Medical And Family History
Your doctor will ask questions about your medical and family history to help determine if an injury or underlying medical condition is the source for the back pain. Some questions your doctor may ask:
- Can you describe your pain?
- Where is the exact location of your back pain?
- When did the pain start and how long have you had the pain?
- What were you doing when you first noticed the pain?
- How severe or bad is the pain?
- What makes the pain worse or better?
Your doctor may ask you to rate your pain on a scale from 1 to 10 to gauge the severity of the pain and talk to you about your ability to perform activities of daily living.
Acute Lower Back Pain Treatment
Most acute lower back pain is mild and settles with simple treatments. Treatment usually depends on the cause and might include:
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A few days of physical rest. It is not considered good to rest for more than a few days otherwise the lower back muscles will stiffen and even cramp, which will make recovery difficult.
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Simple treatments like hot or cold packs, physical activity, exercise and physical therapy.
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Pain medications like anti-inflammatories and anti-spasm medications to provide pain relief.
If the cause of the pain has been treated but the pain continues and is long lasting , debilitating and has not been responding to treatments an assessment should be made by a pain management specialist physicians, who can assess and treat most types of chronic pain including chronic lower back pain.
Surgery For Lower Back Pain
Because the vast majority of patients recover from their low back pain with little help from a doctor, the rationale behind choosing surgery must be convincing. Eighty percent of patients with sciatica recover eventually without surgery.
Severe progressive nerve problems, bowel or bladder dysfunction and the cauda equina syndrome make up the most clear-cut indications for back surgery. Back surgery will also be considered if the patients signs and symptoms correlate well with studies such as MRI or electromyogram .
In the most serious cases, when the condition does not respond to other therapies, surgery may well be necessary to relieve pain caused by back problems. Some common procedures include:
- Discectomy, such as a or removal of a portion of a
- a bone graft that promotes the vertebrae to fuse together
- removal of the lamina to create more space and reduce irritation and inflammation
References and useful links
- 1, 2. Excerpted from Low Back Pain Fact Sheet, National Institute of Neurological Disorders and Stroke, National Institutes of Health
- Low Back Pain Fact Sheet, National Institute of Neurological Disorders and Stroke, National Institutes of Health. Reviewed, July 26, 2003.
- Deyo RA, Weinstein JN, Low Back Pain, N Engl J Med, Vol 344, No. 5, Feb 1, 2001, pp 363-370.
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What Are The Signs And Symptoms Of Back Pain
Back pain may be experienced anywhere along the spine from the neck to the buttocks. In some cases, pain may also be felt in one or both legs. Its common to be a bit restricted in daily activities such as bending, lifting, sitting and walking while youre experiencing back pain.
Movement of your torso may be limited by back pain. There may also be tenderness when pressure is applied to the joints of the spine. Reduction of reflexes, strength and sensation in the legs can be a sign of nerve compression.
Its common for people with back pain to feel distressed about their recovery. People with persistent back pain can develop fear of movement and activity , worrying that it will make things worse or increase their pain. Living with persistent back pain may also lead to mood issues, such as anxiety, irritability, frustration and depression.
Treatment Options For Lower Back Pain
If you see a physiotherapist or GP for lower back pain, they will probably encourage you to try the self-help measures outlined above first. They can also advise you on what exercises you can do to help your back, or may refer you to a group exercise programme. But if your pain doesnt improve, they may be able to recommend other options you can try. They can also refer you to a specialist if necessary.
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What Causes Lower Back Pain
Many injuries, conditions and diseases can cause lower back pain. They include:
- Strains and sprains: Back strains and sprains are the most common cause of back pain. You can injure muscles, tendons or ligaments by lifting something too heavy or not lifting safely. Some people strain their back by sneezing, coughing, twisting or bending over.
- Fractures: The bones in the spine can break during an accident, like a car crash or a fall. Certain conditions increase the risk of fractures.
- Disk problems: Disks cushion the vertebrae . Disks can bulge from their position in the spine and press on a nerve. They can also tear . With age, disks can get flatter and offer less protection .
- Structural problems: A condition called spinal stenosis happens when the spinal column is too narrow for the spinal cord. Something pinching the spinal cord can cause severe sciatic nerve pain and lower back pain. Scoliosis can lead to pain, stiffness and difficulty moving.
- Arthritis: Osteoarthritis is the most common type of arthritis to cause lower back pain. Ankylosing spondylitis causes lower back pain, inflammation and stiffness in the spine.
- Disease:Spine tumors, infections and several types of cancer can cause back pain. Other conditions can cause back pain, too. These include kidney stones and abdominal aortic aneurysm.
