Treatment Options For Acute Lower Back Pain
Most low back pain is due to muscle strain and spasm and does not require surgery. To treat the pain, medications such as acetaminophen , nonsteroidal anti-inflammatory agents , gabapentin or pregabalin can be used. NSAIDs suppress inflammation, pain and fever by inhibiting certain inflammation-causing chemicals in the body. Acetaminophen reduces pain and fever, but does not inhibit inflammation. Gabapentin and pregabalin, medications that have been used for antiseizure activity, also have the ability to block pain. Opioids provide pain relief and may at times be prescribed to manage severe back pain. However, opioids have many problems, such as habituation, constipation and lightheadedness, and are avoided when possible and used for the shortest possible duration. Epidural injection is an option if the back pain does not respond to these treatments. Each person is different in terms of response to medication.
Other nonsurgical treatments for lower back pain include Intradiscal electrothermal therapy , nucleoplasty, and radiofrequency lesioning.
Sleep On A Quality Mattress
Lower back pain sufferers usually benefit from sleeping on a medium-firm mattress. However, your preferred sleep position also should influence your mattress selection. To maintain good posture, side sleepers should select a softer mattress. Back and stomach sleepers should choose a firmer mattress. If you have lower back pain, its a good idea to avoid sleeping on your stomach altogether.
If your lower back pain doesnt improve after 4 to 6 weeks of home care using these suggestions, you should see your doctor. You also should contact your doctor right away if you have any red flags, including:
- A history of cancer or a recent infection
- A recent fall or other accident
- Extreme fatigue
- Signs of infection, such as fever, chills, sweats
- Nerve problems, such as shooting pain, numbness or tingling
- Changes in bowel or bladder function
Other options for treating lower back pain may include physical therapy, pain management with cortisone injections or, in certain cases, surgery. Although lower back surgery can be beneficial for patients who are experiencing nerve problems and injured discs, its not typically recommended for patients with other types of lower back pain.
Download the Virtua Health Guide to Back Pain, or call to request a consultation with a Virtua back pain specialist.
Low Back Pain Shouldn’t Sideline You
Explore the common but under treated and misunderstood issues that accompany chronic back pain in our Back Pain Series. Part 1 explains the latest treatments that could relieve that aching back.
Many Penn State alumni fondly remember David K., now 34, as the student who crawled to class. Mired by back pain throughout his four years of college, David saw tons of doctors from top neurosurgeons to psychologists for the pain. Instead of listening to the popular college music of his day like REM, he listened to the soothing sounds of pain expert John E. Sarno, MD, on cassette tapes called Mind Over Back Pain when he drove his Mustang around the college campus.
“If you don’t have chronic back pain, you can’t possibly imagine what it feels like,” he says. “It’s unbearable — literally.” He says that there were many times he couldn’t walk and would have to crawl from his fraternity house all the way to class so he would not miss a midterm or final exam. “My fraternity brothers made a lot of fun of me,” he says. “Still do.”
About 80% of Americans — or four in five — experience low back pain at some point in their lives and understand David’s plight all too well. Many people with chronic low back pain are working age and for them, back pain is the most frequent case of lost productivity. Treatment for back pain costs roughly $100 billion a year, according to the American Academy of Orthopaedic Surgeons in Rosemont, Ill.
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What Are The Risk Factors For Developing Low Back Pain
Anyone can have back pain. Factors that can increase the risk for low back pain include:
Age: The first attack of low back pain typically occurs between the ages of 30 and 50, and back pain becomes more common with advancing age. Loss of bone strength from osteoporosis can lead to fractures, and at the same time, muscle elasticity and tone decrease. The intervertebral discs begin to lose fluid and flexibility with age, which decreases their ability to cushion the vertebrae. The risk of spinal stenosis also increases with age.
Fitness level: Back pain is more common among people who are not physically fit. Weak back and abdominal muscles may not properly support the spine. Weekend warriorspeople who go out and exercise a lot after being inactive all weekare more likely to suffer painful back injuries than people who make moderate physical activity a daily habit. Studies show that low-impact aerobic exercise can help maintain the integrity of intervertebral discs.
Weight gain: Being overweight, obese, or quickly gaining significant amounts of weight can put stress on the back and lead to low back pain.
Genetics: Some causes of back pain, such as ankylosing spondylitis , have a genetic component.
Smoking: It can restrict blood flow and oxygen to the discs, causing them to degenerate faster.
Backpack overload in children: A backpack overloaded with schoolbooks and supplies can strain the back and cause muscle fatigue.
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.
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Exercise To Loosen Muscles
Although it may seem counterintuitive to exercise when lower back pain is causing you grief, the right kind of movement can help eliminate the discomfort. Its always important to consult your physician before you engage in exercise when you have pain, but this conversation is well worth having if youre suffering.
First, you should keep in mind that not all exercise is beneficial in combating back pain. Try to avoid toe-touch exercises and sit-ups, which may add to the stress on your spine instead of relieving it. Leg lifts are another exercise to stay away from when you are hurting. If your core is not strong, leg lifts could be too demanding on your body if youre already experiencing pain.
Several types of exercises can be useful when you need to relieve back pain. Partial crunches can aid in strengthening your core without applying too much pressure to the area. Slow and controlled wall-sit exercises may also be useful. Other repetitions to consider include bringing each knee to the chest in succession, pelvic tilts, and swimming.
Whats Causing The Muscle Spasms
People will often blame the movement, suspecting they simply made one wrong move such as bending over with bad mechanics. This is probably true, especially in situations outside of what you ordinarily do, but for things youve done a million times before, like reaching for your shoes or unloading the dishwasher, why this time and why now?
