Injections And Other Procedures
If you have severe sciatica, your doctor may suggest an epidural injection. Epidural injections contain a local anaesthetic and steroid to relieve pain and reduce inflammation. Theyre only recommended for sciatica and not non-specific lower back pain.
If your back pain is chronic and other treatments havent helped, your doctor may suggest a procedure called radiofrequency denervation. Its only suitable for certain types of back pain. Your doctor will refer you to a specialist to assess whether it would help you.
Upper Back Pain When Sitting
Many people experience pain in their necks and upper backs as a result of craning forward while sitting to look at a computer monitor or phone display. Although its tempting to sprawl out and watch television for hours, this can also easily throw your back out of alignment.
That uncomfortable feeling of stiffness when you finally do move or stand up is telling you something.
Better posture makes a difference.
Its likely your parents or teachers cautioned you to sit up straight when you were a child, and with good reason.
Sitting in one position too long isnt healthy. Doing it with your back rounded forward, slumped to one side, or leaning too far back can put stress on parts of your spine for an extended period. This can lead to pain, as well as other issues.
To help you sit straighter, position your body along an imaginary straight line extending the length of your back, out of your head, and up to the ceiling. Keep your shoulders level and dont let your pelvis rotate forward. Doing so causes a curve in your lower back.
If you sit up perfectly straight, youll feel the small of your back stretch and lengthen.
How Soon After Treatment Will I Feel Better
If your pain is caused by a urinary tract infection, your pain may be gone after the seven to 10-day course of antibiotics. If its caused by endometriosis, the pain might be with you longer as thats a lifelong issue. When you talk to your healthcare provider about the cause of your pain, find out what the timeline is.
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Georgia’s Only Nationally Ranked Orthopedic Program For Kids And Teens
We are among the best orthopedic programs in the nation for kids and teens based on factors like overall outcomes, number of patients treated, fewer complications, best practices and more.
Nicholas D. Fletcher, MD, is a Pediatric Orthopedic Surgeon and serves as Medical Director of Spine Quality and Outcomes at Childrens Healthcare of Atlanta. He is also an Associate Professor of orthopedic surgery at Emory University School of Medicine. Dr. Fletchers areas of clinical expertise include spine and hip conditions. For children with scoliosis, kyphosis and spondylolisthesis, he offers a range of nonsurgical and surgical options, including Mehta casting, bracing and posterior spinal fusion, as well as magnetic expandable growing rods and VEPTR.
This content is general information and is not specific medical advice. Always consult with a doctor or healthcare provider if you have any questions or concerns about the health of a child. In case of an urgent concern or emergency, call 911 or go to the nearest emergency department right away. Some physicians and affiliated healthcare professionals on the Childrens Healthcare of Atlanta team are independent providers and are not our employees.
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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How Is Back Pain Diagnosed
Your health professional will first assess your back pain. They may ask questions including:
- When did your back pain begin?
- What activities were you doing differently to normal before your back pain started?
- How would you describe the pain? Is there tingling or numbness?
- What makes the pain better or worse?
If your pain doesnt settle after a few weeks or starts getting worse, ask your doctor or other health care professional about other management options. You may be referred for tests if there is reason to suspect a more serious cause for your back pain.
In most situations, imaging such as X-ray, CT or MRI scans are not helpful unless there is an obvious injury or strain.
Unnecessary tests can be expensive, and many investigations will show changes in your spine that reflect the normal passage of time, rather than damage to your spine.
More Advanced Care Options
Surgery When other therapies fail, surgery may be considered to relieve pain caused by worsening nerve damage, serious musculoskeletal injuries, or nerve compression. Specific surgeries are selected for specific conditions/indications. However, surgery is not always successful. It may be months following surgery before the person is fully healed and there may be permanent loss of flexibility. Surgical options include:
Implanted nerve stimulators
- Spinal cord stimulation uses low-voltage electrical impulses from a small implanted device that is connected to a wire that runs along the spinal cord. The impulses are designed to block pain signals that are normally sent to the brain.
- Dorsal root ganglion stimulation also involves electrical signals sent along a wire connected to a small device that is implanted into the lower back. It specifically targets the nerve fibers that transmit pain signals. The impulses are designed to replace pain signals with a less painful numbing or tingling sensation.
- Peripheral nerve stimulation also uses a small implanted device and an electrode to generate and send electrical pulses that create a tingling sensation to provide pain relief.
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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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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.
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What To Look For In A Mattress
Your mattress matters too.
Doctors used to recommend very firm orthopedic mattresses to people with lower back pain. But dont go out and buy one just yet. Recent surveys have shown that people who use extremely firm mattresses may have the poorest sleep.
That said, a mattress thats too soft wont help very much with alignment.
If you have the funds to buy something new, try choosing a firm or medium-firm mattress made with good-quality innersprings or foam. You may also improve the innerspring mattress you already own by adding a memory foam mattress topper.
It may be difficult to tell if that mattress at the store really feels comfortable after only a few minutes of testing. Some companies let you test out a mattress over a set period of time and then return it if its not for you.
Not in the market right now? You can see if a firmer mattress would help you by placing an inexpensive plywood board under your current mattress. You can even place your mattress on the floor to see if lessening the movement of the springs helps with your pain.
Chronic Low Back Pain Of No Specific Origin
Low back pain is defined as pain, tightness, and stiffness between the lower end of the rib cage and the buttocks. “Chronic” means the pain has lasted for twelve weeks or longer, and “no specific origin” means the pain cannot be traced to any specific cause, incident, or injury.
