Treatment Options For Lower Back Pain
If you see a physiotherapist or GP for lower back pain, they will probably encourage you to try the self-help measures outlined above first. They can also advise you on what exercises you can do to help your back, or may refer you to a group exercise programme. But if your pain doesnt improve, they may be able to recommend other options you can try. They can also refer you to a specialist if necessary.
When You Should Go To The Er For Back Pain
If your back pain is accompanied by any of the following symptoms, head to your closest emergency room because you could be dealing with a more serious condition or injury:
- Sudden spike in pain, discomfort, weakness or numbness
- Loss of bladder function
- Unexplainable weight loss
- The pain results from a fall or severe blow to your back
If you experience any of these symptoms, its a good idea to talk to your doctor so you can determine next steps for managing pain.
When To Call A Doctor
Consult your doctor if you have back pain thats intense, worrisome, or that doesnt go away with self-care measures. Its also important to call your doctor if your lower back pain is making it hard for you to go about your daily activities.
Most cases of lower back pain on the right side are not medical emergencies. However, dont hesitate to get immediate medical help if you experience back pain thats accompanied by any of the following symptoms:
- loss of bladder or bowel function
- sudden, severe pain
- weakness or loss of sensation in your lower body
- pain accompanied by fever, clammy skin, a rapid heart rate, nausea, vomiting, or any other concerning symptoms
The appropriate treatment for lower back pain emergencies depends on the cause. If the source of the pain isnt obvious, you may need one or more of the following screenings to determine the right course of action:
- an MRI to check your spinal cord, nerve roots, and other soft tissue
- an X-ray to look at your spine and other joints for signs of fracture or other concerns
- blood tests to check for markers of inflammation
If nerve or muscle problems are the cause of lower back on the right, epidural injections of corticosteroids may be necessary if the pain and loss of mobility and function are severe.
If appendicitis is diagnosed and it cant be managed by antibiotics, then emergency surgery to remove the appendix may be necessary.
- nerve compression in your spine
- disc degeneration
- an abdominal aortic aneurysm
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How To Prevent Back Pain
One of the most effective ways of preventing back pain is strengthening your core muscles. Specific exercises that work to improve the strength of the abdominal wall and muscles in the lower back can help prevent injury.
Proper lifting techniques will help prevent injury. Keep the object close to your body and put the weight of the object on your legs, not your back. This reduces the risk of back strain and prevents additional injuries due to falling or losing your balance.
The solution to back pain is not always surgery. Proper diagnosis and an effective treatment program can help you avoid surgical procedures, even if you have chronic back pain. Back pain is not a normal part of the ageing process. It can be diagnosed and treated, allowing you to live a fulfilling and active life, without pain. A chiropractor can help you learn proper strengthening techniques and body mechanics that can help you move towards a pain-free back.
Contact us today to schedule your comprehensive appointment and find out how we can put our experience to help heal your back pain.
Chronic Lower Back Pain
When back pain continues for more than three months, it is considered chronic. Although for most people an episode of back pain is over by that time, in some cases it progresses and can have a major impact on ones ability to function. For some patients, physical therapy with local heat or ice application , combined with a home exercise program and education in proper positions for lifting and other movement techniques can make a major difference. Patients must learn to tolerate a certain degree of pain, or they may allow themselves to become more disabled than necessary. Patients at the Hospital for Special Surgery have had success with graded exercise to work through the pain, gradually increasing the exercise quota at each session so they can learn to tolerate more exercise in spite of the pain, and get back to work and activities. Read more detail on this topic in .
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Common Causes Of Chronic Lower Back Pain
“Chronic lower back pain is less likely to be caused by injury to your muscles and ligaments and more likely to be due to issues with the lumbar disks, nerves, joints or vertebrae,” says Dr. Palmer. “There are several potential causes of chronic pain in the lower back.”
In general, osteoarthritis and degenerative disk disease are the underlying cause of many types of chronic lower back pain. However, lower back pain can also be caused by accident-related trauma and acute stress.
Sleeping In A Bad Position
A third of a persons life is spent sleeping. So, if sitting for eight hours a day causes back pain, why wouldnt sleeping in a poor position be any different? This is exacerbated by poor mattress conditions, pillow positions, sleeping positions, and many more.
So, the next time you wake up with a kink in your back, try and see what might be causing it. Its difficult to fix your position when youre passed out, so its best to make your sleeping environment as comfortable as you can be while youre awake. That means looking for a supportive yet soft mattress, using the right pillows, and perhaps even changing the size of your bed so you dont move around as much.
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The Most Common Causes Of Lower Back Pain Are A Strain Or Sprain
Whether you notice it or not, your lumbar spine gets put to work throughout the entire day.
Amid all of this work and motion, a lower back sprain or strain can result from an acute injury, such as one experienced while falling, lifting something too heavy or playing sports. A sprain or strain can also develop over time due to repetitive movements or poor posture.
“Straining a muscle or spraining a ligament are the most common causes of lower back pain,” says Dr. Palmer. “While they can be serious, these common causes of lower back pain aren’t long-lasting taking anywhere from a few days to heal or, at most, a few months.”
Your doctor can help you determine the particular course of self-care that can help heal your lower back pain.
