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What Can I Do For Chronic Lower Back Pain

Lower Back Pain Causes

How To Fix Chronic Low Back Pain || Simple Lower Back Stretches

Nonspecific low back pain means that the pain is not due to any specific or underlying disease that can be found. It is thought that in some cases the cause may be an over-stretch of a ligament or muscle. In other cases the cause may be a minor problem with a disc between two spinal bones , or a minor problem with a small facet joint between two vertebrae. There may be other minor problems in the structures and tissues of the lower back that result in pain. However, these causes of the pain are impossible to prove by tests. Therefore, it is usually impossible for a doctor to say exactly where the pain is coming from, or exactly what is causing the pain.

To some people, not knowing the exact cause of the pain is unsettling. However, looked at another way, many people find it reassuring to know that the diagnosis is nonspecific back pain which means there is no serious problem or disease of the back or spine.

Inflammatory Back Pain Vs Mechanical Back Pain

Lower back inflammation is a symptom complex rather than a condition and often indicates inflammation of the vertebrae and/or joints of the spine.

But how can you know if your lower back pain is caused by inflammation or by a mechanical problem

Here are the major differences

ILBP

  • Pain persists for more than 3 months
  • The back pain and stiffness tend to ease with physical activity and exercise
  • NSAIDs are effective pain relievers

Mechanical

  • Pain after standing, bending forward, trunk flexion or extension
  • Pain when doing sit-ups, driving long distance, getting out of a chair, running
  • Pain when coughing or sneezing

What Are Some Other Causes Of Lower Back Pain

The shape of your spine, and well as spinal diseases, are other culprits in lower back pain. Depending on a range of factors, your doctor may look for:

Abnormal spinal curvature. A normal spine resembles a gently curved letter S when seen from the side. Abnormal curves include:

  • Lordosis, in which the spine curves too far inward at the lower back
  • Kyphosis, in which the spine is abnormally rounded in the upper back
  • Scoliosis, in which the spine curves from side to side, often in a C shape

Normal and abnormal curves of the spineArthritis. There are more than 100 types of arthritis, many of which can cause lower back pain. The most common types include osteoarthritis , rheumatoid arthritis, and ankylosing spondylitis.

Cauda equina syndrome . Compression of the bundle of nerves that forms below the spinal cord in the lumbar spine. It is a rare but serious disorder that requires immediate medical attention and possibly emergency surgery. CES got its name from the fact that the fanned-out bundle of nerves resembles the base of a horses tail.

Discitis or osteomyelitis.Both infections of discs and bone can cause severe pain and require prompt medical attention.

Spinal tumors. When cells divide and multiply unchecked, the result is a tumor. Both benign and malignant tumors can cause lower back pain. They can either originate in the spine or metastasize there, meaning theyve spread from somewhere else in the body.

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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:

Injections. An epidural steroid injection or a selective nerve block may provide short-term pain relief when lower back pain causes sciatica symptoms, such as leg pain.

What Is Lower Back Pain

Chronic Lower Back Pain Management Tips &  Treatment ...

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.

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Other Types Of Diagnosis

  • A chiropractor will diagnose through touch, or palpation, and a visual examination. Chiropractic is known as a direct approach, with a strong focus on adjusting the spinal joints. A chiropractor may also want to see the results of imaging scans and any blood and urine tests.
  • An osteopath also diagnoses through palpation and visual inspection. Osteopathy involves slow and rhythmic stretching, known as mobilization, pressure or indirect techniques, and manipulation of joints and muscles.
  • A physical therapist focuses on diagnosing problems in the joints and soft tissues of the body.

From The Physio: 3 Secrets Of Chronic Lower Back Pain

December 29, 2021Nadir Mawji

In this article I will discuss the top three secrets of chronic lower back pain. In my practice as a physiotherapist I have come across many beliefs and myths surrounding chronic lower back pain.

First of all, it’s helpful to know what is chronic lower back pain and how it is defined. Technically speaking chronic lower back pain refers to paint that’s been present for over three months. In the medical field we like to classify chronic pain because it helps us to understand what treatments might be best for this problem. In contrast, acute lower back pain is pain that has been there for less than three months or has suddenly come on. In most cases, the specific cause of lower back pain cannot be identified.

If you are interested, I have written about why I became a physiotherapist. I have used both my personal experiences as a patient and former back-pain sufferer as well as my clinical training as a physiotherapist to come up with this article.

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What Is Low Back Pain

The low back, also called the lumbar region, is the area of the back that starts below the ribcage. Almost everyone has low back pain at some point in life. Itâs one of the top causes of missed work in the U.S. Fortunately, it often gets better on its own. When it doesn’t, your doctor may be able to help with several effective treatments.

Less Common Causes Of Low Back Pain

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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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When Are Diagnostic Tests For Lower Back Pain Necessary

Many patients do not need X-rays in the first few weeks of pain because their pain will end up resolving. Many more do not need CT scans or MRI imaging, which are overly sensitive and often reveal abnormalities not related to the patients pain. These forms of imaging can be extremely useful, however, if a person has chronic or severe pain, and/or neurological symptoms. Blood tests may be ordered if an infection or tumor is suspected.

Low Back Pain Symptoms: Does Your Back Hurt

Low back pain symptoms range from sharp and stabbing to a dull ache. The pains can be constant or intermittent and positional. Acute low back pain can appear suddenly after injury. Chronic back pain is defined as pain lasting more than three months. Consult a doctor if you have prolonged back pain longer than 72 hours.

