Lower Back Pain And Cancer
Cancer involving the lumbar spine is not a common cause of back pain. However, in people who have a prior history of cancer, for example, in the breast or prostate, or who have weight loss or loss of appetite along with back pain cancer needs to be considered.
Night pain can be a clue to cancer in the spine. A benign tumor called osteoid osteoma, which most often affects young people, causes pain that tends to respond well to aspirin. Multiple myeloma is a malignancy that occurs when the plasma cells in the bone marrow begin spreading uncontrollably. It is most common in older people, and can cause pain in many parts of the spine. When tumor or infection are suspected, blood tests may be ordered, including a CBC , sedimentation rate , and protein electrophoresis .
Avoid Prolonged Static Posture
It is important to pay attention to the joints and muscles of your spine and hip. Prevent fatigue and stresses on these joints by following simple tips, such as:
- Avoid excessive sitting or consider using a standing desk while you work. When you sit for a long duration, the pressure on your spinal discs increase. Aim to get up every hour and walk a short distance to take the load off your discs.
When you have a flare-up of symptoms, consider less exertive activities, such as reading a book, listening to music, or crafting. These activities can help divert your mind from the pain and let your back rest at the same time.
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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Yoga: Stretching For Back Pain
If back pain doesn’t go away in three months, there’s evidence that yoga can help. In one recent study, people who took 12 weeks of yoga classes had fewer symptoms of low back pain than people who were given a book about care for back pain. The benefits lasted several months after the classes were finished. The study suggests conventional stretching also works just as well. Make sure your instructor is experienced at teaching people with back pain and will modify postures for you as needed.
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.
- 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.
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
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What Is Lower Back Pain
Low back pain can result from many different injuries, conditions or diseases most often, an injury to muscles or tendons in the back.
Pain can range from mild to severe. In some cases, pain can make it difficult or impossible to walk, sleep, work or do everyday activities.
Usually, lower back pain gets better with rest, pain relievers and physical therapy . Cortisone injections and hands-on treatments can relieve pain and help the healing process. Some back injuries and conditions require surgical repair.
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.
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Skeletal Disease Or Injury
Skeletal disease or injury affecting the nerves on the right side of the back can lead to pain.
- Cartilage deterioration: This is wearing away of the cartilage at the ends of the bones, due to either age or disease.
- Bony growths: Small overgrowths of bones in the spine may crowd the spinal cord and cause pain and numbness or pinch other nearby structures. A general narrowing of the spinal canal is known as spinal stenosis.
- Scar tissue: This may form due to injury or the result of spinal surgery.
- Injury or disease of the discs: These are the “cushions” between each of the spinal vertebrae. A disc may be partly pushed out of place, causing pressure on a nerve. A disc may also rupture and lose some of its contents, causing pain and pressure on the surrounding nerves .
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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Are You Making Your Back Pain Worse
Don’t be guilty of exacerbating your already achy back. Try these tips for preventing added low back pain:
- Wear comfortable, low-heeled shoes if you are on your feet all day.
- Don’t slouch when standing or sitting.
- At home or work, make sure work surfaces are at a comfortable height.
- Warm-up and stretch before exercise or other strenuous physical activity.
- Don’t try to lift objects that are too heavy and don’t twist while lifting.
- Live a healthy lifestyle, stop smoking, and keep off the extra weight.
What Are The Causes Of Lower Back Pain
The vast majority of patients experience back pain because of mechanical reasons. They strain a muscle from heavy lifting or twisting, suffer a sudden jolt in a car accident, experience stress on spinal bones and tissues resulting in a , or suffer from osteoarthritis, a potentially painful degeneration of one or more spinal joints. Common causes for low back pain are:
- mechanical or functional injury
- active infection
- referred pain
To choose the safest and most effective therapy, doctors need to consider the full spectrum of possible underlying issues, such as inflammatory conditions, fracture, infection, as well as some serious conditions unrelated to the back that radiate pain to the back.
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What Are Some Less Invasive Or Noninvasive Back Pain Treatments
Your doctor has a wide range of treatments that may help your lower back pain. In general, expect your doctor to take a stepped care approach. That means starting with simple, low-cost treatments and moving to more aggressive approaches later. Keep in mind that many treatments take time to reach their full effect.
Medications. When over-the-counter pills and topicals dont do enough to relieve back pain, your doctor may recommend a prescription drug. Examples include:
- Antiseizure medication, such gabapentin or pregabalin, for nerve-related pain
- Muscle relaxants, such as baclofen or carisoprodol
- Prescription NSAIDs, such as celecoxib, diclofenac, or fenoprofen
- Opioids, such as oxycodone or hydrocodone, on a short-term basis.
Physical therapy . PT for lower back pain involves passive and active therapies to help the patient build core muscle strength, improve spinal flexibility and range of motion, correct posture and more. Your physical therapy sessions may include:
- Transcutaneous electrical nerve stimulation
Hot Or Cold Therapy For Low Back Pain
Hot or cold packs may help ease pain and reduce symptoms. The soothing relief from heat, or the dulling relief from a cold pack, is only temporary and will not treat more serious causes of back pain. However, they may provide greater mobility for people with acute, subacute, or chronic pain, allowing them to get up and get moving.
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Getting Active And Hydrated
Staying hydrated is a great way to relieve back spasms quickly. This is even more important if you live in a warm area or your job requires exerting lots of physical energy.
Generally, experts recommend that you drink eight 8-ounce glasses of water, which is about two litres, or half a gallon of water every day. In reality, your actual water intake would depend on your individual needs, lifestyle, and prevailing weather conditions. Heres a simple table you can use as a reference.
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.
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Symptoms Of Lower Back Pain
Sometimes a pain may develop immediately after you lift something heavy, or after an awkward twisting movement. Sometimes it can develop for no apparent reason. Some people just wake up one day with low back pain.
Although nonspecific back pain is sometimes called simple back pain, simple does not mean that the pain is mild. The severity of the pain can range from mild to severe. Typically, the pain is in one area of the lower back but sometimes it spreads to one or both buttocks or thighs. The pain is usually eased by lying down flat. It is often made worse if you move your back, cough, or sneeze. So, nonspecific low back pain is mechanical in the sense that it varies with posture or activity.
Most people with a bout of nonspecific low back pain improve quickly, usually within a week or so, sometimes a bit longer. However, once the pain has eased or gone it is common to have further bouts of pain from time to time in the future. Also, it is common to have minor pains on and off for quite some time after an initial bad bout of pain. In a small number of cases the pain persists for several months or longer. This is called chronic back pain .
A Recent Study On Chiropractic Care For Low Back Pain
A 2018 study published in JAMA Network Open is among the latest to weigh in on the pros and cons of chiropractic care for treating low back pain. Researchers enrolled 750 active-duty military personnel who complained of back pain. Half were randomly assigned to receive usual care while the other half received usual care plus up to 12 chiropractic treatments.
After six weeks of treatment, those assigned to receive chiropractic care:
- reported less pain intensity
- experienced less disability and more improvement in function
- reported higher satisfaction with their treatment
- needed less pain medicine.
While no serious side effects were reported, about 10% of those receiving chiropractic care described adverse effects . Five percent of those receiving usual care had similar complaints.
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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 Lumbar Strain Diagnosed
In addition to a complete medical history and physical exam, diagnosing low back pain may include the following. However, specialized tests aren’t often required.
- X-ray. A diagnostic test that produces images of internal tissues, bones, and organs onto film.
- CT scan. This is an imaging test that uses X-rays and a computer to make detailed images of the body. It shows details of the bones, muscles, fat, and organs.
- MRI. This test uses a combination of large magnets, radiofrequencies, and a computer to make detailed images of organs and structures in the body.
- Radionuclide bone scan. A nuclear imaging technique that uses a very small amount of radioactive material, which is injected into your blood to be detected by a scanner. This test shows blood flow to the bone and cell activity in the bone.
- Electromyogram . A test to evaluate nerve and muscle function.
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Treatment Of Nonspecific Pain
Approach to the Treatment of Nonspecific Acute Low Back Pain
Reassure the patient that the prognosis is often good, with most cases resolving with little intervention
Advise the patient to stay active, avoiding bed rest as much as possible, and to return to normal activities as soon as possible
Advise the patient to avoid twisting and bending
Initiate trial of a nonsteroidal anti-inflammatory drug or acetaminophen
Consider a muscle relaxant based on pain severity
Consider a short course of opioid therapy if pain is severe
Consider referral for physical therapy if it is not the first episode
Consider changing to a different nonsteroidal anti-inflammatory drug
Consider referral for physical therapy if not done at initial visit
Consider referral to a spine subspecialist if pain is severe or limits function
*Two to four weeks after the initial visit, if the patient has not significantly improved.