Most susceptible are individuals who perform heavy physical work, especially when there is ongoing anxiety, depression, and emotional stress at the same time. The longer the stress and back pain continue, the more difficult it is to ease the symptoms and return the patient to normal functioning.
Treatment involves nonsteroidal anti-inflammatory drugs and sometimes opioid medications for pain, though both have risks when used long term. Antidepressants may also be tried, along with psychological counseling.
Corticosteroid injections for the back are effective for some patients, and fusion surgery is sometimes attempted. Lifestyle changes in the form of improved diet, exercise, and stress management are very helpful in most cases.
Rarity: Common
Top Symptoms: lower back pain, unintentional weight loss, back pain that shoots to the butt, fever, involuntary defecation
Symptoms that always occur with chronic low back pain of no specific origin: lower back pain
Symptoms that never occur with chronic low back pain of no specific origin: thigh numbness, buttocks numbness, lower back pain from an injury
Urgency: Primary care doctor
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Tips For Dealing With Lower Back Pain
By Robert Greenleaf, MD, Spine Surgeon
Lower back pain is extremely common and one of the top reasons for missed workdays. Thats because the lower back supports the weight of the upper body and is subject to a lot of stress and strainespecially during everyday movements like lifting and twisting.
One of two things typically causes lower back pain: a sudden injury or the wear and tear of aging, arthritis and physical activity. No matter the cause of your lower back pain, here are 10 recommendations that can help you relieve it and prevent future problems.
Lower Back And Groin Pain
28 November 2015
If you have a pain in your lower back and in your groin, then this article may be of interest. You may think that you have two separate conditions or problems, but these two pains, though they are in different parts of the body are more often linked or associated than not. This can apply even if one pain is quite mild and the other is quite severe.
When I assess patients in my clinic for groin back, frequently it appears that there is also an element of dysfunction in the lower back or hip.
Often the groin element can be what is known as a referred pain. This means that the pain is being referred to the groin from a problem or cause in another part of the body.
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In my experience, if groin pain is a referral from the lower back, it tends to be one of four causes – so lets look at each of them in turn
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What Causes Pain In The Right
Right-hand side pain of your lower back is caused by conditions that affect your muscles and the interconnected structures of your spinal column including your facet joints, discs and nerve roots as well as some serious health problems.
Muscle strain is the most common reason for low back pain and it can cause pain mainly on the lower right-hand side of your back. A muscle strain occurs when your muscle is overstretched or torn through twisting, lifting heavy objects or if it encounters an impact such as a sports injury or car accident. Typically, the pain from a muscle strain feels better within a few weeks and does not require medical attention.
Lower right back pain can also have orthopaedic and neurological causes including:
- Kidney disorders – kidney infections and stones can cause pain on one side of your back.
- Colon disorders – such as inflammation of your appendix and inner walls of your large intestines can manifest as back pain.
- Female reproductive problems – including endometriosis and benign growths within the walls of your uterus can sometimes cause back pain.
- Cancer tumours – may cause pain that begins in your abdomen and radiates to your back, sometimes on one side.
Unexplained Acute Low Back Pain
Unexplained low back pain means chronic pain that comes on gradually, over time, with no specific injury, event, or illness causing it.
Common causes:
- Prolonged sitting and lack of fitness can weaken back muscles and cause pain from lack of support.
- Ankylosing spondylitis, a form of arthritis.
- Spinal stenosis, a narrowing of the spinal column that puts pressure on the spinal cord.
- Certain types of cancer, in rare cases.
Those most susceptible are over 30, overweight and/or pregnant, and not physically fit. Smoking interferes with healing after any sort of stress to the back.
If there are additional symptoms, medical care should be sought: fever, unexplained weight loss, leg weakness or numbness, or trouble urinating.
An exact diagnosis is made through blood tests and through imaging such as x-rays, CT scan, or MRI.
Once more serious causes are ruled out, treatment may include medications to ease pain, swelling, and inflammation. Steroid injections are useful in some cases.
Overall, exercise and maintaining a healthy weight can be very helpful with easing chronic low back pain.
Rarity: Common
Top Symptoms: lower back pain, back pain that shoots to the butt, fever, back pain
Symptoms that always occur with unexplained acute low back pain:lower back pain
Symptoms that never occur with unexplained acute low back pain:buttocks numbness, thigh numbness, involuntary defecation, fever
Urgency: Self-treatment
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What Is Back Pain
Back pain refers to pain that you may feel in your back or spine. It is a very common problem: 1 in 6 Australians report having back problems, and 4 out of 5 experience it sometime in their life. While both men and women report that they experience back problems, it is more commonly reported by people 25 years and older.
Back pain can be grouped into different categories. Lower back pain refers to pain felt in the lower part of the spine . Back problems can also affect the upper back , the neck as well as the tailbone .
People experience back pain in different ways. Some people say it feels like a sharp pain other people report aches or spasms. You may feel stiff, or find it hard to turn or bend in certain directions. In some cases, such as sciatica, pain can travel down one or both your legs.
Back pain can impact you physically and mentally. People suffering from back pain may feel irritable or short-tempered. They may worry about whether the pain will control their life and may experience feelings of helplessness.
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.
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Seated Hip Flexor And Quad Stretch
Start with your legs in a 90/90 position by bending your knees at a 90-degree angle so your right shin and left thigh are both parallel to the short side of the mat. Tuck your pelvis under so you are not in an anterior tilt and then walk your hands behind you and away from your glutes as you lean back. You can either stay on your hands or come down on to your forearms. You can bring blocks beneath your forearms to help you find a middle ground that’s comfortable for you. Repeat on the other side. This is one of my favorite stretches to do when Ive been sitting for too long.
