Injections For Lower Back Pain
Injections are also administered in treatment of lower back pain. Types of lower back pain injections include the following:
- Botox Injection â This type of injection is shot directly into the back muscle to alleviate lower back pain and treat the condition.
- Amticon Vulsants â This is also prescribed for treating lower back pain.
- Anesthetic or Steroid Injections â This type of injection is prescribed for lower back pain to provide short time relief.
Can Back Pain Lead To Complications
The good news is that most people recover from back pain within a few weeks.1 See your doctor if you experience additional symptoms, such as:
- loss of bowel and/or bladder control
- severe pain that gets worse instead of better over time
- problems with passing urine or bowel movements
- numbness or a pins-and-needles sensation in your legs, back or elsewhere
- unexplained weight loss
- back redness or swelling
For some people, back pain becomes an ongoing problem. Around 1 in every 2 people who experience back pain will experience it again, and for 1 in 5 people, back pain may last beyond 8 to 12 weeks. Possible complications that result from persistent, long-term back pain include:
- dependence on strong pain medicines, such as opioids
- reduced quality of life
- more difficulty finding work and keeping active
See your healthcare professional if your back pain is unresolved and limits your movement and activities. A health care professional can help you find ways to manage your pain and regain a better quality of life.
One Back Pain Treatment You Probably Dont Need
Back pain can be incredibly frustrating, and going under the knife may seem like the quickest, easiest fix to bring relief. But the truth is, many people dont need surgery for lower back pain management, Dr. Park says.
If your back pain is musculoskeletal, you will not require surgery, but if its a pinched nerve thats due to a disc herniation or something else, you may need to have surgery, he says. But even in those people, when you go through a six-to-eight-week course of treatment that includes physical therapy and activity modification, 85 to 90 percent of the time, they wont need surgery.
However, if you try the treatments above and dont see any improvement or still feel pain, talk to your doctor about a referral to a pain management specialist, as more specific tests or treatments may be required to get to the bottom of whats going on.
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How Is Back Strain Diagnosed
Unless pain has persisted for more than six weeks, diagnostic testing may not be needed. But if pain has persisted that long, it is important to rule out other things like a herniated disk. The following tests may be ordered by a doctor:
X-ray: Your doctor will look at the structure of your backbones and joints.
MRI: This 3D image is more specific than an x-ray. It can show the spinal cord, roots of the nerve, and soft tissue problems like enlargements or tumors.
Your doctor will also conduct a history and physical to see what exactly caused your strain.
Ways To Treat Chronic Back Pain Without Surgery
Back pain is considered chronic if it lasts three months or longer. It cancome and go, often bringing temporary relief, followed by frustration.Dealing with chronic back pain can be especially trying if you dont knowthe cause.
Back pain rehabilitationspecialistAndrew Nava, M.D., offers insights into common chronic back pain causes and nonsurgicaltreatment optionsand advises not to give up hope.
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Who Can Get A Back Strain
Does your back hurt? You are not alone. Most people at one time or another will suffer from a slight back problem. In the United States, back pain is one of the most common medical problems.
Back injuries often occur during sports, tasks at work, or home projects. When the lower spine muscles become swollen and inflamed, this is known as a strain. A strain can lead to muscle spasms and pain. Though less complicated than a fracture, the healing process depends on the cause and treatment.
Over a lifetime, more than eighty percent of people will have low back pain. It is seen more commonly among people ages 40 to 80, and in women. Over 100 billion dollars are spent each year in the United States because of low back pain factoring in decreased wages and absence from work.
A few people are more likely to develop a back strain. Risk factors include a family history of back pain, long periods of sitting, lifting of heavy items, and diseases such as arthritis or osteoporosis.
Spinal Manipulation By Chiropractors Works About As Well As Exercise Or Over
Passive therapies can also play a role in helping people manage back pain, though theres no silver bullet among them, and their effects also tend to be modest and short-lived. The research base for these alternative therapies is also generally weak: Theres a lot of variability among the practice styles and programs on offer, even within one category of treatment like massage. It can be difficult to blind the patients to the treatment they are receiving, and the people who seek out particular therapies acupuncture, massage are probably more amenable to them, which may bias the results. With that said, heres what we know.
Spinal manipulation, the cranking and tweaking on offer when you visit a traditional chiropractor, is among the most popular approaches to back pain. Practitioners lay their hands on the patient and move their joints to or beyond their range of motion a technique thats often accompanied by a pop or crack.
There is some evidence the approach can help people with chronic back pain but not any more than over-the-counter painkillers or exercise, and you need to take precautions when seeking out a chiropractor.
The Cochrane review on acute pain found that spinal manipulation worked no better than placebo. So people with a short episode of back pain should probably not bother seeing a chiropractor.
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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 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.