Perhaps youre thinking spinal disc herniation. But were here to tell you that making one wrong movement usually is not the root cause of a herniated disc. An acute disc herniation would typically require more forceful impact such as an industrial accident or car collision. Otherwise, there are two explanations for the everyday disc herniation: cumulative injury and genetics both of these involve the disc slowly herniating over time. Slowly herniating discs are an underlying issue that go undiagnosed in up to 63% of individuals whom experience little to no pain despite their MRIs revealing one or more herniated discs. Understanding acute spinal disc herniation makes this aforementioned scenario entirely plausible.
For example, lets say youve had a herniated disc for years without knowing about it. Then one day you finally moved in such a way that the disc became more compressed than usual or the disc pressed onto a nearby nerve triggering a protective yet painful response by your body.
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When To See A Spine Specialist For Chronic Back Pain
Sometimes back pain comes on quick, and you know exactly what caused it. After some stretching, resting and pain relievers, you’ll remember to bend with your knees next time.
But, other times, people experiencing back pain are often left thinking: I don’t even remember when the pain started or what I did to cause it. The reality is that the source of you back pain may not always be evident which can also make it hard to know when it’s time to see an expert.
Dr. Hwang says the following five signs likely indicate that it’s time to see a spine specialist for your back pain:
1. Your pain is severe. While some back pain is only mild to moderate, severe back pain is when your pain is constant, intense or gets worse when you’re resting or at night.
2. Your pain is persistent. If your back pain lasts longer than three months, it’s considered chronic and may require a tailored treatment plan.
3. Your pain isn’t isolated to your back. If your pain is traveling down your leg, you have numbness or weakness in your hips or legs, or you’re experiencing tingling in your legs and feet, it may be a sign that there’s pressure on your spine.
4. Everyday activities have become difficult. If your back pain is already affecting routine activities, don’t let it get so debilitating that it keeps you from doing things you enjoy.
- Find a Houston Methodist spine specialist that can treat your back pain at a location convenient for you
Forgotten Remedies For Back Pain Relief
Back pain is absolutely debilitating for us. Especially when it is chronic pain. When the cold packs and Advil dont solve the problem, we are forced into bed rest and stronger opioid medications.Bed rest and drugs can lead to a vicious cycle of constant pain and further injury if not treated.The traditional route of going to the doctor and physical therapy can be a good choice for some people. There are a number of basics like dont lift heavy objects or use ice packs. But there are also a number of overlooked remedies for back pain relief that have proven to be effective.Here are 5 we see work well:
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Inflammatory Lower Back Pain
Although comparatively few patients have low back pain due to a systemic inflammatory condition, the problem can be life long and can impair function significantly. The good news is that treatments can help essentially all patients, and can lead to major improvements.
Seronegative are a group of inflammatory diseases that begin at a young age, with gradual onset. Like other inflammatory joint diseases, they are associated with morning stiffness that gets better with exercise. Sometimes fusion of vertebrae in the cervical or lumbar regions of the spine occurs. Drugs called TNF-alpha blocking agents, which are used for rheumatoid arthritis, are also used to treat the stiffness, pain, and swelling of spondyloarthropathy, when the cases are severe and not responsive to traditional medications
People who have spondyloarthropathy have stiffness that is generally worst in the morning, and have decreased motion of the spine. They also can have decreased ability to take a deep breath due to loss of motion of the chest wall. Its important for the physician to look for problems with chest wall expansion in patients with spondyloarthropathy.
syndrome is one of the forms of spondyloarthropathy. It is a form of arthritis that occurs in reaction to an infection somewhere in the body, and it carries its own set of signs and symptoms. The doctor will look for:
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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About Lower Back Pain
Lower back pain is pain in the area of your back from the bottom of your ribs to the top of your legs. It can come from any of the many structures that make up your back. These include bones, joints, muscles, ligaments, nerves and tendons.
Your spine supports your back. Its made up of 24 separate bones called vertebrae stacked on top of one another. The lower section of your spine is called the lumbar spine. Below the vertebrae, at the bottom of your spine, are bones called your sacrum and coccyx. You may hear lower back pain referred to as lumbosacral pain.
Discs of cartilage sit between each vertebra, acting as shock absorbers and allowing your spine to bend. Some lower back pain originates from these discs. Your spinal cord threads through the vertebrae, carrying nerve signals between your brain and the rest of your body. If nerves at the base of your spine become compressed or inflamed, it can cause sciatica. Sciatica is a type of pain that starts in your back or buttocks and spreads down your leg.
Its usually difficult for doctors to say exactly whats causing back pain. This is because there are so many different parts to your back and tissues that surround it. Even tests such as X-rays and magnetic resonance imaging scans arent helpful for most people.
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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Complementary Alternative Emerging Treatments
In some cases, doctors suggest therapies that are not considered current standard of care. They probably wont be covered by insurance, but they may be worth considering. Examples include:
. 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.
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.
. 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.
Urgent Advice: Ask For An Urgent Gp Appointment Or Get Help From 111 If:
You have back pain and:
- a high temperature
- you’ve lost weight without trying to
- there’s a lump or swelling in your back or your back has changed shape
- the pain does not improve after resting or is worse at night
- the pain is made worse when sneezing, coughing or pooing
- the pain is coming from the top of your back , rather than your lower back
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Common Causes Of Chronic Lower Back Pain
“Chronic lower back pain is less likely to be caused by injury to your muscles and ligaments and more likely to be due to issues with the lumbar disks, nerves, joints or vertebrae,” says Dr. Palmer. “There are several potential causes of chronic pain in the lower back.”
In general, osteoarthritis and degenerative disk disease are the underlying cause of many types of chronic lower back pain. However, lower back pain can also be caused by accident-related trauma and acute stress.