How Is Back Pain Treated
You can do several things to manage back pain. A conversation with your doctor or physiotherapist can help address any concerns you may have and help you to better understand your treatment. Remember that not all information is trustworthy, so let your healthcare team know about treatments you are considering before you begin them.
Ways to manage back pain include the following:
Strong pain medication is not recommended for back pain. Research shows strong pain medication provides little benefit and can cause side effects such as drowsiness, sedation and/or dependence.
If you have severe back pain and your current medication is not adequately managing it, talk to your doctor about a suitable treatment plan. In some cases, your doctor may suggest an injection that can numb the pain such as an epidural injection, or a surgical procedure, such as a laminectomy to help manage your pain.
There are many other treatments to manage back pain, but they have not been well proven. These include:
- herbal medicines
- laser therapy
- heat and cold therapy
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Causes Of A Strained Back Muscle
Sometimes even simply pulling or twisting a tendon or muscles may result in a strained back. That means, even a single instance of overstressing the lower back muscles or improper lifting can cause back strain. If you have a long-term strain, it may be the result of repetitive, prolonged muscles and tendon use.
As we discussed above, a sprain may occur after a sudden twist, fall, or a blow to the joint, affecting its normal position. All these conditions can stretch the ligament beyond the normal movement range and cause injury.
In addition to that, there can be many factors that may put you at greater risk of getting a sprained or strained back. These can include:
-Curving your lower back excessively
-Having weak abdominal or back muscles
Usually, athletes and sports persons experience this problem as their daily routine involves a lot of pulling, pushing, and weight lifting. They are at higher risk of a lower back injury.
Which Low Back Exercise Is Right For You
If you are experiencing pain on one side of your back or leg, then try the first exercise and monitor symptoms as you exercise. Watch for centralization, which is a decrease in leg or thigh pain and an increase in low back pain. Centralization that occurs while you are performing an exercise is a good sign and indicates that the particular exercise is the correct one for you to be doing.
If your symptoms worsen, fail to centralize, or only centralize partially, move on to the next exercise in the list. Attempt the exercise, and monitor any changes in your symptoms. Remember pain that moves closer to your spine is a good sign.
Before starting any exercise for your back, it is a good idea to check in with your healthcare provider to be sure that exercise is safe for you to do. Your local physical therapist can help you decide on the best exercises for your specific condition.
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Will Bed Rest Help Back Pain
Doctors often recommend continuing your usual activities of daily living as soon as possible. Studies suggest that strict bedrest can often prolong or worsen low back pain. Bed rest can also lead to secondary complications such as depression, decreased muscle tone, and blood clots in the legs. You should try and keep moving while avoiding activities that noticeably aggravate or worsen back pain. By staying active, those who suffer from low back pain can gain greater flexibility and quicker recovery.
When To See Your Doctor About Back Pain
You should see your doctor or physiotherapist if you have back pain that is not getting better after a few weeks of trying simple exercises and following the tips for a healthy back.
Although rare, back pain can be a sign of a more serious condition. If you experience any of the following ‘red flag’ symptoms with your back pain then please see a doctor urgently.
|‘Red flag’ symptoms see a doctor urgently if you have:
You should also see your doctor or physiotherapist if:
- your pain is worse in your lower leg than your back and is not easing
- you have weakness and numbness in one of your legs
- you have a rash in the same area as your pain.
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What Is The Role Of Invasive Procedures In Chronic Low Back Pain
A recently published review summarised the available evidence about the efficacy of surgery and other invasive interventions for low back pain and sciatica. A number of interventions, including facet joint, epidural, trigger point, and sclerosant injections, have not clearly been shown to be effective. No sound evidence is available for the efficacy of spinal stenosis surgery. Surgical discectomy may be considered for selected patients with sciatica due to lumbar disc prolapse that do not respond to initial conservative management. The role of fusion surgery for chronic low back pain is under debate. Recent randomised clinical trials comparing fusion surgery with conservative treatment showed conflicting results.- Recommendations that fusion surgery should be applied in carefully selected patients are difficult to follow because no clear and validated criteria exist to identify these patients in advance.
Box 3: Recommendations in the European clinical guidelines for diagnosis and treatment of chronic low back pain
RecommendedCognitive behaviour therapy, supervised exercise therapy, brief educational interventions, and multidisciplinary treatment, short term use of non-steroidal anti-inflammatory drugs and weak opioids.
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
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Find Back Pain Relief: Lighten Your Bags
Carrying an overstuffed purse, briefcase, or handbag can strain the low back. If you must carry a heavy load, consider using a wheeled briefcase instead. By reducing the amount of weight you’re carrying, you reduce the amount of pressure on the spine. Help keep your kids’ backs healthy by making sure their backpacks are not overloaded. A heavy backpack could mean future back pain for your little ones.
Identifying Subgroups Of Patients More Amenable To Specific Treatments
A recently published randomised clinical trial found that patients with acute or subacute low back pain had significantly better functional outcomes when they received a matched treatment compared with an unmatched treatment. The authors examined all patients before treatment and assigned them to one of three groups thought most likely to benefit the patients. Patients were subsequently randomised irrespective of this subgroup assignment towards one of the three interventions groups with the same treatments. The analyses were focused on matched versus unmatched treatment according to their baseline subgroup assignment.
