Expert Q& a: Back Strain Or Arthritis
Understand the difference between spinal arthritis and other types of back pain, and try these pain-relieving tricks.
Question: I am a 35-year-old man who has had pain in my lower back for the past couple of weeks, and Id like to know some methods for low back pain relief. Because my mother and an aunt both have arthritis, Im also wondering if I’m developing arthritis, too.
A: It’s possible, but very unlikely, that you have arthritis of the spine. The most common cause of acute low back pain in people your age is back strain. This condition is caused by strain to the muscles or ligaments supporting the spine or a herniation of the lumbar disks . It is not always possible to differentiate between the two causes, nor is it necessary. In the vast majority of cases, the pain improves and subsides over several weeks.
Assuming your problem is simple back strain , the following advice can help you achieve low back pain relief:
Doyt Conn, MD
Emory University School of Medicine
Techniques For Good Posture:
- Sit in a firm chair with armrests to relieve pressure in your back and shoulders.
- Keep your upper back straight and shoulders relaxed. Keep stomach muscles pulled in, and maintain the proper curve in your lower back. You can do this by tightening your stomach and buttocks. Some people are more comfortable sitting with the back of the chair at a 15- to 20-degree angle. A small cushion behind the lower back to maintain the natural curve of the back also can be quite helpful.
- Keep your knees slightly higher than your hips.
- Use a footstool or book under your feet if necessary.
- Keep your feet flat on the floor or other surface.
- Don’t sit for a long period of time. Stand up every now and then to stretch tight muscles and give them a chance to relax.
- Stand with weight equal on both feet.
- Avoid locking your knees.
- Ease tension in your back by placing one foot on a footstool.
- If you stand for long periods of time, wear flat or low-heeled shoes.
- Keep your back straight by tightening your stomach muscles and buttocks.
- When sleeping,
Lie on your side with your knees bent.
- If more comfortable, place a pillow between your knees while sleeping on your side.
- If you sleep on your back, ask your doctor or physical therapist if placing pillows under your knees would help your lower back pain or make it worse.
- Use a firm mattress.
How To Prevent Arthritis
When it comes to arthritis, there are some widespread misconceptions about it. Many people might think arthritis is something that happens to random individuals without any rhyme or reason. Theres no preventing it, and youll either develop it or you wont. Others might think its entirely genetic, and so the chances of developing it are deciding by our family history.
Maybe youre a long-time arthritis patient. Maybe youre just beginning to feel stiffness in your joints, and youre wondering if you might be experiencing the beginnings of arthritis. Or maybe youre just curious, and youre wondering if there are any steps you can take to prevent yourself from developing this condition in the first place.
Whatever the case may be, its always best to be well-informed. Thats why weve put together a guide to arthritis. Here, well talk about what it is, what causes it and what steps you can take to prevent yourself from developing it, or else what steps you can take to help lessen your symptoms.
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Research And New Developments
Previous research has shown that ankylosing spondylitis has a strong genetic component and were currently funding several research projects to further understand this. Previously, we part funded research that identified a specific gene, called IL23R, thats linked to the condition. Were now funding a follow-on project to investigate how changes in this gene lead to the development of ankylosing spondylitis.
Were also supporting a study thats investigating a gene called RUNX3. Researchers are investigating whether this molecule can be targeted with drugs. Results from this research may lead to the development of new and more effective drug treatments.
Were funding a project investigating the protein HLA-B27. This protein is found in over 90% of people with ankylosing spondylitis. Its thought that HLA-B27 proteins tend to fold incorrectly inside cells, which may lead to the immune system releasing chemicals that cause inflammation. This research aims to generate HLA-B27 specific treatments that overcome the problems associated with current treatment options.
Can Lumbar Arthritis Be Prevented
Your age, family history, and gender can all contribute to arthritis development. Although these factors are outside of your control, there are certain things that you can do to limit the pressure on your vertebrae. Reduced pressure may prevent flares of lumbar arthritis or other symptoms.
To reduce your risk of flare-ups:
Maintain a healthy weight. Carrying excess weight can put unnecessary stress on your joints.
Opt for low-impact exercise. Stretching, yoga, and swimming can all relieve pressure on your back.
Move with care. When dealing with heavy objects, be sure to lift with your knees and not with your back.
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Other Otc Pain Relievers
Along with medications, there are supplements and creams that you can buy at the drugstore to relieve arthritis pain. People may also use topical treatments along with other medications.
Many people with OA use the supplements glucosamine and chondroitin. For those with moderate to severe OA knee pain, the combination of the two may ease aches, although medical studies have not shown clear proof that they help a lot. If you choose to try it, take it for at least 3 months before you decide if it helps.
There donât seem to be any major side effects from glucosamine and chondroitin supplements, but because they are supplements, the FDA doesnât regulate them in the same way as drugs. That means itâs tough to be sure of the content and quality of supplements you see in stores.
Though the benefit is still unclear, one study showed long-term use of fish oil supplements improved pain and function.
Skin creams made from capsaicin, an extract from chili peppers, may help relieve mild arthritis pain. You may notice a mild stinging or burning feeling when you rub it on your skin, but it usually fades over time. Test the medication on a small part of your skin to make sure youâre not sensitive to any of the ingredients.
Cold or warm compresses on a painful joint a few times per week may also improve pain, swelling, and range of motion. Cold therapy may also help you feel better right after you exercise.
Low Back Pain Caused By Osteoarthritis
The most common symptom of spinal osteoarthritis is pain in the lumbar spine . This pain may also radiate down to the pelvis, buttocks, groin or thighs. It is usually treated through a combination of:
- and that strengthens a person’s core
- , acetaminophen, and/or adjuvant pain medication
When these treatments are not enough to alleviate pain and stiffness, a patient may require procedural pain management, such as or blocking of the medial nerve through radiofrequency neurotomy, where heat generated by radio waves disrupts the nerves ability to transmit pain signals.
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Use Heat And Cold Therapy
A hot or cold compress which works better for pain relief? The answer is they both have their place.
Applying heat to the area of the back that hurts provides soothing pain relief for a lot of people. You can choose dry heat applied directly to the sore spots.
Or you can try moist heat, like a warm, moist towel or even a warm bath. The Healthy Back Institute offers a state-of-the-art heating pad thats been shown to melt away pain and restore mobility in just 10 minutes.
On the other hand, using ice packs or a cold compress can help numb arthritis pain.You can alternate between the two, but feel free to use whatever method provides you with the most pain relief.
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Heat And Cold Therapy
Scientists have proven that applying heat or cold continuously or in frequent intervals can considerably reduce even chronic back pain and offer great relief.
Heat can be either moist or dry. Heating lamps, pads, and wearable heat packs are some of the dry heat sources. A warm bath and warm clothes that are soaked in warm water can be the moist sources.
*All individuals are unique. Your results can and will vary.
Cold compressor filled with ice, cold therapy are also beneficial. However, it should be noted that ice should never be applied directly to the skin as it can cause sudden sensation in the nerves and joints around the area.
Also, keeping ice for too long can result in joint stiffness and may even increase the pain. A period of 20-25 minutes is considered as ideal and it can be done 2-3 times a day for best results.
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Are Glucosamine And Chondroitin Supplements Helpful For Treating Osteoarthritis Of The Hand
Supplements are not reviewed or approved by the Food and Drug Administration . They are not required to undergo the same rigorous clinical trial methods that medications must undergo in the U.S. Some clinical trials show benefits with pain relief however, there is no proof that these supplements slow the progression of osteoarthritis. If you plan to try these, always check with your healthcare provider before using supplements. These products may interfere with medications you currently take.
A note from Cleveland Clinic
Dull or burning joint pain, morning stiffness, swollen joints in your hand are all symptoms of arthritis. Many types of arthritis could affect your hands. Many treatment options are available depending on your exact arthritis type. Medications can reduce joint pain and swelling. Researchers are still working on ways to slow the progression of osteoarthritis. See your healthcare provider if you think you have arthritis in your hands. They will perform a complete exam and offer you a complete treatment plan, which includes hand exercises, use of hot and cold packs, other lifestyle tips and traditional treatments including medications, braces/splints, steroid injections and surgery.
Last reviewed by a Cleveland Clinic medical professional on 07/06/2021.
How Is Arthritis In The Hand Treated
Treatment options depend on the type of arthritis, stage of arthritis, how many joints are affected, your age, activity level, the hand affected and other existing medical conditions.
Goals of treatment are to:
- Improve mobility and function.
- Increase your quality of life.
- In the case of rheumatoid or psoriatic arthritis, to slow the progression of the disease.
Treatment options include splinting/bracing, medications, injections, non-drug approaches and surgery.
Splits or braces support and protect the affected joint, reduce deformity, provide joint stability, lessen strain, and promote proper joint alignment. Your healthcare provider, occupational therapist or hand therapist will discuss splinting/bracing options, how and when to wear them and how long to wear them .
