We Need Make Our Default Choices More Back
Theres a pretty simple adage public health officials stick to: Make it easy for people to stay healthy, and make it hard for them to get sick.
When it comes to back pain in America, we make it easy for people to get sick and hard for them to stay healthy.
Theres a complete disconnect between what insurance providers will cover for people and what actually helps their back pain. Its still much easier to get your opioids or back surgery paid for by your insurance provider than to get a massage or exercise program reimbursed.
More states need to move in the direction of places like Oregon, where insurance payers are making the default options for people with back pain healthier by expanding access to, and coverage for, non-drug options.
For example, the Oregon Health Plan has ensured that alternatives like acupuncture and physical therapy are covered. Its also expanded access to treatment for the behavioral health factors that are associated with back pain by paying primary care clinics extra to be able to hire behavioral health specialists and meet patients who may not have had access to those services. Finally, its opened non-medication pain clinics, where people with low back pain can get a range of treatments as well as help to taper off their opioid prescriptions.
Manage Or Reduce Stress
Stress can trigger muscle tension and painful spasms, including in the back. If long-term stress or a traumatic event seems to have caused back pain, a person can try stress-relief techniques, such as:
- Mindfulness meditation.One study showed that mindfulness-based stress reduction improved back pain. Mindfulness involves being aware of what the body is doing and using meditation techniques to assist with the pain.
- Deep breathing. Taking deep breaths in and out for several minutes can calm the bodys stress response.
- Progressive muscle relaxation. This involves tensing and relaxing muscles in the body, focusing on one muscle group at a time. Lying on their back, a person can start with their feet and gradually move up to the shoulders.
- Guided imagery. This involves focusing on specific mental images to bring about a feeling of relaxation. One study found guided imagery and music helps with work-related chronic stress.
- Yoga. Yoga focuses on particular poses and breathing and can help with relaxation, especially when practiced regularly. One review found yoga to be an effective stress management tool.
Many smartphone apps are available to guide a person through relaxation techniques and meditation.
Seeking Help For Lower Back Pain
You may not need to seek help from a health professional for lower back pain. Most people find their lower back pain improves by itself within a few weeks. But if thereâs no improvement after two to three weeks or the pain is getting worse, seek advice from a GP or physiotherapist. Itâs also worth seeking help if your back pain is stopping you from doing normal activities, or if it goes on longer than six weeks.
Physiotherapists are often best placed to help with back pain. In some areas, you may be able to self-refer to a physiotherapist on the NHS, whereas in others you need a referral through your GP. You can also choose to pay for private physiotherapy.
There are some circumstances when you should always see a doctor straightaway for back pain though. These include if:
- you have numbness or tingling around your bottom or genitals
- you cant control your bladder or bowels
- youre unsteady when you walk, or your legs or feet feel weak, you have sudden, severe lower back pain
- youve been in a major accident, such as a traffic collision or fall
- you have osteoporosis
- theres a visible deformity in your back
- the pain continues when youre lying down or overnight, disturbing your sleep
- you have a history of cancer or have had a recent bacterial infection
- you also have a fever, chills or unexplained weight loss
These can be signs of more serious problems.
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Treatment Options For Spinal Stenosis Pain
I know we talk about this a lot, but you cannot start treating spinal stenosis until you have a full diagnosis from a physician. This can be accomplished by a physical exam, in conjunction with diagnostic imaging tests . After a physician has fully diagnosed your condition, you can move forward to a discussion of treatment strategy. Treating pain from spinal stenosis typically begins with conservative methods like pain medication and injection therapy. If conservative methods fail, or the stenosis begins to threaten the spinal nerves, surgical intervention may be necessary.
What Structures Make Up The Back
The lower backwhere most back pain occursincludes the five vertebrae in the lumbar region, which supports much of the weight of the upper body. The spaces between the vertebrae are maintained by round, rubbery pads called intervertebral discs that act like shock absorbers throughout the spinal column to cushion the bones as the body moves. Bands of tissue known as ligaments hold the vertebrae in place, and tendons attach the muscles to the spinal column. Thirty-one pairs of nerves are rooted to the spinal cord and they control body movements and transmit signals from the body to the brain.
Other regions of vertebrate are cervical , thoracic , and sacral and coccygeal segments.
