Ask About Prescription Medications
If your back pain hasnt resolved itself within four to six weeks, make an appointment with your doctor, who will examine your back and ask you to sit, stand, bend, walk, and lift your legs to see how your pain is affecting your mobility. Youll likely be asked to rate your pain on a scale of one to 10, and they may do imaging tests, like an X-ray or MRI. Then, he or she may recommend one of the following prescribed therapies:
- Muscle relaxants: Medications like cyclobenzaprine or baclofen can help relieve painful back spasms. If you go this route, just know that side effects can include fatigue and dizziness.
- Topical pain medications: These creams and ointments, like Voltaren gel, are meant to be rubbed directly on to the area thats hurting you.
- Cortisone shots: If other treatment measures fail, your doctor may recommend an injection of cortisone, a potent anti-inflammatory. There are risks, including thinning of nearby bone, and relief typically lasts just a few months, tops.
When To See A Doctor
People can often treat back pain with home remedies and some patience. However, a person should speak with a healthcare professional about chronic or severe back pain.
A healthcare professional may recommend physical therapy, medication, or other treatments. People with existing health conditions or who take regular medications should speak with a medical professional before trying herbal medications or supplements.
Mechanical Lower Back Pain
Because it represents 97% of cases, mechanical low back pain deserves to be discussed first. To determine the factors that bring out the pain, the doctor will consider the following causes of mechanical low back pain:
- Spondylolisthesis .
- Osteoarthritis .
- Spinal stenosis .
Low back pain that gets worse with sitting may indicate a herniated lumbar disc . This is because certain positions of the body can change the amount of pressure that an out-of-place disc can press on a nerve. This is one reason we suggest to people with low back pain to periodically get up and stretch or walk around rather than continually stay sitting. Acute onset, that is, pain that comes on suddenly, may suggest a herniated disc or a muscle strain, as opposed to a more gradual onset of pain, which fits more with osteoarthritis, spinal stenosis, or spondylolisthesis.
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You Can Fix This Chronic Problem Once And For All
Although it may seem easy to fix , many of us assume that the solution is also simple. We subsequently look for easy solutions only to feel disappointed or to believe that our particular solution is not possible.
This is simply not the case. Back pain is complex, with many factors and the process to overcome it should be viewed as a step-by-step and multifaceted one.
To be able to address it, first, begin with what is required to keep your lumbar spine healthy and what causes it to suffer chronic pain.
The lumbar spine consists of your lumbar vertebrae, vertebral discs, interconnecting facet joints, a complex nervous supply that travels in between each vertebra, soft tissue, ligaments, tendons, and muscles.
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.
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Individualized Exercise Therapy For Chronic Low Back Pain
This systematic review, meta-analysis, and meta-regression investigated the effects of individualized interventions, based on exercise alone or combined with psychological treatment, on pain intensity and disability in patients with chronic non-specific low-back pain.
Databases were searched up to January 31, 2022, to retrieve respective randomized clinical trials of individualized and/or personalized and/or stratified exercise interventions with or without psychological treatment compared to any control.
The findings show:
- Fifty-eight studies were included. At short-term follow-up , low-certainty evidence for pain intensity and very low-certainty evidence for disability indicates superior effects of individualized versus active exercises, and very low-certainty evidence for pain intensity ), but not for disability compared to passive controls.
- At long-term follow-up , moderate-certainty evidence for pain intensity and disability indicates effects versus passive controls.
Sensitivity analyses indicate that the effects on pain, but not on disability were robust. Pain reduction caused by individualized exercise treatments in combination with psychological interventions is of clinical importance.
Bonus Tip: Consider Taking A Vitamin D3 Supplement
If your doctor agrees, consider taking a vitamin D3 supplement. Vitamin D is essential for bone, neuromuscular, and immune system function. Taking a vitamin D3 supplement can help reduce back pain by increasing the absorption of calcium in your body and improving bone strength.15
Finding the perfect pain relief technique is usually a process of trial and error, making it worth exploring various approaches. Try these natural pain-relieving strategies for your back pain and see what works best for you. Severe pain that is not relieved by self-care must be evaluated by a health professional for an accurate diagnosis and treatment plan.
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Exercises For Low Back Pain
Doing exercises to strengthen the lower back can help alleviate and prevent lower back pain. It can also strengthen the core, leg, and arm muscles.
According to researchers, exercise also increases blood flow to the lower back area, which may reduce stiffness and speed up the healing process.
Below, we explain how to do 10 exercises that strengthen the lower back and may help people manage lower back pain:
Bridges work a persons gluteus maximus, which is the large muscle of the buttocks. People engage this muscle when they move their hips, particularly when they bend into a squat.
The gluteus maximus is one of the most important muscles in the body, and keeping it strong can help support the lower back.
To perform a bridge:
- Lie on the ground and bend the knees, placing the feet flat on the floor hip-width apart.
- Press the feet into the floor, keeping the arms by the sides.
- Raise the buttocks off the ground until the body forms a straight line from the shoulders to the knees.
- Squeeze the buttocks with the shoulders remaining on the floor.
- Lower the buttocks to the ground and rest for a few seconds.
- Repeat 15 times and then rest for 1 minute.
- Do 3 sets of 15 repetitions.
2. Knee-to-chest stretches
Doing a knee-to-chest stretch can help elongate the lower back, relieving tension and pain.
To perform the knee-to-chest stretch:
3. Lower back rotational stretches
To perform the lower back rotational stretch:
4. Draw-in maneuvers
Lumbar Flexion Rotation Stretch
The flexion rotation stretch is started by lying on one side. Usually, your painful side is down on the table. Straighten your bottom leg, and tuck your top leg behind your bottom knee.
Reach your top hand to your top shoulder blade, and rotate your spine so your top shoulder moves backwards toward the floor. Hold this position for a second or two, and then return to the starting position. Repeat 10 repetitions, and note any changes in your symptoms.
Still dealing with symptoms? You may need to try a lumbar flexion progression. Check out the final step in this program to learn how to get started on that.
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About Our Health Information
At Bupa we produce a wealth of free health information for you and your family. This is because we believe that trustworthy information is essential in helping you make better decisions about your health and wellbeing.
How Your Back Works
The spine, which is also called the backbone or spinal column, is one of the strongest parts of the body and gives us a great deal of flexibility and strength.
Its made up of 24 bones, known as vertebrae, one sitting on top of the other. These bones have discs in between and lots of strong ligaments and muscles around them for support. There are also the bones in the tailbone at the bottom of the back, which are fused together and have no discs in between.
On either side of the spine, running from top to bottom, are many small joints called the facet joints.
The spinal cord passes inside the vertebrae, which protect it.
The spinal cord connects to the brain through the base of the skull and to the rest of the body by nerves that pass through spaces between the bones of the spine. These nerves are also known as nerve roots.
As you grow older, the structures of your spine, such as the joints, discs and ligaments, age as well. The structures remain strong but its usual for your back to get stiffer as you get older.
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Being Mindful Of Your Movements
How many times has someone told you to lift with your legs, not with your back? Though its almost become cliché, its good advice. Your lower back supports a lot of the function of your body. Even if you lift using correct posture most of the time, a few haphazard hoists can be all it takes to cause long-term pain.
For example, parents with small children will lean over and pick them up out of a crib several times a day. Once or twice might not put much strain on the back, but repeating this movement hundreds or thousands of times over the years can cause serious discomfort. Mind those movements today, and your back will be more forgiving in the future.
Fractures And Lower Back Pain
are often very difficult pain problems and indicate the possible presence of . In patients with severe osteoporosis, spinal fractures can occur with no early warning and no significant trauma the patient does not have to fall to fracture a vertebrae.
Patients with spinal compression fractures experience spasms and, often, very high pain levels.
In patients with low back pain where the cause is difficult to determine, especially for elderly patients with osteoporosis, a fracture in the sacrum may be the cause of the pain. A standard X-ray or bone scan may not show a sacral fracture. Imaging techniques such as CT scan or MRI can often reveal these fractures.
It is very important that patients with acute lumbar compression fractures be tested for osteoporosis. A bone density study is needed, unless the patient has no other osteoporosis risk factors and has had a very high impact fracture. Studies have shown that many patients with fractures in the U.S. are discharged from hospitals with no plans for management of their bone density problems, which then are left to worsen.
Although pain can be very intense, it is best for patients with lumbar fracture to resume activity as soon as possible. This is especially true for elderly patients, who can too easily become weakened, and develop other complications, if mobility is reduced for too long. may be needed for pain control, for as brief a period as possible.
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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.
The Importance Of An Accurate Diagnosis
The physician will need to take a careful medical history and do a physical exam to look for certain red flags that indicate the need for an X-ray or other imaging test. In most cases, however, imaging such as X-ray, MRI , or CT scan is unnecessary.
There may also be certain clues in a patients medical history. Low back, nonradiating pain is commonly due to muscle strain and spasm. Pain that radiates into the buttock and down the leg may be due to , a condition in which a bulging disc presses on the sciatic nerve, which extends down the spinal column to its exit point in the pelvis and carries nerve fibers to the leg. This nerve compression causes pain in the lower back radiating through the buttocks and down one leg, which can go to below the knee, often combined with localized areas of numbness. In the most extreme cases, the patient experiences weakness in addition to numbness and pain, which suggests the need for quick evaluation.
A persistent shooting or tingling pain may suggest lumbar disc disease. A pain that comes and goes, reaching a peak and then quieting for a minute or two, only to reach a peak again, may suggest an altogether different cause of back pain, such as a kidney stone.
When tumor or infection are suspected, the doctor may order blood tests, including a CBC and sedimentation rate .
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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 there’s no improvement after two to three weeks or the pain is getting worse, seek advice from a GP or physiotherapist. It’s 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.
Back Surgery For Severe Back Pain Relief
Back surgery is typically recommended when other, more conservative treatments arent able to help you feel better. Back surgery can be used to treat herniated discs, degenerative disc disease, spine injuries and even severe lower back pain. When its done under the right circumstances and at the right time, back surgery can be an effective long-term solution for chronic back pain.
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Where Can I Get More Information
For more information on neurological disorders or research programs funded by the National Institute of Neurological Disorders and Stroke, contact the Institute’s Brain Resources and Information Network at:
Office of Communications and Public LiaisonNational Institute of Neurological Disorders and StrokeNational Institutes of HealthBethesda, MD 20892
NINDS health-related material is provided for information purposes only and does not necessarily represent endorsement by or an official position of the National Institute of Neurological Disorders and Stroke or any other Federal agency. Advice on the treatment or care of an individual patient should be obtained through consultation with a physician who has examined that patient or is familiar with that patient’s medical history.