Steroids reduce inflammation and relieve pain. Steroids are usually used if medications dont control inflammation or if the inflammation is limited to a few joints. Injections are administered directly into the affected joint. Because steroids can weaken tendons and ligaments, injections are repeated only a few times.
Other management strategies
A complete treatment plan for arthritis of the hand includes these additional approaches:
If nonsurgical treatments no longer provide relief and the cartilage at the ends of your bones has worn away, surgery may be an option. There are several approaches:
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Surgery For Back Arthritis
Surgery is a last resort when it comes to arthritis in the back. Know that 95 percent of people with back pain will not need surgery, and 75 percent will fully recover within three months, says Dr. Tiso.
Doctors recommend that you try medications, physical therapy, and weight loss before considering surgery, says Dr. Kilian. The best surgical outcomes often occur in patients who are actively involved in physical therapy and have a healthy body weight, he says.
The type of surgery depends on the type of arthritis and region of the back that is affected. Depending on the procedure performed, surgery aims to decompress any pinched nerves and free up the nerve roots from bone spurs and other tissues that may be pressing on them.
What Can I Do For Low Back Pain At Home
If your lower back pain has just started, the best thing you can do is start a log. Record your symptoms, times, dates and which activities trigger the pain or make it worse or better. Take this information to your family physician if the pain doesnt resolve on its own. It will make diagnosing the cause much easier.
Once you know which motion or position causes your lower back pain, try to avoid it and see if you get better. Icing the painful spot can also help. And so can over-the-counter pain relievers that help reduce inflammation. Just remember that pain killers treat only the symptom pain and not its cause.
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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.
What Questions Should I Ask My Doctor
If you have ankylosing spondylitis, you may want to ask your healthcare provider:
- Why did I get ankylosing spondylitis?
- What is the best treatment for ankylosing spondylitis?
- What are the treatment risks and side effects?
- What lifestyle changes should I make to manage the condition?
- Is my family at risk for developing ankylosing spondylitis? If so, should we get genetic tests?
- Am I at risk for other types of arthritis or back problems?
- What type of ongoing care do I need?
- Should I look out for signs of complications?
A note from Cleveland Clinic
Ankylosing spondylitis is a form of arthritis that mostly affects the spine. Its a lifelong condition without a cure. However, exercise, medications and lifestyle changes can help manage symptoms so you can enjoy a long, productive life. Its rare for someone with AS to become severely disabled. Talk to your healthcare provider about the steps you can take to stay active and manage symptoms.
Last reviewed by a Cleveland Clinic medical professional on 07/21/2020.
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How Is Osteoarthritis Of The Spine Diagnosed
The best way to confirm a diagnosis of osteoarthritis is by X-ray. The doctor will take a medical history and perform a physical exam to see if the person has pain, tenderness, loss of motion involving the neck or lower back, or if symptoms are suggestive, signs of nerve involvement such as weakness, reflex changes, or loss of sensation.
The doctor may order certain tests to aid in the diagnosis of osteoarthritis of the spine. These tests include:
- X-rays to look for bone damage, bone spurs, and loss of cartilage or disc however, X-rays are not able to show early damage to cartilage.
- Blood tests to exclude other diseases
- Magnetic resonance imaging to show possible damage to discs or narrowing of areas where spinal nerves exit
Arthritis In Back Symptoms Diagnosis And Treatment
Back pain is a global epidemic listed as one of the top ten diseases and injuries that contribute to disability-adjusted life year as published in a study by WHO. The prevalence of common back pain is from 60-70 percent. Arthritis in back symptoms is one of the most debilitating kinds of pain that originates in the neck and the lower back areas. People who suffer from arthritis in back often find themselves defeated with the sensation that all they end up doing is lie down hoping to stop the suffering by being stationary. But even if this measure provides relief, it can never help with the symptoms in the long term.
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Who Gets Osteoarthritis Of The Spine
In general, osteoarthritis happens as people get older. Younger people may get it from one of several different causes:
- injury or trauma to a joint
- a genetic defect involving cartilage
For people younger than age 45, osteoarthritis is more common among men. After age 45, osteoarthritis is more common among women. Osteoarthritis occurs more often among people who are overweight. It also occurs more frequently in those who have jobs or do sports that put repetitive stress on certain joints.
Kidney Disease And Kidney Failure
Kidney disease and resulting renal failure can cause pain in the lower back below the rib cage and at the sides of the body. Renal conditions that affect kidney function also cause edema in the legs and feet due to increased sodium and fluid retention because the kidneys cannot properly filter out sodium from the blood.
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