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What To Do About Lower Back Pain
It is prudent for you to visit your doctor if you have been experiencing recurring and persistent low back pain. The doctor will carry out examinations on you and recommend the right treatment procedure for you. There are two major treatment options for lower back pain. We have the surgical treatment and non surgical treatment options. Surgical treatment for lower back pain can only be carried out in severe cases with evidence of structural changes that require corrective surgical measures and where nerves are badly damaged or wearing out rapidly. Non surgical option is whereby the physician will try to alleviate the pain without any surgery. Non surgical treatment is administered in a number of ways which includes pain medication, application of heat or ice, manual manipulation, exercises and therapeutic massage.
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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Severe Lower Back Pain During Period
Lower back pain is a common symptom of premenstrual syndrome, which affects the majority of women during their periods. It isnt usually serious, however, if you have an underlying condition, such as dysmenorrhea, endometriosis, fibroids or premenstrual dysphoric disorder, you may develop severe lower back pain during your periods.
Can Further Bouts Of Back Pain Be Prevented
Evidence suggests that the best way to prevent bouts of low back pain is simply to keep active and to exercise regularly. This means general fitness exercise such as walking, running, swimming, etc. There is no firm evidence to say that any particular back strengthening exercises are more useful to prevent back pain than simply keeping fit and active. It is also sensible to be back-aware. For example, do not lift objects when you are in an awkward twisting posture.
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Addendum: Americas Most Famous Back Guru
No back pain article would be complete without a mention of the late John Sarno, an NYU professor of rehabilitation medicine and probably Americas best-known back guru. He believed there is an emotional basis for all chronic back pain.
More specifically, he thought that the brain distracts us from experiencing negative emotions by creating pain. We may not want to accept the uncomfortable truths that we are angry with our children, or that we hate our job, so instead of thinking those thoughts, we focus on the pain.
Back pain researchers and doctors generally still dont find Sarnos theories entirely convincing particularly his one-size-fits-all diagnosis and Ive written about why at length here. But Sarno got some things right. As Ive mentioned, its now mainstream to view chronic back pain as a biopsychosocial condition, and central sensitization is also gaining traction. Both ideas suggest its not just whats going on in your body and back that matters for your pain.
That means he was also ahead of his time when it came to treatment. What recommended as treatment was essentially cognitive behavioral therapy elimination of fear avoidant behavior and catastrophizing before anyone had ever heard of it, Ramin said, and its exactly what is being used now to treat patients with central sensitization.
Complementary And Alternative Techniques Include:
- Acupuncture is moderately effective for chronic low back pain. It involves inserting thin needles into precise points throughout the body and stimulating them , which may cause the body to release naturally occurring painkilling chemicals such as endorphins, serotonin, and acetylcholine.
- Behavioral approaches include:
- Biofeedback involves attaching electrodes to the skin and using an electromyography machine that allows people to become aware of and control their breathing, muscle tension, heart rate, and skin temperature people regulate their response to pain by using relaxation techniques
- Cognitive therapy involves using relaxation and coping techniques to ease back pain
Spinal injections include:Trigger point injections can relax knotted muscles that may contribute to back pain. An injection or series of injections of a local anesthetic and often a corticosteroid drug into the trigger point can lessen or relieve pain.
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Injections And Other Procedures
Depending on the source of your pain for example, if you have sciatica epidural injections may be helpful. Injections in the spine arent recommended for non-specific lower back pain though. If your back pain is chronic and other treatments havent helped, there is a procedure called radiofrequency denervation that uses a needle to treat the pain. This is only suitable for some people and you may need to have other tests beforehand. Speak to your specialist for advice.
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 spine the gradual thinning of the cartilage inside the spine
- Spinal stenosis narrowing 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.
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When To Contact A Doctor
Sometimes, people know the cause of their sharp lower back pain. For example, the pain may happen after they bend to pick something up or after an intense workout at the gym. In these cases, rest and home care may be enough to help the body heal.
However, there are some occasions when a person should contact a doctor, including:
- when the pain does not respond well to home treatments
- when pain that has no known cause lasts for longer than a couple of days
- when they experience tingling or weakness in the legs
People should take note of any symptoms as they appear to share with the doctor. The doctor will likely ask the person to describe their symptoms and how long they have persisted. They may also ask the person to do a series of movements to try to find the exact point of pain in the back and determine the underlying cause.
In some cases, the doctor may also order imaging tests, such as X-rays or MRI scans, to help with the diagnosis.
Lower Back Pain Causes
Nonspecific low back pain means that the pain is not due to any specific or underlying disease that can be found. It is thought that in some cases the cause may be an over-stretch of a ligament or muscle. In other cases the cause may be a minor problem with a disc between two spinal bones , or a minor problem with a small facet joint between two vertebrae. There may be other minor problems in the structures and tissues of the lower back that result in pain. However, these causes of the pain are impossible to prove by tests. Therefore, it is usually impossible for a doctor to say exactly where the pain is coming from, or exactly what is causing the pain.
To some people, not knowing the exact cause of the pain is unsettling. However, looked at another way, many people find it reassuring to know that the diagnosis is nonspecific back pain which means there is no serious problem or disease of the back or spine.
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