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How Is Chronic Back Pain Treated

  • NSAIDs help decrease swelling and pain or fever. This medicine is available with or without a doctor’s order. NSAIDs can cause stomach bleeding or kidney problems in certain people. If you take blood thinner medicine, always ask your healthcare provider if NSAIDs are safe for you. Always read the medicine label and follow directions.
  • Acetaminophen decreases pain and fever. It is available without a doctor’s order. Ask how much to take and how often to take it. Follow directions. Read the labels of all other medicines you are using to see if they also contain acetaminophen, or ask your doctor or pharmacist. Acetaminophen can cause liver damage if not taken correctly. Do not use more than 4 grams total of acetaminophen in one day.
  • Prescription pain medicine called narcotics or opioids may be given for certain types of chronic pain. Ask your healthcare provider how to take this medicine safely.
  • Muscle relaxers help decrease pain and muscle spasms.
  • Steroids decrease inflammation that causes pain.
  • Anesthetic medicines may be injected in or around a nerve to block pain signals from the nerves.
  • Antidepressants may be used to help decrease or prevent the symptoms of depression or anxiety. They are also used to treat nerve pain.

Lower Back Pain And Cancer

How Do I Fix Lower Back Pain?

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 .

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What Causes Chronic Lower Back Pain

There are several causes of lower back pain, but most cases are due to a mechanical injurystraining a muscle from lifting something that was too heavy. Other examples of mechanical injuries include a herniated or bulging disc caused by a car accident and arthritis caused by wear and tear of the spinal bones over time. When pain lasts more than 12 weeks, it is defined as chronic. While most injuries to the lower back heal completely, approximately 20% of the time the acute injury turns into a chronic pain condition that lasts for a year or more. An accurate diagnosis is important for ruling out other sources such as inflammation, fractures, infections, and cancer.

When To Get Medical Help And Advice

Nine out of 10 people find their lower back pain improves within four to six weeks. You may find that you feel better sooner than this, in a few weeks. But contact your GP if the pain is severe, getting worse over time or isnt improving after four to six weeks. Also, contact your GP urgently if you feel unwell or have a high temperature. And if you have had cancer or osteoporosis, your GP may want to check that there isnt a more serious cause.

Seek medical attention right away if you:

  • have numbness or tingling around your bottom or genitals
  • cant control when you pee or cant go at all
  • lose control of your bowels
  • are unsteady when you walk, your legs feel weak or your foot is dropping or dragging

These may be signs that the nerves at the bottom of your spine are being squashed. This is called cauda equina syndrome and needs urgent treatment.

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What Should I Know About Back Pain

Back pain is a very common problem and will affect many of us at some point during our lives.

The good news is that in most cases it isnt a serious problem, and it might just be caused by a simple strain to a muscle or ligament.

As far as possible, its best to continue with your normal everyday activities as soon as you can and to keep moving.

Being active and exercising wont make your back pain worse, even if you have a bit of pain and discomfort at first. Staying active will help you get better. Taking painkillers can help you do this.

What Can Cause Lower Back Pain

Can yoga help chronic lower back pain?

Most acute low back pain is mechanical in nature, meaning that there is a disruption in the way the components of the back fit together and move. Some examples of mechanical causes of low back pain include:

Congenital

  • Skeletal irregularities such as scoliosis , lordosis , kyphosis , and other congenital anomalies of the spine.
  • Spina bifida which involves the incomplete development of the spinal cord and/or its protective covering and can cause problems involving malformation of vertebrae and abnormal sensations and even paralysis.

Injuries

  • Sprains , strains , and spasms
  • Traumatic Injury such as from playing sports, car accidents, or a fall that can injure tendons, ligaments, or muscle causing the pain, as well as compress the spine and cause discs to rupture or herniate.

Degenerative problems

  • Intervertebral disc degeneration which occurs when the usually rubbery discs wear down as a normal process of aging and lose their cushioning ability.
  • Spondylosis the general degeneration of the spine associated with normal wear and tear that occurs in the joints, discs, and bones of the spine as people get older.
  • Arthritis or other inflammatory disease in the spine, including osteoarthritis and rheumatoid arthritis as well as spondylitis, an inflammation of the vertebrae.

Nerve and spinal cord problems

Non-spine sources

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Relax And Stay Positive

Trying to relax is a crucial part of easing the pain as muscle tension caused by worrying about your condition may make things worse.

Read more about:

Although it can be difficult, it helps to stay positive and recognise that your pain should get better. People who manage to stay positive despite their pain tend to recover quicker.

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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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.

What Structures Make Up The Back

Lower Back Pain

The lower backwhere most back pain occursincludes the five vertebrae in the lumbar region, which supports much of the weight of the upper body. The spaces between the vertebrae are maintained by round, rubbery pads called intervertebral discs that act like shock absorbers throughout the spinal column to cushion the bones as the body moves. Bands of tissue known as ligaments hold the vertebrae in place, and tendons attach the muscles to the spinal column. Thirty-one pairs of nerves are rooted to the spinal cord and they control body movements and transmit signals from the body to the brain.

Other regions of vertebrate are cervical , thoracic , and sacral and coccygeal segments.

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Lower Back Pain Symptoms Diagnosis And Treatment

The lumbar spine, or low back, is a remarkably well-engineered structure of interconnecting bones, joints, nerves, ligaments, and muscles all working together to provide support, strength, and flexibility. However, this complex structure also leaves the low back susceptible to injury and pain.

Watch:Lumbar Spine Anatomy Video

This article presents a model for understanding symptoms, physical findings, imaging studies, and injection techniques to come to a precise diagnosis.

Once an accurate diagnosis of the cause of the lower back pain is attained, treatment options can be selected based on todays best medical practices.

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