function
• Walking and balance
• Activities that reproduce symptoms

The purpose is not simply to identify an abnormality, but to determine whether it actually explains the patient’s symptoms.

Imaging

X-rays may be used to assess alignment, instability, advanced degeneration, fracture or previous surgery.

Musculoskeletal ultrasound may evaluate selected muscles, tendons and soft tissues around the lower back, hip and pelvis. It can also guide targeted procedures when appropriate.

MRI is not required for every episode of back pain. It may be recommended when there is persistent radiating pain, significant numbness or weakness, suspected spinal stenosis, or when the result would change the treatment plan.

If MRI is required, imaging can be arranged at a nearby radiology centre and reviewed by Dr. Kim.

Treatment

Treatment depends on the diagnosis, severity of the condition and your functional goals.

Options may include:

• Load modification and rehabilitation
• Regenerative Physical Therapy
• Shockwave Therapy for selected soft-tissue pain
• Medication when appropriate
• Ultrasound- or fluoroscopy-guided injections
• PDRN-based regenerative injections
• Medial branch block or epidural treatment when indicated
• Activated PRF Therapy
• Selected cell-based regenerative treatments
• Surgical referral when necessary

Treatment is introduced step by step. A procedure should not be selected simply because an X-ray or MRI shows degeneration.

The goal is not only to reduce pain, but to restore the capacity of the spine and surrounding tissues to tolerate daily load.

Learn more about Regenerative Physical Therapy →

Learn more about Shockwave Therapy →

Activated PRF

For selected patients with chronic facet-related pain, ligament or soft-tissue pain, or other appropriate spinal and surrounding tissue conditions, Dr. Kim may recommend Activated PRF Therapy.

Activated PRF is prepared from the patient’s own blood using Nucellin’s mechanically activated platelet- and fibrin-based protocol.

The treatment is intended to support the biologic environment around the affected tissue. It is not a routine cure for disc degeneration or significant nerve compression, and results vary according to the diagnosis and severity of the condition.

Learn more about Activated PRF Therapy →

Cell-Based Treatment

Selected patients with chronic degenerative spinal or surrounding musculoskeletal pain may be considered for autologous blood-, bone marrow- or adipose-derived cell-based treatment.

These treatments are not appropriate for every patient with back pain. They are not routine first-line treatments for non-specific back pain, severe spinal stenosis, major instability or significant nerve compression.

Suitability depends on the suspected pain source, neurologic findings, imaging, stage of degeneration, previous treatment and the patient’s goals. Current evidence for cell-based treatment in spinal conditions remains limited.

Learn more about Cell-Based Therapy →

When Surgery May Be Appropriate

Non-surgical treatment is not always the right answer.

A surgical opinion may be appropriate when there is:

• Progressive muscle weakness or foot drop
• Significant neurologic loss
• Severe nerve compression with persistent disabling symptoms
• Major spinal instability
• Fracture, infection or tumour
• Cauda equina syndrome
• Persistent pain and loss of function despite appropriate non-surgical treatment

The goal is not to avoid surgery at all costs, but to determine when non-surgical treatment is reasonable and when surgery may provide a better result.

When to Seek Medical Attention

Arrange an assessment if your back pain:

• Persists or repeatedly returns
• Extends into the buttock or leg
• Causes numbness, tingling or weakness
• Limits sitting, walking, work, exercise or sleep
• Is progressively worsening
• Has not improved despite previous treatment

Seek urgent medical care for new loss of bladder or bowel control, difficulty urinating, numbness around the groin or inner thighs, rapidly progressive leg weakness, new foot drop, severe pain with fever, or pain after major trauma.

International Patients

International patients can consult directly with Dr. Kim in English.

You may send or bring previous X-rays, MRI images and medical reports. Same-day consultation, X-ray or ultrasound assessment and selected treatments may be possible when medically appropriate.

If MRI is required, we can arrange imaging at a nearby radiology centre.

Bone marrow- and adipose-derived procedures require separate planning.

A painful back is not always a damaged back. The correct target matters.

Contact Nucellin Orthopedic Clinic →