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Dont Slump Over Your Desk
When sitting in an office chair, use the same good posture techniques you use when standing. Its critical to keep good posture and support your back when sitting down, especially if you do it for several hours per day. Choose a quality chair that provides firm support for your lower back, and make sure your knees are a little higher than your hips when you sit.
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Things You Can Do To Ease Back Pain
Any of these conditions can cause inflammation or pressure on nerves or pain. When this happens, Cleveland Clinic back pain specialists recommend:
When To See A Doctor
People can often treat back pain with home remedies and some patience. However, a person should speak to a doctor about chronic or severe back pain.
A doctor may recommend physical therapy, medication, or other treatments. People who have existing health conditions or who take regular medications should speak to a doctor before trying any herbs or supplements.
The U.S. Food and Drug Administration do not monitor supplements for purity or quality, so it is essential to research reputable companies first.
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- Beck, B. D., Hansen, & angst . M., & Gold, C. . Coping with work-related stress through guided imagery and music : Randomized controlled trial. Journal of Music Therapy, 52, 323352
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What Can Cause Lower Back Pain
Most acute low back pain is mechanical in nature, meaning that there is a disruption in the way the components of the back fit together and move. Some examples of mechanical causes of low back pain include:
Congenital
- Skeletal irregularities such as scoliosis , lordosis , kyphosis , and other congenital anomalies of the spine.
- Spina bifida which involves the incomplete development of the spinal cord and/or its protective covering and can cause problems involving malformation of vertebrae and abnormal sensations and even paralysis.
Injuries
- Sprains , strains , and spasms
- Traumatic Injury such as from playing sports, car accidents, or a fall that can injure tendons, ligaments, or muscle causing the pain, as well as compress the spine and cause discs to rupture or herniate.
Degenerative problems
- Intervertebral disc degeneration which occurs when the usually rubbery discs wear down as a normal process of aging and lose their cushioning ability.
- Spondylosis the general degeneration of the spine associated with normal wear and tear that occurs in the joints, discs, and bones of the spine as people get older.
- Arthritis or other inflammatory disease in the spine, including osteoarthritis and rheumatoid arthritis as well as spondylitis, an inflammation of the vertebrae.
Nerve and spinal cord problems
Non-spine sources
Ask Your Doctor About Biofeedback
In recent years, biofeedback a type of mind-body technique that uses electrical sensors to help you make subtle changes in your body has grown in popularity as an effective way to manage back pain. A suggested that biofeedback could reduce the intensity of back pain and muscle tension, both as a standalone treatment and when combined with other treatments.
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Tips For Easing Back Pain
Use these self-care tips to ease your back ache and pain associated with arthritis.
1. Relief is Possible
2. Get Wet
3. Move and Strengthen It
4. Find Your Zen
5. Cinch It In
6. Trim It Down
7. Visit China
8. Manipulate It
9. Apply Pressure
10. Put It Together
11. Medicate It
Managing Pain
Go To Work If You Can
It’s important to try to stay in work even if you’re in pain. Research shows that people become less active and more depressed when they don’t work.
Being at work may distract you from the pain and might not make it worse.
Talk to your supervisor or boss if parts of your job are difficult to begin with, but stress that you want to be at work if that’s the case.
If you have been off work for 4 to 6 weeks, plan with your doctor, therapist or employer how and when you can return.
You could go back to work gradually. For instance, you might start with 1 day a week and gradually increase the time you spend at work.
You could also agree changes to your job or pattern of work if it helps a health and safety rep or occupational health department may be useful here.
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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.
Support Your Body In A Warm Pool
The buoyancy of the water lets you enjoy the benefits of exercise with less pain. Exercising in water also helps regulate the functioning of nerves and muscles, relieving pain.14
If you prefer warmer pools, look into water exercise classes and hydrotherapy pools. Water therapy exercises are often done in water that is about 83 degrees to 88 degrees. Hydrotherapy pool temperatures are often more than 90 degrees.
See Water Therapy Exercise Program
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When Surgery Is Necessary
When conservative treatment for low back pain does not provide relief or neurologic symptoms are worsening or severe, surgery may be needed. Candidates for surgery present any of the following:
- Reasonably good health
- Back and leg pain limits normal activity or impairs quality of life
- Progressive neurologic deficits develop, such as leg weakness, numbness or both
- Loss of normal bowel and bladder functions
- Difficulty standing or walking
- Medication and physical therapy are ineffective
If surgery is recommended, neurosurgeons have a variety of options available to help relieve pressure on the nerve roots. If several nerve roots and discs are causing the pain or if degeneration and instability exist in the spinal column, the neurosurgeon may choose: a minimally invasive approach a more open decompression or fusing the vertebrae together with bone grafts and stabilizing them with instrumentation, including metal plates, screws, rods and cages, depending on the extent of disease. After such surgery, patients may gain restored mobility in the back, including the ability to bend over. In addition, patients may require postoperative physical therapy.
The benefits of surgery should always be weighed carefully against the risks. Although a large percentage of patients with low back pain report significant pain relief after surgery, it is not guaranteed that surgery will help.
New Understanding Of Chronic Pain
Patients who report continuing pain in the absence of a definitive pathology are sometimes dismissed by health professionals. Even in the absence of such an identifiable cause, however, chronic pain can lead to neurological feedback processes that only serve to worsen the pain and make it more difficult to treat.
Pain is inherently subjective, and a greater awareness of the need for taking pain seriously is growing among the health community as well as the public at large. This is particularly true for chronic back pain sufferers.
While a great majority of back pain cases are self-limiting and resolve on their own, the risk of recurrence and development of chronic disease is significant.
failed back surgeryneuropathic pain
The above considerations have led to a proliferation of services available to patients seeking both medical and alternative treatment for back pain.
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Work On Your Coping Skills
A study conducted in 2019 showed that patients who were positive about their outlook for chronic pain got better faster than the patients who had a negative outlook. Our perception and coping mechanisms can really affect the way we feel pain. Do not focus on the worst-case scenarios, instead, try to make your day better and more positive with small things. There are a lot of people who deal with chronic pain but end up leading really fruitful lives. This is only because they have developed healthy coping skills such as medications, exercise, healthy diets, and much more.
Identify Your Triggers That Increase Pain
Did you know that stress can lead to more pain sensations in the body? It is important to identify your stress triggers so that your pain level does not increase. Start by observing your thoughts, feelings, and reactions whenever you experience more pain in your body. Is the situation too stressful? Do you think you can handle it better? What would you do differently if given the chance? Being aware of your triggers is the first step in helping you eliminate or eradicate them completely. You can even think of keeping a diary for your anxiety or stress triggers to see how it affects your pain. This can be used as a beneficial monitoring tool to help track your progress.
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Understanding The Lower Back
The lower back is also called the lumbosacral area of the back. It is the part of the back between the bottom of the ribs and the top of the legs.
Most of the lower back is made up from muscles that attach to, and surround, the spine. The spine is made up of many bones called vertebrae. The vertebrae are roughly circular and between each vertebra is a disc. The discs between the vertebrae are a combination of a strong fibrous outer layer and a softer, gel-like centre. The discs act as shock absorbers and allow the spine to be flexible.
Common Causes Of Chronic Back Pain
Chronic back painis usually age-related, but can also result from a prior injury. The mostcommon causes include:
- Arthritis of the spinethe gradual thinning of the cartilage inside the spine
- Spinal stenosisnarrowing of the spinal canal that may lead to nerve pain
- Disc problems, such as a herniated or bulging disc
- Myofascial pain syndromeunexplained muscle pain and tenderness
In some cases, its difficult to pinpoint the cause of chronic back pain.If your doctor has exhausted all diagnostic options, its time to seek asecond opinion from a back pain specialist, recommends Nava. Itsimportant not to make rushed decisions or undergo extensive medicalprocedures until the origin of the pain is found. Not only may they nothelp they could make the pain worse, warns Nava.
If the source of the pain is not known or cant be treated, your bestoption may be to work with your doctor on reducing the flare-ups and makingthe pain manageable with nonsurgical treatments.
Back Pain Causes and Treatments Webinar | Stephanie Van, M.D.
Chronic back pain is a persistent source of discomfort for many adults. In this webinar, our expert Stephanie Van, M.D., discusses common causes of back pain along with strategies for relief.
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