“The treatment for a pulled back muscle or strained back ligament is fairly simple and can include pain and anti-inflammatory medications, muscle relaxers, ice to help reduce inflammation, heat to promote healing, and avoiding strenuous activity until the pain recedes,” explains Dr. Palmer. “The best course of care will depend on the severity of your injury as well as your overall core and lower body strength.”
If your lower back pain persists despite treatment, it may be time to consider other causes of lower back pain.
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.
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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.
When Should I See A Doctor For Lower Back Pain
If your back pain does not resolve within 6-12 weeks, you should see your primary care doctor. They may refer you to physical therapy or to an orthopedist. With doctor approval, massage therapy might also be a benefit.
There are also a few red flags you need to be aware of to understand whether or not your back pain might be a more serious issue. If you…
- Have back pain associated with serious trauma
- Have cancer or have a history of cancer
- Have trouble going to the bathroom or cant hold your urine or stool
- Are experiencing neurological dysfunction like leg weakness or numbness
- Lose sensation around the groin area
- Have a fever in associated with your back pain
…its best to seek emergency care ASAP.
But again, unless youre experiencing any of these symptoms, you can take a breath. Try to give your lower back some R& R, and if youre really worried, your primary care physician can guide you on your next best steps.
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When To See A Doctor
Its always a good idea to get in touch with a healthcare practitioner if you are experiencing back pain.
Some lower back pain symptoms signal serious problems. If you have any of the following symptoms, get medical attention as soon as possible:
- Loss of sensation in one or both legs
- Loss of bladder and bowel control
- Numbness, tingling, weakness, or radiating pain in your legs
Some of these symptoms may indicate a medical emergency that requires immediate treatment.
Depending on your diagnosis, your doctor may also prescribe a long-term treatment plan to manage and prevent chronic pain, like physical therapy, therapeutic exercises, steroid injections, or lifestyle changes.
How Can Back Pain Be Prevented
In most cases, you can prevent back pain by making changes to your lifestyle.
Doing exercise helps to keep your back flexible and strong. Exercise improves your posture and helps your muscles to support your spine. Exercises that can help prevent back pain include:
- low-impact aerobic exercise
- strengthening exercises, such as lifting weights, climbing stairs or hiking hills
- stretching exercises, such as Pilates and yoga
Maintaining a good posture is important when you sit at home, in your workplace, or in your car. Try not to slouch, and use equipment that supports your back, such as a lumbar support or footstool if you need.
Keeping a healthy weight is also important. Excess fat can strain your back and lead to back pain, sciatica and inflammation.
Practise safe lifting in your home or workplace. Whenever you pick up a heavy load, squat down, hold the object close to your body, and lift with your legs.
In addition:
- Quit smoking Smoking increases your chances of developing persistent back pain.
- Relax Learning relaxation techniques and mindfulness can help to reduce stress and muscle tension in your back.
- Avoid high heels wearing high heels can place strain on your back.
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What To Do If Youre Experiencing Lower Back Pain
Heres some good news: If youre currently putting up with lower back aches, theres a good chance that it will heal on its own. Most people who have acute low back pain are actually going to get better on their own in six weeks or less, says Dr. Popko.
Many cases get better with rest and home treatment. Try the usual things: heat, if that helps, ice, if that helpsand classes of drugs like ibuprofen are very, very useful, says Dr. Rifkin.
It also could help to avoid movements that aggravate the pain, but make sure to stay as active as you can. Prolonged bed rest may make back strains worse as the muscles around the spine begin to weaken and lose tone. You also might want to look into making your work space better for your bodys needs and see if that helps.
Less Common Causes Of Low Back Pain
While considerably less common, low back pain may also be caused by:
Infection. Also called osteomyelitis, a spinal infection is rare but can cause severe pain and is life threatening if untreated. It can be caused by surgical procedures, injections, or spread through the blood stream. Patients with a compromised immune system are more susceptible to developing an infection in the spine.
Tumor. Most spinal tumors start in another part of the body and metastasize to the spine. The most common tumors that spread to the spine start from cancer in the breast, prostate, kidney, thyroid, or lung. Any new symptoms of back pain in a patient with a known diagnosis of cancer should be evaluated for possible spinal metastasis.
Autoimmune disease. Back pain is a possible symptom associated with autoimmune conditions, such as ankylosing spondylitis, rheumatoid arthritis, lupus, crohns disease, fibromyalgia, and others.
This list includes the more common causes of back pain, but there are many more. Finding the optimal treatment for low back pain usually depends on obtaining a correct clinical diagnosis that identifies the underlying cause of the patients symptoms.
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Diagnosis Of Lower Back Pain
A doctor will likely begin by requesting a complete medical history and conducting a thorough physical exam to determine where youre feeling the pain. The physical exam can also reveal whether the pain affects your range of motion.
In addition, a doctor may check your reflexes and responses to certain sensations. This helps them determine if your lower back pain is affecting your nerves.
Unless your symptoms are concerning or you have neurologic loss, a doctor will probably monitor your condition for a few weeks before sending you for more testing. This is because most lower back pain resolves with simple self-care treatments.
Symptoms that require more testing include:
- lack of bowel control
Seek medical attention immediately if you experience any of these symptoms in addition to lower back pain.
How Is Low Back Pain Diagnosed
Along with a complete medical history and physical exam, tests for low back pain may include:
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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 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:
