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Got back pain? Here’s what it means and what to do about it

Back pain, hands and woman exercise outdoor, wellness or muscle tension. Healthy female, athlete

Back pain is different for everyone – some feel it in the lower back after lifting, others in the mid-back after long hours at a desk, or in the upper back and neck after a stressful day. Understanding where your pain is located is key to finding the right relief.

Back pain, hands and woman exercise outdoor, wellness or muscle tension. Healthy female, athlete

“Not all back pain is created equal—low back pain is often mechanical or disc-related, while mid and upper back pain may stem from posture, muscle strain, or even underlying medical conditions,” said Dr. David Doward, pain management physician at Southeast Orthopedic Specialists (SOS). “Gentle daily stretching, core strengthening and early evaluation can go a long way in preventing more serious problems. At SOS, we offer a range of options to get patients back to living without pain.”

Types of Back Pain: Low vs. Mid/High

Low Back Pain (Lumbar)
This is the most common type of back pain. It can often be tied to herniated discs, arthritis, or spinal stenosis. The lumbar spine supports your upper body and helps with daily movement like lifting or walking, making this region especially vulnerable to strain.

Mid & Upper Back Pain (Thoracic)
Often overlooked, this type is commonly due to posture, prolonged sitting, or muscular tension. It can also stem from joint stiffness, overuse, or even underlying conditions like scoliosis or osteoporosis.

Upper Back & Neck Region
Pain here may arise from cervical disc issues, tight shoulders, or stress-related muscle tension – especially common with technology use or even driving.

Yoga & Stretching: Gentle, Daily Tools for Relief

When practiced consistently, stretching and yoga are excellent first-line methods to increase mobility, relieve tension, and support spine health.

Practice safely by moving slowly and mindfully, tuning into how your body feels as you stretch. Pair each stretch with deep breathing – inhale deeply through the nose and exhale slowly through the mouth to oxygenate muscles and enhance relaxation. Above all, avoid pushing into pain. If a stretch becomes uncomfortable, ease off immediately and if it persists, reach out to a specialist for guidance.

Regenerative Medicine: Healing from the Inside Out

When stretching and strengthening aren’t enough, regenerative medicine offers a natural next step that promotes real healing without surgery or long-term medication.

“We now have tools to help the body heal itself – restoring  joint and tissue function using what’s already inside you,” said Dr. Pavel Balduyeu, pain management physician at SOS. “Regenerative medicine allows us to treat the root cause of pain with fewer medications and no surgery.”

Regenerative Medicine treatments offered at SOS include:

  • Platelet-Rich Plasma (PRP) Therapy
    This is when a small sample of your blood is spun in a centrifuge to isolate healing platelets, which are then injected directly into the painful or injured area. These platelets stimulate tissue repair and reduce inflammation.
  • Bone Marrow–Derived Stem Cell Injections
    This is when stem cells are drawn from your own bone marrow and injected into injured tissues like spinal joints or soft tissue structures. These cells support healing at a deeper, cellular level.

Regenerative care accelerates the body’s natural healing by repairing damaged tissues – which can improve circulation and help restore joint function. This drug‑and surgery‑free approach often lessens or eliminates the need for pain medications, offering a faster, more sustainable recovery from injuries or chronic inflammation.

“At SOS, we view fluoroscopic‑guided injections as a strategic bridge between conservative therapy and surgery for low‑back pain,” said Dr. Frank Collier, pain management physician at SOS.

Under real‑time X‑ray guidance, Dr. Collier can place medication with pinpoint accuracy, targeting herniated discs, facet joints, SI joints, spinal stenosis, or inflamed nerves. These treatments can reduce inflammation and restore mobility without systemic medications. In many cases, this minimally invasive technique can get patients moving again safely and efficiently quicker than usual traditional methods.

When to Seek Expert Help

If your back pain hasn’t improved after two weeks of stretching or yoga, or if you’re experiencing sharp, persistent pain, numbness, tingling, or weakness, it’s time to consult a spine specialist.

At Southeast Orthopedic Specialists, our team can help determine whether regenerative care, guided rehab, or another treatment is right for you. In the meantime, start with a few gentle stretches each day, listen to your body and most importantly – track how you feel.

Finding Treatment at SOS

At SOS, our team of highly trained, fellowship‑educated physicians and specialists is committed to delivering expert orthopedic and spine care across six convenient locations in Duval, St. Johns, and Clay counties.

“Back pain isn’t one-size-fits-all. Lower back pain often involves disc problems or nerve compression, which can cause pain to radiate into the legs. Mid or upper back pain, on the other hand, is more commonly related to facet joint arthritis or muscular strain from poor posture, said Dr. Isaac Gooding, pain management specialist at SOS. “Understanding the difference is the first step toward effective treatment — from targeted stretches to minimally invasive procedures that can provide lasting relief. At SOS, we’re here to help.”

If you’re experiencing back pain, our pain management experts are ready to help—whether you prefer to schedule an appointment or take advantage of our SOS Direct walk‑in clinics for same‑day evaluation. To get started, call us at 904‑634‑0640 or schedule an appointment online to find a location near you.

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Former pro sports doctor joins Southeast Orthopedic Specialists to treat residents in Northeast Florida

Dr. David Doward to help deliver spine and sports medicine care

JACKSONVILLE, June 9, 2025 – Southeast Orthopedic Specialists (SOS) is excited to welcome Dr. David Doward to its expanding team of musculoskeletal (MSK) experts. Dr. David Doward is a board-certified physician in Physical Medicine and Rehabilitation, and fellowship trained in Interventional Spine and Sports Medicine. Dr. Doward specializes in comprehensive pain management treatments and is recognized for his patient-centered, non-surgical approach to musculoskeletal (MSK) care, helping individuals regain mobility and get back to activities they love.

Dr. Doward earned his medical degree from Weill Cornell Medical College following undergraduate and premedical studies at Lafayette College and Columbia University. He completed his residency in Physical Medicine and Rehabilitation at Stanford University Hospitals & Clinics and pursued advanced fellowship training in Interventional Spine and Sports Medicine at the prestigious Hospital for Special Surgery.

Throughout his career, Dr. Doward has authored nine peer-reviewed publications, contributed to six research studies, and served as a team physician for the Jacksonville Jaguars and Jacksonville Sharks. He has also provided medical coverage for elite international tennis events, including the Davis Cup and Fed Cup.

Known for his thoughtful clinical insight, hands-on care, and collaborative treatment planning, Dr. Doward partners closely with patients and referring providers to craft individualized care plans that align with each patient’s goals and lifestyle.

“We are so excited to have Dr. Doward on our team and look forward to the positive impact his care and expertise will bring to our patients and the Northeast Florida community,” said Donnie Romine, CEO of Southeast Orthopedic Specialists. “His impressive academic background, experience treating elite athletes, and dedication to delivering personalized, high-quality care makes him an exceptional addition to the SOS family as we continue to expand access to exceptional orthopedic and spine care in the region.”

Outside of medicine, Dr. Doward enjoys traveling, playing tennis, and spending quality time with his family.

With the addition of Dr. Doward, Southeast Orthopedic Specialists continues to strengthen its mission of delivering comprehensive, patient-centered musculoskeletal care to communities across Northeast Florida. At SOS, patients can count on a seamless experience — from initial evaluation and non-surgical treatment to surgery and recovery — all managed by a trusted team under one roof.

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About Southeast Orthopedic Specialists 

Established in 2001, Southeast Orthopedic Specialists has grown into the regional leader in musculoskeletal care. Southeast Orthopedic Specialists was founded on the principle of providing high-quality, comprehensive care in the Northeast Florida region. The entire spectrum of musculoskeletal healthcare services is provided to patients including orthopedic surgery, spine care, physical medicine and rehabilitation, pain management, chiropractic and podiatry. Services including physical therapy, regenerative medicine, advanced imaging, durable medical equipment and musculoskeletal urgent care are offered in multiple locations throughout the region. Physicians at Southeast Orthopedic Specialists are leading experts in their field with decades of experience, including the completion of multiple fellowships and groundbreaking research. Visit www.se-ortho.com to learn more.

 

About Healthcare Outcomes Performance Company (HOPCo)  

Healthcare Outcomes Performance Company (HOPCo) is the national leader of integrated musculoskeletal value-based health outcomes management, practice management and health system service line management. This includes comprehensive expertise across all MSK specialties, including orthopedics, spine, neurosurgery, hand, pain management, rehabilitation and neurology. HOPCo’s integrated care, analytics and facilities development and management platforms have proven to increase the quality of patient care while reliably reducing the total cost of care across the care continuum for practices, health systems and payors alike. HOPCo’s affiliated payors, practices and health systems successfully participate in highly efficient value-based contracting (bundled payments, chronic episodes of care initiatives, population health programs and other advanced risk-based arrangements) utilizing HOPCo’s proprietary platforms, IT solutions, integrated analytics and evidence-based comprehensive care pathways. Visit https://hopco.com to learn more.

