What if Your Back Pain Diagnosis is Wrong? It Might Be This.

Still living with chronic back pain even after trying multiple treatments? You might not have a treatment problem. You might have a diagnosis problem. In this episode of The Pain Diaries Podcast, Melbourne Pain Specialists Dr Nick Christelis and Dr Bradley Lewinsohn break down why many back pain treatments fail and what actually changes when you get the right diagnosis first. This is not just a list of treatments. It’s a shift in how chronic back pain should be understood and managed. Key takeaway (TL;DR) • Most chronic back pain is treated at the symptom level, not the source • The same treatment can fail or succeed depending on the diagnosis • Real progress happens when treatment follows a clear, accurate diagnosis • There is no single fix, but there is a structured pathway that works What you’ll learn in this episode • Why “trying everything” often fails in chronic back pain • The difference between disc, facet joint, nerve-related and sacroiliac pain • Why imaging (MRI/X-ray) doesn’t always explain your pain • The role of diagnostic blocks in identifying the true pain source • When treatments like injections, radiofrequency, or neuromodulation actually work • Why surgery is not always the answer—and when it might be • How pain specialists build a structured, diagnosis-led treatment plan 20 treatment options are discussed. Chapters: 00:00 - Welcome and setting the scene for the podcast 01:27 - When you're told nothing works for your chronic back pain 02:52 - the right treatment for the right diagnosis 04:10 - Epidural steroid injection 04:55 - Intradiscal biaculoplasty 05:20 - Radiofrequency ablation vs. pulsed radiofrequency 10:00 - Nerve root pulsed radiofrequency 10:35 - Disc surgery 11:30 - Intradiscal biologics 13:20 - The first treatments before pain procedures 13:50 - Facet joint medial branch blocks 15:00 - Facet joint Radiofrequency ablation 16:20 - Radiofrequency techniques for the sacroiliac joint 19:30 - Injections to the sacroiliac joint & ligaments - steroid or glucose or platelet-rich plasma 21:00 - Fusion surgery of the sacroiliac joint 22:30 - Epidural steroid and hydrodilation for canal stenosis 24:35 - Pulsed radiofrequency of the nerve roots 25:35 - Pulsed radiofrequency of peripheral nerves 26:40 - Peripheral nerve stimulation 27:20 - Phenol injections 29:20 - Local anaesthetic and botox & PRP to the muscles 32:45 - Advanced therapies: 1) Spinal cord stimulation & 2) Intrathecal drug delivery 34:00 - The most important aspect in getting long-lasting relief for chronic back pain 35:45 - Restorative therapy IStill unsure why your back pain isn’t improving? This guide breaks it down clearly: https://painspecialistsaustralia.com.... Follow us on the following channels.   / painspecialistsaustralia     / pain_specialists_australia     / pain-specialists-australia      / @painspecialistsaustralia   Contact us here https://painspecialistsaustralia.com.... Become a referrer here https://referrals.painspecialistsaust... And finally, a reminder, the information in these videos are not intended nor implied to be a substitute for professional medical advice, diagnosis or treatment. All content, including text, graphics, images, and information, contained in these videos are for general information purposes only and does not replace a consultation with your own doctor/health professional.