- Spondylolisthesis: This condition causes the vertebrae in the spine to slip out of place. Spondylolisthesis leads to low back pain and often leg pain as well.
Simple Stretches To Relieve Lower Back Pain
Lower back pain can be a debilitating and painful condition.
Fortunately, staying physically active may be the most effective and cost-efficient way to soothe or prevent it.
Here are 8 simple stretches to relieve lower back pain.
3 ).
Although its origin varies, changes in the lumbar, or lower back, structure due to musculoskeletal damage are considered to be the main cause .
Your musculoskeletal system is made up of bones, muscles, tendons, ligaments, and other connective tissues that provide form, support, stability, and movement to your body.
Other muscles that play an important role in maintaining the normal curvature of your spinal column are reported to be associated with lower back pain. These include the hip flexor and hamstring muscles .
Minor lower back pain normally gets better on its own within a few days or weeks. It can be considered chronic when it persists for more than three months .
In either case, staying physically active and regularly stretching can help reduce lower back pain or prevent it from returning .
The remainder of this article provides eight stretches for lower back pain, all of which you can do in the comfort of your own home with minimal or no equipment.
Summary Lower back pain is an incredibly common condition that can be relieved or prevented with regular exercise and stretching.
The knee-to-chest stretch can help lengthen your lower back, relieving tension and pain.
To perform the knee-to-chest stretch:
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Ask About Prescription Medications
If your back pain hasnt resolved itself within four to six weeks, make an appointment with your doctor, who will examine your back and ask you to sit, stand, bend, walk, and lift your legs to see how your pain is affecting your mobility. Youll likely be asked to rate your pain on a scale of one to 10, and they may do imaging tests, like an X-ray or MRI. Then, he or she may recommend one of the following prescribed therapies:
- Muscle relaxants: Medications like cyclobenzaprine or baclofen can help relieve painful back spasms. If you go this route, just know that side effects can include fatigue and dizziness.
- Topical pain medications: These creams and ointments, like Voltaren gel, are meant to be rubbed directly on to the area thats hurting you.
- Cortisone shots: If other treatment measures fail, your doctor may recommend an injection of cortisone, a potent anti-inflammatory. There are risks, including thinning of nearby bone, and relief typically lasts just a few months, tops.
Ways To Relieve Back Pain Naturally
There are a wide variety of natural remedies to soothe your back, which can help reduce the intake of medications or provide an added benefit to your existing medical treatment.
Take a look at these natural pain-relieving strategies and find out what works best for you:
Read on to learn more about effective pain-relieving strategies for chronic back pain from natural methods.
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When Is Surgery A Good Idea For Back Pain
These red flags can be indicators for surgery, if theyre found to berelated to your spine condition:
- New or progressing bowel/bladder issues
- Weakness in limbs
- Gait and balance problems
- Evidence of increased reflexes
Surgery can also be an option for chronic back pain if there is a knowncause confirmed by imaging and if other treatments didnt help. Getopinions from at least two surgeons, suggests Nava, as pain can stillcome back after the surgery.
Lower Back Pain: Is It In Your Genes
One of the main reasons a person develops low back pain and another doesn’t may lie in their genes. With disc degeneration, Andersson says, âIf you take twins — one who is doing heavy physical work and one who is doing desk work — and you compare their MRI exams, they are essentially identical. This tells you that genetic factors are very important.â
If you have chronic low back pain, you’ve likely inherited the tendency, and you’re probably hardwired for it. The lower back contains sensitive receptors called nociceptive fibers, which send pain signals to the brain. “Some people have a lot of nociceptive fibers — for example, in their discs — while others have relatively few,” Wisneski tells WebMD. That may be why one person can lift heavy weights many times and never experience low back pain, while another who barely lifts anything is in constant agony.
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How Is Lower Back Pain Diagnosed
Your provider will ask about your symptoms and do a physical exam. To check for broken bones or other damage, your provider may order imaging studies. These studies help your provider see clear pictures of your vertebrae, disks, muscles, ligaments and tendons.
Your provider may order:
- Spine X-ray, which uses radiation to produce images of bones.
- MRI, which uses a magnet and radio waves to create pictures of bones, muscles, tendons and other soft tissues.
- CT scan, which uses X-rays and a computer to create 3D images of bones and soft tissues.
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Electromyography to test nerves and muscles and check for neuropathy , which can cause tingling or numbness in your legs.
Depending on the cause of pain, your provider may also order blood tests or urine tests. Blood tests can detect genetic markers for some conditions that cause back pain . Urine tests check for kidney stones, which cause pain in the flank .
Rub On Medicated Creams
Skin creams, salves, ointments, or patches may help when your back feels stiff, sore, and tense. Many of these products contain ingredients such as menthol, camphor, or lidocaine that can cool, heat, or numb the affected area.
Put on creams right where you hurt. Ask someone to apply it if you have trouble reaching the spot.
âIt’s not going to be a mainstay at providing significant relief, but it can calm things down,â Ray says.
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Can A Pinched Nerve Cause Knee Pain
When your spine has a pinched nerve or a bulging lumbar disc, the pain in your lower back can be redirected to your knees. This is one of the reasons why some people only experience discomfort in their knees but not in their back.
A pinched nerve is a type of nerve that is compressed by the surrounding structures. When that nerve is disrupted, there are symptoms in that part of the body. If the bone, tissue, or other structures surrounding the nerve exert too much pressure on it, it can become pinched. It is possible that you have a pinched peroneal nerve if you feel a shooting pain in your leg. In addition to the lower back, the back, and the outside of your thigh, you may experience pain due to this condition. Your doctor will perform an examination to see if there is a problem, and he or she will take your medical history. When compressed, the peroneal nerve, which runs along the outside of your knee, can become pinched. The most common cause is crossing your legs, but anything outside or inside your knee that puts pressure on your nerve can also cause it. In the field of physical therapy, strengthening and gait training can be beneficial.
Example Progression Of Treatment Regimens For Lumbar Degenerative Disc Disease
Treatments need to be individualized. However, as a general rule, lumbar degenerative disc disease treatments start with basic pain control and non-invasive treatments and progress, if needed, to more extensive and/or invasive treatments.
One example of how treatment approaches may progress over time would be:
- Bed rest, or reduced activity, for the first 1 to 2 days after onset of severe pain, combined with anti-inflammatory medication such as ibuprofen, and ice and/or heat therapy
- Prescription muscle relaxant medications, as needed, for up to 1 week
- Gentle stretching and aerobic exercise, for at least 3 times a week
- Physical therapy if after 3 weeks there is no improvement in pain
- An epidural injection if after 3 to 6 weeks there is little to no improvement in pain
- Spinal surgery if after 6 to 12 months the pain is severe, ongoing and significantly limits daily activities
Bed rest beyond the first 2 days of sharp, severe pain is not usually advised, because regular movement improves blood circulation and muscle strength and helps the body to heal more quickly than bed rest.
The above is just one example of a typical progression of treatments, and additional therapies or a different type of progression of care is not uncommon based on the patientâs condition and the treating physicianâs preferences as well as other variables.
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Symptoms Of Lower Back Pain
The symptoms of lower back pain can vary from person to person. It may come on suddenly, perhaps after youve lifted something heavy or moved in a way thats hurt your back. Or it may come on gradually over time or for no clear reason. Some people get a dull pain in their back, while others describe it as more of a tearing or burning pain. You may find certain things make the pain worse, and other things help to relieve it. The pain can range from mild to severe.
If you have sciatica, pain can spread from your back or buttock down your leg, sometimes as far as your foot or toes.
When Should I Worry About Hip And Back Pain
It is most likely a hip issue if the pain persists in the front of the hip/groin region and spreads to the knee down the thigh. If the pain is felt in the back of the hip/buttocks region and radiates down the hamstring to the calf, it could be a spine problem.
Back And Hip Pain: When To Seek Medical Help
It is critical to seek medical attention if you have lower back or hip pain. There are several treatments available for relieving your pain, and depending on the cause of your pain, you may need to try a different one.
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Top Causes Of Chronic Low Back Pain
Here are the top causes of low back pain and tips for prevention.
It’s hard to find any part of Elin Laird’s life that hasn’t been touched by pain. “I can’t stand for too long. I can’t sit for too long. Pretty much if I’m at home, I’m lying in bed,” says the 39-year-old single mother. “I can’t be as active in my son’s life. I can’t travel as much. I’ve lost so much of my life.”
Laird describes the pain of her herniated disc as similar to having “an ice pick shoved in the base of my spine.” It’s a pain that no therapy â from steroids to painkillers to surgery â has managed to budge. And she is far from alone in her discomfort.
“Eighty percent of the population of the United States, at some point in their life, is going to have back pain,” says Ronald J. Wisneski, MD, an orthopedic surgeon, specialist in spinal disorders and spine surgery, and associate in the Department of Orthopedic Surgery at Geisinger Medical Center in Danville, Pa. Most of the time, that pain is centered in the lower back and non-specific, meaning there is no primary cause found. About 2% to 10% of people who experience low back pain develop chronic low back pain, which affects daily living for at least 3 months.
What could be triggering your back pain? To get an idea, WebMD talked to two orthopaedic surgeons about the most common causes of chronic lower back pain — and what you can do about it.