Up to date evidence for clinicians regarding benefits and harms of treatments for a variety of disorders including low back pain
Cochrane Back Review Group The activities of the review group responsible for writing systematic Cochrane reviews on the efficacy of treatments for low back pain
Cochrane Collaboration The organisation responsible for writing systematic reviews and meta-analyses on the efficacy of treatments which are published in the Cochrane Library
European Guidelines The recently issued European guidelines on the prevention and treatment of low back pain
A patient’s perspective
Mrs Mooren-Baars, aged 76 years, Breille
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How To Treat Low Back Pain
- Over-the-counter pain medications such as acetaminophen, aspirin, ibuprofen, and naproxen to relieve pain and inflammation.
- Prescription drugs like muscle relaxants or pain relievers can provide short-term relief.
- Over-the-counter topical creams, gels, patches, or sprays with lidocaine, menthol, or capsaicin stimulate nerves in the skin, dulling pain. They can be particularly helpful for localized pain due to sore muscles.
- Hot or cold pads may help ease pain, reduce inflammation, and improve mobility.
- Core exercises that strengthen your abs and muscles lining the spine may help take the stress off the back, Rosner says. Check with your doctor before beginning any exercise program to make sure the exercises are right for your condition.
- Mindfulness-based stress reduction , an eight-week program of meditation and gentle yoga, can improve chronic lower back pain.
Causes Of Lower Back Spasms
Back spasms can be the result of injuries to the muscles, tendons, and ligaments in the back, or they can be related to more serious medical conditions. Heavy lifting is a common cause of back spasms.
In addition to heavy lifting, any activity that puts excessive strain on the muscles and ligaments in the lower back can cause an injury. Sports such as football and golf can lead to back spasms because they demand that the back turn suddenly and repeatedly.
Your back muscles may be more vulnerable if you have weak abdominal muscles, which help support the back. Weak or stiff muscles in the back itself can be injured more easily than muscles that are stronger and more limber.
Back spasms may occur if you have arthritis or a ruptured disc in your spine. Arthritis in the lower back can put pressure on the spinal cord, which may cause pain in the back and the legs. A ruptured or bulging disc in the vertebrae may also pressure a nerve and result in back pain.
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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.
Understanding The Lower Back
The lower back is also called the lumbosacral area of the back. It is the part of the back between the bottom of the ribs and the top of the legs.
Most of the lower back is made up from muscles that attach to, and surround, the spine. The spine is made up of many bones called vertebrae. The vertebrae are roughly circular and between each vertebra is a disc. The discs between the vertebrae are a combination of a strong fibrous outer layer and a softer, gel-like centre. The discs act as shock absorbers and allow the spine to be flexible.
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How Common Is Lower Back Pain
Around four out of five people have lower back pain at some point in their lives. Its one of the most common reasons people visit healthcare providers.
Some people are more likely to have lower back pain than others. Risk factors for lower back pain include:
- Age: People over 30 have more back pain. Disks wear away with age. As the disks weaken and wear down, pain and stiffness can result.
- Weight: People who are obese or carry extra weight are more likely to have back pain. Excess weight puts pressure on joints and disks.
- Overall health: Weakened abdominal muscles cant support the spine, which can lead to back strains and sprains. People who smoke, drink alcohol excessively or live a sedentary lifestyle have a higher risk of back pain.
- Occupation and lifestyle: Jobs and activities that require heavy lifting or bending can increase the risk of a back injury.
- Structural problems: Severe back pain can result from conditions, such as scoliosis, that change spine alignment.
- Disease: People who have a family history of osteoarthritis, certain types of cancer and other disease have a higher risk of low back pain.
- Mental health: Back pain can result from depression and anxiety.
Get Enough Restorative Sleep
Pain is a leading cause of insomniadifficulty with falling asleep and/or staying asleep. Inadequate sleep can also make your back pain worse. This vicious cycle makes it more difficult for you to get restorative sleep.
Getting enough restorative sleep is needed for the bodys tissues to heal and recharge energy levels. If you have trouble sleeping, it is important to address pain or other factors that are causing it. Your doctor might recommend lifestyle changes, medications, or other treatments depending on what is disrupting your sleep.
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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.
Know Your Otc Medications
Nonprescription pain relievers can help with muscle aches and stiffness. The two main types of over-the-counter options are nonsteroidal anti-inflammatory drugs and acetaminophen. NSAIDs include aspirin, ibuprofen, and naproxen.
True to their name, NSAIDs help lower inflammation that can lead to swelling and tenderness. But acetaminophen does not relieve inflammation. You can reach for either type of pain reliever for occasional back pain. NSAIDs may work a bit better, Hemani says, if you have arthritis of the spine or other inflammatory conditions.
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Gently Stretch Your Joints And Soft Tissues Through Yoga
Yoga is an effective way to stretch your back, improve the health of muscles and joints, enhance distribution of healing nutrients through blood circulation, and increase the flexibility of the spine.12
When you start, perform the stretches slowly and advance only if you feel comfortable without pain. Gradually, you will be able to add more stretches to your routine. An ideal time for yoga is early morningto help loosen your spine and also reduce stiffness and aches in your back.
Diagnosis Of Lower Back Pain
Your physiotherapist or GP will usually be able to diagnose lower back pain from your symptoms and by examining you. A physiotherapist is a healthcare professional who specialises in maintaining and improving movement and mobility. You may want to go straight to see a physiotherapist if a self-refer service is available in your area. If its not, you can see your GP who can advise and refer you.
Usually further tests wont help. But if you have other symptoms, your GP may recommend tests including:
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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 spondyloarthropathies 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: