What Are The Treatments For Lower Back Pain
Lower back pain usually gets better with rest, ice and over-the-counter pain relievers. After a few days of rest, you can start to get back to your normal activities. Staying active increases blood flow to the area and helps you heal.
Other treatments for lower back pain depend on the cause. They include:
- Medications: Your provider may recommend nonsteroidal anti-inflammatory drugs or prescription drugs to relieve pain. Other medications relax muscles and prevent back spasms.
- Physical therapy : PT can strengthen muscles so they can support your spine. PT also improves flexibility and helps you avoid another injury.
- Hands-on manipulation: Several hands-on treatments can relax tight muscles, reduce pain and improve posture and alignment. Depending on the cause of pain, you may need osteopathic manipulation or chiropractic adjustments. Massage therapy can also help with back pain relief and restore function.
- Injections: Your provider uses a needle to inject medication into the area thats causing pain. Steroid injections relieve pain and reduce inflammation.
- Surgery: Some injuries and conditions need surgical repair. There are several types of surgery for low back pain, including many minimally invasive techniques.
Low Back Pain Fact Sheet
If you have had lower back pain, you are not alone. Back pain is one of most common reasons people see a doctor or miss days at work. Even school-age children can have back pain.
Back pain can range in intensity from a dull, constant ache to a sudden, sharp or shooting pain. It can begin suddenly as a result of an accident or by lifting something heavy, or it can develop over time as we age. Getting too little exercise followed by a strenuous workout also can cause back pain.
There are two types of back pain:
- Acute, or short-term back pain lasts a few days to a few weeks. Most low back pain is acute. It tends to resolve on its own within a few days with self-care and there is no residual loss of function. In some cases a few months are required for the symptoms to disappear.
- Chronic back pain is defined as pain that continues for 12 weeks or longer, even after an initial injury or underlying cause of acute low back pain has been treated. About 20 percent of people affected by acute low back pain develop chronic low back pain with persistent symptoms at one year. Even if pain persists, it does not always mean there is a medically serious underlying cause or one that can be easily identified and treated. In some cases, treatment successfully relieves chronic low back pain, but in other cases pain continues despite medical and surgical treatment.
How Common Is Lower Back Pain
Around four out of five people have lower back pain at some point in their lives. Its one of the most common reasons people visit healthcare providers.
Some people are more likely to have lower back pain than others. Risk factors for lower back pain include:
- Age: People over 30 have more back pain. Disks wear away with age. As the disks weaken and wear down, pain and stiffness can result.
- Weight: People who are obese or carry extra weight are more likely to have back pain. Excess weight puts pressure on joints and disks.
- Overall health: Weakened abdominal muscles cant support the spine, which can lead to back strains and sprains. People who smoke, drink alcohol excessively or live a sedentary lifestyle have a higher risk of back pain.
- Occupation and lifestyle: Jobs and activities that require heavy lifting or bending can increase the risk of a back injury.
- Structural problems: Severe back pain can result from conditions, such as scoliosis, that change spine alignment.
- Disease: People who have a family history of osteoarthritis, certain types of cancer and other disease have a higher risk of low back pain.
- Mental health: Back pain can result from depression and anxiety.
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What Are The Most Common Lower Back Surgery Procedures
Spine surgery is not necessary for most people who have lower back pain. If you do need it, your doctor will recommend an appropriate procedure to address your specific symptoms and medical situation. Common spine surgeries include:
Spinal Fusion. Two or more vertebrae are permanently fused together to limit excess spinal motion. Your surgeon will use a combination of bone, bonelike material, screws, plates and rods to hold the vertebrae together so they can heal into a single unit. Spinal fusion may be done to correct spinal deformities or to increase the spines stability in severe cases of spinal osteoarthritis or herniated discs.
Laminectomy and laminotomy. Laminectomy is a surgery in which your surgeon removes the back portion of one or more vertebrae to create more space for the spinal cord or other nerves. In people with severe arthritis, bone spurs within the spinal canal can grow large enough to press on the spinal cord, causing pain and limiting mobility. In a similar surgery known as laminotomy, your surgeon will remove a small piece of bone called the lamina from the back of the vertebra.
Nonspecific Low Back Pain
This is the most common type of back pain. The majority of cases of sudden-onset low back pain are classed as nonspecific. This is the type of back pain that most people will have at some point in their lives. It is called nonspecific because it is usually not clear what is actually causing the pain. In other words, there is no specific problem or disease that can be identified as the cause of the pain. The severity of the pain can vary from mild to severe. This type of back pain is discussed further below.
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How To Treat A Pulled Muscle
Prevention should always be the primary goal:
- Maintain strong abdominal and back core muscles to help stabilize your spine and prevent strain on back muscles.
- Live a healthy lifestyle, including weight management and low-impact aerobic exercises, to build muscle strength and prevent strain.
- Maintain a neutral posture when sitting or standing.
- Utilize leg muscles instead of back muscles when lifting objects to prevent back muscle fatigue and injury.
Muscular back pain usually goes away after several weeks of home care, says Dr. Van Dien. Despite the popular belief that you must rest, early mobilization and walking following an acute back strain will help keep muscles loose and prevent further lower back tightness. Over-the-counter anti-inflammatory medication and alternating ice and heat can be helpful with the initial onset of pain. Your doctor may also recommend a course of physical therapy.
If You Have Low Back Pain Try These Steps First
- By Monique Tello, MD, MPH, Contributor
Low back pain, the scourge of mankind: it is the second leading cause of disability here in the United States, and the fourth worldwide. Its also one of the top five medical problems for which people see doctors. Almost every day that I see patients, I see someone with back pain. Its one of the top reasons for lost wages due to missed work, as well as for healthcare dollars spent, hence, a very expensive problem.
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What Causes Or Increases My Risk For Chronic Back Pain
Conditions that affect the spine, joints, or muscles can cause back pain. These may include arthritis, spinal stenosis , muscle tension, or breakdown of the spinal discs. The following increase your risk for back pain:
- Aging
- Lack of regular physical activity
- Repeated bending, lifting, or twisting, or lifting heavy items
- Obesity or pregnancy
- Injury from a fall or accident
- Driving, sitting, or standing for long periods
- Bad posture while sitting or standing
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.
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Can I Prevent Lower Back Pain
You cant prevent lower back pain that results from disease or structural problems in the spine. But you can avoid injuries that cause back pain.
To reduce your risk of a back injury, you should:
- Maintain a healthy weight: Excess weight puts pressure on vertebrae and disks.
- Strengthen your abdominal muscles: Pilates and other exercise programs strengthen core muscles that support the spine.
- Lift the right way: To avoid injuries, lift with your legs . Hold heavy items close to your body. Try not to twist your torso while youre lifting.
What Home Remedies For Lower Back Pain Actually Work
Unless youve had a major injury, such as a fall or car accident, you probably dont need to rush to the doctor for back pain. You may want to try these simple self-care strategies first.
Avoid bed rest. When lower back pain strikes, people often think complete rest will relieve back pain. However, a review of many clinical studies found that patients who retreated to bed actually experienced more pain and recovered more slowly than patients who stayed fairly active
Use ice and/or heat. Many people find that using ice or cold packs for periods of up to 20 minutes at a time helps reduce pain and swelling. Always wrap ice or a cold pack in a thin towel before putting it on your body so you dont injure your skin. You may also find that heat, such as a heating pad or warm bath, eases pain. Ice is recommended in the first 48 hours after injury then you can try a combo of ice and heat.
Try over-the-counter remedies. Short-term use of OTC pain relievers, such as the nonsteroidal anti-inflammatory drugs ibuprofen and naproxen, may ease your lower back pain. Also consider OTC creams, gels, patches, or sprays applied to the skin. They stimulate the nerves in the skin to provide feelings of warmth or cold in order to dull the sensation of pain.
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How To Get Up From The Floor
To get up safely from lying face down:
Inflammation Is Likely A Culprit Too
Beyond our now more sedentary lifestyle, the inflammatory nature of COVID-19 is the primary culprit for back and joint pain, according to Haines.
Viral infections can cause inflammation which can wreak havoc on our muscles and joints, Haines said.
While prior variants of COVID-19 caused significant inflammation in the lungs, inflammation can occur in any part of the body, according to McNally. When that inflammation settles in the muscles and joints of the back, pain can occur.
McNally says that while back pain may seem like an inconvenient but minor symptom, it can be a warning sign for a greater problem if it persists for more than a few days, whether COVID-19 related or not.
A sustained high fever could be an infection in the spine, McNally said. The fever could likely be part of the COVID-19 infection, but close monitoring is still necessary.
McNally says that other red flags would be loss of bladder or bowel function or numbness in the legs. If any of these symptoms occur, you should seek care as soon as possible.
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How Is Back Pain Treated
Acute back pain usually gets better on its own. Acute back pain is usually treated with:
- Medications designed to relieve pain and/or inflammation
- analgesics such as acetaminophen and aspirin
- non-steroidal anti-inflammatory drugs such as ibuprofen and naproxen may be sold over the counter some NSAIDS are prescribed by a physician
- muscle relaxants are prescription drugs that are used on a short-term basis to relax tight muscles
- topical pain relief such as creams, gels, patches, or sprays applied to the skin stimulate the nerves in the skin to provide feelings of warmth or cold in order to dull the sensation of pain. Common topical medications include capsaicin and lidocaine.
Exercising, bed rest, and surgery are typically not recommended for acute back pain.Chronic back pain is most often treated with a stepped care approach, moving from simple low-cost treatments to more aggressive approaches. Specific treatments may depend on the identified cause of the back pain.
What Are Some Complementary Alternative And Emerging Treatments For Lower Back Pain
In some cases, doctors suggest therapies that are not considered standard of care. They probably wont be covered by insurance, but they may be worth considering. Examples include:
Platelet-rich plasma . PRP treatments use a small sample of your own blood that has concentrated amounts of blood building blocks known as platelets. Your doctor then injects the PRP directly into a damaged disc. The theory is that PRP injections use your own healing system to accelerate improvement of injured tendons, ligaments, muscles, and joints. PRP treatment has a longer track record in knee osteoarthritis, but a recent review article in the Journal of Spine Surgery suggests it may have a useful role for back pain, too. PRP needs a lot more research before it can be considered a proven technique.
Stem cells. In this emerging treatment, your doctor injects stem cells harvested from your hip into the intervertebral disc or discs causing your pain. Doing so may lessen pain and the degenerative effects of aging, though, like PRP, more research is needed before stem cells for lower back pain could eventually become the standard of care.
Acupuncture. Your doctor probably doesnt perform acupuncture , but may support you trying it as a complementary therapy. Acupuncture involves careful insertion of fine, sterile needles into specific points on your body. This may stimulate the release of your natural pain-killing chemicals.
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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 .
How To Get Into Bed
To get into bed safely:
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Less Common Causes Of Low Back Pain
Inflammation of the joints of the spine sometimes causes back pain. Osteoarthritis is the common form of arthritis and usually occurs in older people. Ankylosing spondylitis is another form of arthritis that can occur in young adults and which causes pain and stiffness in the lower back. Rheumatoid arthritis may affect the spine but you are likely to have other joints affected too.
Various uncommon bone disorders, tumours, infection and pressure from structures near to the spine occasionally cause low back pain .
The rest of this leaflet is mainly about nonspecific low back pain – the common type of low back pain.
How To Sit On A Chair
To sit on a chair safely:
To help your back and make sitting more comfortable:
- Try to get up and change position regularly
- Try to sit right back in the chair
- Put a rolled up towel in the small curve at the bottom of your spine
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