Traction Ultrasound And Tens
If your back pain doesnt respond to conventional treatments, you may need to consider alternative options.
Traction uses a system of weights to align your spine and possibly help slipped discs move back into place.
Ultrasound involves massaging the soft tissues around your back injury with sound waves that warm the muscles, causing them to relax and heal more quickly.
Transcutaneous electrical nerve stimulation is electronic stimulation of the nerves through electrodes placed on your skin.
The electricity blocks pain signals that travel through the nerve paths.
Ask your doctor about these treatment methods.
What Exactly Is The Lower Back Anyway
Your lower back is known as the lumbar region of the spine. It has a lot of heavy lifting to do: The lumbar spine carries the weight of your entire upper body, plus biomechanical stresses that occur with movement.
The lumbar spine has five vertebraebackbones. Each vertebra has a large disc cushiony gel wrapped in a tough membrane on its front side that acts as a shock absorber. Each vertebra also has two cartilage-lined facet joints on its back side. Working together, discs and facet joints allow the spine to safely bend and twist.
Your lower back also includes ligaments, tendons, and muscles. Ligaments are strong bands that hold the vertebrae and discs together. Tendons attach muscles to the vertebrae. These structures help limit excessive movement that could harm the spinal cord.
Types Of Doctors That Might Treat Your Back Pain
Back pain seems to be a problem that plagues so many, so it can be easy to operate under the assumption that treatment is relatively interchangeable. There are actually many different types of doctors that specialize in more specific areas of treatment when it comes to back injury or chronic pain.
It is important that you seek help from the correct type of doctor if you want your pain addressed in the most expedient and thorough fashion. Here is a more in-depth look at the most common types of spine doctors and how they might be able to help you with your pain.
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What Are The Treatments For Lower Back Pain
Lower back pain usually gets better with rest, ice and over-the-counter pain relievers. After a few days of rest, you can start to get back to your normal activities. Staying active increases blood flow to the area and helps you heal.
Other treatments for lower back pain depend on the cause. They include:
- Medications: Your provider may recommend nonsteroidal anti-inflammatory drugs or prescription drugs to relieve pain. Other medications relax muscles and prevent back spasms.
- Physical therapy : PT can strengthen muscles so they can support your spine. PT also improves flexibility and helps you avoid another injury.
- Hands-on manipulation: Several hands-on treatments can relax tight muscles, reduce pain and improve posture and alignment. Depending on the cause of pain, you may need osteopathic manipulation or chiropractic adjustments. Massage therapy can also help with back pain relief and restore function.
- Injections: Your provider uses a needle to inject medication into the area thats causing pain. Steroid injections relieve pain and reduce inflammation.
- Surgery: Some injuries and conditions need surgical repair. There are several types of surgery for low back pain, including many minimally invasive techniques.
Maintain Correct Posture During Activities
To protect your lower back from injury, its important to maintain proper posture when performing physical activitiesespecially if you play sports or have a job that requires repetitive motions. Avoid slouching as much as possible and aim to keep your spine erect. When lifting, bend and straighten from the knees, not the waist. And be sure to move your hips when twisting from side to side.
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How Orthopedic Treatment Can Help
Orthopedic spine specialists who don’t have a specialty in orthopedic surgery use non-surgical methods to treat patients who suffer from lower back pain. They specialize in musculoskeletal disorders that affect the lower back in people with sports injuries and other traumatic injuries, as well as disorders and diseases of the spine. They may work with other spine specialists mentioned above to manage the lower back pain and restore movement.
Other Causes Of Back Pain
There are many other potential causes of back pain, but most are rare. Be sure to see a doctor if you experience regular back pain that does not go away.
After ruling out the more common causes of back pain, your doctor will perform tests to determine if you have a rarer cause. These can :
- one of the vertebrae moving out of place and onto a nearby vertebra, called degenerative spondylolisthesis
- loss of nerve function at the lower spinal cord, called cauda equina syndrome
- fungal or bacterial infection of the spine, such as Staphylococcus, E. coli, or tuberculosis
Back pain can have many symptoms, including:
- a dull, aching sensation in the lower back
- a stabbing or shooting pain that can radiate down the leg to the foot
- an inability to stand up straight without pain
- a decreased range of motion and reduced ability to flex the back
The symptoms of back pain, if due to strain or misuse, are usually short lived but can last for days or weeks.
Back pain is chronic when symptoms have been present for 3 months.
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Muscle Strain Or Sprain
A muscle strain or sprain is the most common cause of low back pain.
A strain is a tear or stretching in a tendon or muscle, while a sprain is a tear or stretching in a ligament.
Sprains and strains usually happen when you twist or lift something improperly, lift something heavy, or overstretch your back muscles.
These injuries can cause swelling, difficulty moving, and back spasms.
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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What Is The Chiropractic Treatment Approach For Low Back Pain
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What Causes Lower Back Pain And When Should I Get Help
Orthopedic back and spine treatment usually starts with conservative approaches that include pain management, physical and occupational therapies, and rehabilitation. The American Academy of Orthopedic Surgeons reminds us that chronic back pain can get worse if left untreated, so it’s important to visit a doctor early on who can start you with the right treatment.
Some of the most common causes of lower back pain include:
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What Can An Orthopedic Surgeon Do For Back Pain
Article from City Hospital at White Rock
Eighty percent of adults will suffer from lower back pain during their lifetime according to an epidemiology study published by the National Institutes of Health. Lower back pain is the second-most common cause of job-related disability and time off of work. Most chronic sufferers turn to medications, heating pads, and massage to relieve their aches, but when is the right time to see an orthopedic surgeon?
Do you suffer from lower back pain? Youre not alone. In this guide, we will discuss the common causes of lower back pain and how an orthopedic surgeon can help you.
Risk Factors You Can Change With Lifestyle Changes
- Not getting regular exercise
- Doing a job or other activity that requires long periods of sitting, heavy lifting, bending or twisting, repetitive motions, or constant vibration, such as using a jackhammer or driving certain types of heavy equipment
- Smoking. People who smoke are more likely than people who don’t smoke to have low back pain.
- Being overweight. Excess body weight, especially around the waist, may put strain on your back, although this has not been proved. But being overweight often also means being in poor physical condition, with weaker muscles and less flexibility. These can lead to low back pain.
- Having poor posture. Slumping or slouching on its own may not cause low back pain. But after the back has been strained or injured, bad posture can make pain worse. “Good posture” generally means your ears, shoulders, and hips are in a straight line. If this posture causes pain, you may have another condition such as a problem with a disc or bones in your back.
- Being under stress. Stress and other emotional factors are believed to play a major role in low back pain, particularly chronic low back pain. Many people unconsciously tighten their back muscles when they are under stress.
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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.
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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What Are Some Complementary Alternative And Emerging Treatments For Lower Back Pain
In some cases, doctors suggest therapies that are not considered standard of care. They probably wont be covered by insurance, but they may be worth considering. Examples include:
Platelet-rich plasma . PRP treatments use a small sample of your own blood that has concentrated amounts of blood building blocks known as platelets. Your doctor then injects the PRP directly into a damaged disc. The theory is that PRP injections use your own healing system to accelerate improvement of injured tendons, ligaments, muscles, and joints. PRP treatment has a longer track record in knee osteoarthritis, but a recent review article in the Journal of Spine Surgery suggests it may have a useful role for back pain, too. PRP needs a lot more research before it can be considered a proven technique.
Stem cells. In this emerging treatment, your doctor injects stem cells harvested from your hip into the intervertebral disc or discs causing your pain. Doing so may lessen pain and the degenerative effects of aging, though, like PRP, more research is needed before stem cells for lower back pain could eventually become the standard of care.
Acupuncture. Your doctor probably doesnt perform acupuncture , but may support you trying it as a complementary therapy. Acupuncture involves careful insertion of fine, sterile needles into specific points on your body. This may stimulate the release of your natural pain-killing chemicals.
Best Doctors For Back Pain
Since you shouldn’t try to diagnose your own back pain, make your first call to a professional who can assess your problem, such as a primary care physician or a chiropractor.
Both can serve as an entry point for back pain.
Generally speaking, your primary care provider will only offer pain medications or injections designed to reduce pain, but not necessarily correct the issue.
Chiropractors on the other hand, have much more training when it comes to addressing back pain.
A chiropractors training contains over 150 more hours of education in biomechanics, while medical students learn more about pharmaceuticals.
Chiropractors use posture exercises and hands-on spinal manipulation to relieve back pain, improve function, and help the body heal itself.
According to Harvard Health, the most positive research on chiropractic therapy has focused on spinal manipulation for low back pain.
Here’s a few quotes including the scientific journal reference discussing chiropractic care for back pain:
âFor patients with chronic low back pain, clinicians and patients should initially selectnon-pharmacologic treatment with exercise, multidisciplinary rehabilitation, acupuncture, mindfulness-based stress reduction , tai chi, yoga, motor control exercise, progressive relaxation, electromyography biofeedback, low-level laser therapy, operant therapy, cognitive behavioral therapy, or spinal manipulation .â
American College of Physicians
Goertz et al. , Spine
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Team Approach To Pain Management
For some, an integrated team of specialists may be best suited to manage the chronic lower back pain from degenerative disc disease. A team will usually comprise some combination of the following health professionals:
- A pain management specialist, such as a physical medicine and rehabilitation physician or anesthesiologist focused on pain management
- A physical therapist or physiatrist focused on rehabilitation
- A psychologist and/or psychiatrist for co-existing mental health issues, such as depression and/or difficulty sleeping
- An occupational therapist to assist with functional rehabilitation
In addition, a specialized nurse case manager or another health professional may work with the team to coordinate the care needed to treat depression, disability, and chronic pain.
Sometimes the combination of treatments is more effective than individual treatments. For example, the use of cognitive behavioral therapy has been shown to improve the benefits of physical therapy3 and reduce sleep problems.
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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How Is Back Pain Diagnosed
Most people who develop low back pain that comes on suddenly have nonspecific low back pain. If there are no other associated symptoms and the pain is not too bad, many people are confident to just ‘get on with it’ and treat it themselves – and indeed most get better quickly. However, if in doubt, see your doctor for a check-over and advice.
A doctor will usually want to ask questions about your symptoms and to examine you. Basically, the symptoms are usually as described above, with no other worrying symptoms to suggest anything serious or another cause of back pain . The examination by a doctor will not detect anything to suggest a more serious cause of back pain. Therefore, a doctor can usually be confident from his or her assessment that you have nonspecific back pain.
As a general guide, if any of the following occur then it may not be nonspecific low back pain, and there may be a more serious underlying cause. But note: the vast majority of people with low back pain do not have any of the following symptoms or features. They are included here for completeness and as an aid to what to look out for and to tell your doctor should they occur.