 

Media Contact:

Annebeth Ahrenholz

Communications Specialist

Healthcare Outcomes Performance Company (HOPCo)

Annebeth.Ahrenholz@hopco.com

Southeast Orthopedic Specialists Direct clinic welcomes new physician assistant to enhance patient care

Nina Bracy Headshot

Jacksonville, FL – March 17, 2025 – Southeast Orthopedic Specialists (SOS) is pleased to announce the addition of Juanita (Nina) Bracy, PA-C, to its North St. Johns Direct clinic located at 3055 County Road 210 West. With a diverse background in family and sports medicine, Bracy specializes in orthopedic treatment for patients with acute and chronic musculoskeletal conditions. 

Nina Bracy Headshot

A dedicated and compassionate healthcare professional, Bracy brings over 20 years of experience to her role. She holds a master’s degree in physician assistant studies from Samuel Merritt University in Oakland, CA and a Master of Education in Kinesiology from the University of Virginia. Early in her career, she worked as an athletic trainer at Stanford University, followed by a position as a rehabilitation aide at the University of California San Francisco Physical Therapy. 

Most recently, Bracy served as a family medicine physician assistant at Metroplex Medical Center in Texas and as a compensation and pension examiner at Clay Consulting in Florida, where she worked closely with U.S. military veterans. 

“I’m excited to join the Southeast Orthopedic Specialists team and to serve the St. Johns community,” said Bracy. “Throughout my career, I’ve been passionate about helping others—whether treating chronic conditions, supporting athletes or working with veterans. Every patient is unique, and I strive to provide compassionate, individualized care that empowers them to live healthier, more active lives. It’s truly an honor to make a meaningful difference in the lives of those who trust us with their care.” 

“We are committed to providing the highest level of care to those we serve,” said Donnie Romine, CEO of Southeast Orthopedic Specialists. “Nina’s dedication to patient care, combined with her extensive training in both sports medicine and orthopedics make her an invaluable asset as we continue to provide exceptional service at our walk-in clinics.” 

About Southeast Orthopedic Specialists Direct Clinics 

Southeast Orthopedic Specialists Direct clinics are walk-in medical centers where patients can be seen for pain or injuries with no appointment necessary. Direct clinics are staffed by orthopedic physicians and Advanced Practice Providers who specialize in providing comprehensive orthopedic services, including diagnosis, treatment, imaging, bracing and casting. In addition, the clinics offer physical/occupational therapy. Southeast Orthopedic Specialists Direct clinics are conveniently located in Jacksonville – Mandarin, North St. Johns and St. Augustine. For more information or to find a location near you, visit https://se-ortho.com/direct/. 

About Southeast Orthopedic Specialists 

Established in 2001, Southeast Orthopedic Specialists has grown into the regional leader in musculoskeletal care. Southeast Orthopedic Specialists was founded on the principle of providing high-quality, comprehensive care in the Northeast Florida region. The entire spectrum of musculoskeletal healthcare services is provided to patients including orthopedic surgery, spine care, physical medicine and rehabilitation, pain management, chiropractic and podiatry. Services including physical therapy, regenerative medicine, advanced imaging, durable medical equipment and musculoskeletal urgent care are offered in multiple locations throughout the region. Physicians at Southeast Orthopedic Specialists are leading experts in their field with decades of experience, including the completion of multiple fellowships and groundbreaking research. Visit www.se-ortho.com to learn more. 

About Healthcare Outcomes Performance Company (HOPCo) 

Healthcare Outcomes Performance Company (HOPCo) is the national leader of integrated musculoskeletal value-based health outcomes management, practice management and health system service line management. This includes comprehensive expertise across all MSK specialties, including orthopedics, spine, neurosurgery, hand, pain management, rehabilitation and neurology. HOPCo’s integrated care, analytics and facilities development and management platforms have proven to increase the quality of patient care while reliably reducing the total cost of care across the care continuum for practices, health systems and payors alike. HOPCo’s affiliated payors, practices and health systems successfully participate in highly efficient value-based contracting (bundled payments, chronic episodes of care initiatives, population health programs and other advanced risk-based arrangements) utilizing HOPCo’s proprietary platforms, IT solutions, integrated analytics and evidence-based comprehensive care pathways. Visit https://hopco.com to learn more. 

March: Brain Injury Awareness Month

March is Brain Injury Awareness Month when we help raise awareness around the full spectrum of brain injuries, from mild concussions to severe traumatic brain injuries (TBIs).

National Brain Injury Awareness Month 2025

Each year, millions of people experience some type of brain injury and begin their journey to recovery. This month serves as an opportunity to provide education, support and raise awareness for those impacted.

The Impact of Brain Injury on Musculoskeletal Health

According to the Centers for Disease Control and Prevention (CDC), most brain injuries are considered mild, including most concussions. However, even these mild injuries can still be considered serious and can pose challenges in learning, memory, concentration and problem-solving. Many brain injuries can result from several causes, most commonly falls, motor vehicle crashes and sports.

While these injuries can lead to significant cognitive and neurological effects, they may also impact musculoskeletal (MSK) health. Understanding the effect that a brain injury can have on MSK health is important as it can lead to a more comprehensive approach to recovery.

The Connection Between Brain Injury and Musculoskeletal Health

Musculoskeletal health refers to the bones, muscles, ligaments, tendons and other tissues in our bodies. Brain injuries, especially moderate to severe ones, can disrupt the communication between the brain and body, which impairs the ability to control movement, maintain posture and perform physical tasks.

Common Impacts of:

  • Muscle Weakness and Atrophy: One of the most common consequences of brain injury is muscle weakness, which occurs when the brain is unable to properly signal the muscles to contract and function. This can lead to the wasting and gradual loss of muscle mass over time, especially in the arms, legs and core. The loss of muscle mass can occur because of muscle disuse, aging or illness. Without proper motor control, affected individuals may struggle to maintain normal movement patterns, increasing the risk of further injury.
  • Impaired Balance and Coordination: Brain injuries often affect the cerebellum or other areas responsible for motor coordination and balance. This can result in difficulties with walking, standing or performing daily activities. Impaired balance puts individuals at a higher risk of falls and injuries, which in turn can cause further damage to the musculoskeletal system, such as fractures or sprains.
  • Posture: When the brain is unable to communicate effectively with the muscles that control posture, individuals with brain injuries may find it difficult to maintain an upright position. Having poor posture can put an additional strain on the spine, neck, and other joints, causing pain, discomfort, or potentially long-term musculoskeletal conditions like scoliosis or degenerative joint disease.
  • Joint and Soft Tissue Pain: Chronic pain, particularly in the neck, back and limbs is common for individuals with brain injuries. Muscles that are weakened or imbalanced due to a brain injury can place added stress on joints and soft tissues leading to inflammation, stiffness and discomfort.
  • Spasticity and Muscle Tightness: Spasticity is a condition that causes muscles to become stiff and tight, making it difficult to move. Brain trauma can disrupt the pathways between the brain and muscles which can result in uncontrolled muscle tightening and stiffness. This condition can further impact musculoskeletal issues by limiting the range of motion and putting more strain on muscles, joints and tendons.

Rehab for Brain Injury and Musculoskeletal Health

Given the connection between brain injury and musculoskeletal health, rehab efforts should be comprehensive and specialized. Treatment plans that focus only on the brain injury without also addressing MSK health can lead to prolonged recovery times and incomplete healing.

Here’s how a holistic approach can improve outcomes:

  • Physical Therapy: Physical therapy is typically suggested as a method to treat a brain injury, especially when it comes to restoring muscle strength and joint mobility. A skilled physical therapist can create a customized exercise program that targets specific weaknesses and retrains the body to move properly. Strengthening the core, improving posture and working on joint stability can also prevent further MSK damage and improve overall function.
  • Occupational Therapy: Occupational therapy can help individuals with brain injuries regain independence in performing daily activities. It focuses on improving fine motor skills, hand-eye coordination and posture. Occupational therapists may also use assistive devices and adaptive strategies to help individuals perform tasks like dressing and eating.
  • Spasticity Management: For individuals who develop spasticity due to brain injury, specialized treatments such as stretching, medication and sometimes even surgical interventions like tendon lengthening may be necessary to reduce tightness and improve range of motion. Spasticity management is crucial to prevent deformities in patients and to ensure mobility is maintained.
  • Pain Management: Pain management strategies can include heat or cold therapies and pharmacological treatments such as anti-inflammatory medications. These can help individuals cope with chronic musculoskeletal pain after a brain injury.

Preventing Further Injuries and Promoting Recovery

In addition to rehab, there are several ways individuals with brain injuries can protect their musculoskeletal health. Engaging in regular exercise, creating a safe living environment and maintaining a healthy diet can help improve muscle tone, coordination and overall musculoskeletal health while minimizing the risk of falls and injuries.

While the effects of brain injury can be wide-ranging, understanding the impact on the musculoskeletal system can lead to an effective treatment plan. With appropriate therapy, pain management and lifestyle adjustments, individuals recovering from a brain injury can regain mobility, independence and an improved quality of life.

Additionally, by prioritizing both brain and musculoskeletal factors, healthcare providers can help their patients navigate the challenges of a brain injury.

Photo Credit: Adobe

 

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