Understanding Back Pain in 2026: A Science-Based Guide for Utah Patients

"What did you do to Mike?!"

Mike came to our pain clinic in Payson because back pain had taken away something basic: yard work. Not extreme workouts. Not weekend projects. Just normal, everyday tasks.

After a targeted epidural steroid injection, things changed. A few weeks later, Mike wasn't just back outside—he was lifting and moving railroad ties in his yard, something he hadn't been able to do in years.

Not long after that, his neighbor walked into our clinic and said,

"What did you do to Mike?! I want that too."

That moment is a small but powerful example of what modern, minimally invasive back pain therapy can provide. No, there's no guarantee you'll be hauling railroad ties—but with the right diagnosis and targeted treatment, there is a very real opportunity to improve pain, restore function, and meaningfully improve quality of life.

("Mike" is not the patient's real name, but the story is real.)

At Horizon Spine & Pain of Utah, this is exactly what pain management looks like in 2026: science-based, precision-guided care designed to help people move forward—not just cope.

Pain Is Not Just "Wear and Tear"

One of the most important advances in pain science is understanding that pain is an output of the nervous system—not a perfect reflection of tissue damage. MRI findings and pain severity often don't align, and pain can persist even after tissues heal.

Because of this, modern guidelines emphasize individualized, patient-centered care that combines education, movement, and targeted interventional treatments when appropriate, rather than passive care or rushing to surgery. The World Health Organization's 2023 guidelines specifically support this approach for chronic low back pain.

Why Back Pain Becomes Chronic

Most chronic back pain is multifactorial, commonly involving one or more of the following:

• •Disc-related pain
• •Nerve irritation (sciatica or radiculopathy)
• •Facet joint arthritis
• •Sacroiliac (SI) joint dysfunction
• •Vertebrogenic pain associated with Modic changes
• •Lumbar spinal stenosis

A 2025 systematic review of international low back pain guidelines showed strong agreement: outcomes improve when treatment is matched to the dominant pain generator, rather than applying generalized or repetitive therapies.

Matching Minimally Invasive Procedures to the Type of Back Pain

Nerve-Related Pain (Sciatica / Radiculopathy)

Often presents as radiating leg pain, numbness, tingling, or burning.

Epidural steroid injections (interlaminar or transforaminal) can reduce inflammation around irritated nerve roots and help restore movement and function when conservative care alone has not been enough.

Facet-Mediated Back Pain

Typically causes axial low back pain that worsens with standing, extension, or prolonged activity.

Medial branch blocks help confirm the pain source. When positive, radiofrequency ablation (RFA) can provide longer-lasting relief in appropriately selected patients. Consensus guidelines support this approach.

Vertebrogenic Pain

A recognized source of chronic axial low back pain arising from the vertebral endplates, often associated with Modic type 1 or 2 changes on MRI.

For carefully selected patients, basivertebral nerve ablation (BVNA) has demonstrated durable improvements in pain and function in multi-year clinical studies.

Sacroiliac (SI) Joint Pain

Often presents as lower back or buttock pain worsened by standing, walking, or transitions.

SI joint injections can be both diagnostic and therapeutic, helping guide further treatment decisions.

Lumbar Spinal Stenosis

Commonly causes leg pain, heaviness, or fatigue with walking or standing, often relieved by sitting or leaning forward.

Management may include epidural injections, targeted rehabilitation, and—in select cases—minimally invasive decompression strategies depending on anatomy and symptoms.

A Modern, Stepwise Approach to Overcoming Back Pain in 2026

Effective pain management isn't about doing everything—it's about doing the right things in the right order:

• •Identify the most likely pain generator
• •Use image-guided procedures strategically
• •Restore movement, strength, and confidence
• •Avoid unnecessary surgery and prolonged medication use when possible

This approach aligns with contemporary guideline recommendations and real-world outcomes.

How Horizon Spine & Pain of Utah Can Help

Horizon Spine & Pain of Utah is a comprehensive interventional pain clinic in Payson, serving patients throughout Utah County, including Salem, Spanish Fork, Springville, and Mapleton.

While minimally invasive spine procedures are a core part of what we do, we offer much more than what can be listed on a single page. Our services include, but are not limited to:

• •Epidural steroid injections
• •Medial branch blocks and radiofrequency ablation
• •Sacroiliac joint injections
• •Basivertebral nerve ablation
• •Regenerative therapies
• •Infusion-based pain therapies
• •Targeted image-guided injections throughout the spine and joints
• •Thoughtful, evidence-based medication management
• •Coordination of rehabilitation and conservative care

Our goal is not just temporary relief—but improved function, independence, and quality of life, while avoiding unnecessary surgery whenever possible.

A Final Thought — Back to Mike

Mike didn't come to our clinic hoping to lift railroad ties. He just wanted his normal life back.

That's what modern pain care is really about. When pain is understood correctly and treated precisely, people regain confidence and independence—whether that means yard work, walking farther, sleeping better, or simply not planning life around pain.

You may not end up hauling railroad ties.

But in 2026, there is a very real opportunity to improve your quality of life.

Frequently Asked Questions About Back Pain Treatment in Utah

When should I see a pain specialist for back pain?

If pain lasts more than 4–6 weeks, keeps returning, radiates into the leg, or limits daily function.

Do I need an MRI before coming in?

Not always. Imaging is used when it helps guide diagnosis or treatment.

Are injections just temporary relief?

Some are short-term, while others—like RFA or BVNA—can provide longer-lasting improvement in selected patients.

How do you decide which procedure is right for me?

Based on your symptoms, exam, prior treatments, and imaging—not a one-size-fits-all approach.

Do you offer treatments besides injections?

Yes. We also provide regenerative therapies, infusions, targeted injections, medication management, and coordinated rehab care.

Will I need surgery?

Most patients do not. Many improve with minimally invasive, non-surgical treatments.

What results should I expect?

Results vary, but many patients experience meaningful improvement in pain and function.

Do you see patients outside of Payson?

Yes. We treat patients throughout Utah County.

Ready to Take the Next Step?

Horizon Spine & Pain of Utah

• •📍 15 S. 1000 E. #250, Payson, UT 84651
• •📞 Call or Text: 385-298-1008
• •📧 frontdesk@horizonpainutah.com

A short conversation can help determine whether a targeted, minimally invasive approach is right for you.

References

• •World Health Organization. WHO Guidelines on Chronic Low Back Pain. 2023.
• •Oliveira CB et al. Agreement across international low back pain guidelines. The Spine Journal. 2025.
• •Cohen SP et al. Consensus practice guidelines on lumbar facet interventions. Regional Anesthesia & Pain Medicine. 2020.
• •Fischgrund JS et al. Long-term outcomes of basivertebral nerve ablation. Spine. 2024.