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What Could Severe Lower Back Pain Mean

Complementary And Alternative Techniques Include:

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  • Acupuncture is moderately effective for chronic low back pain. It involves inserting thin needles into precise points throughout the body and stimulating them , which may cause the body to release naturally occurring painkilling chemicals such as endorphins, serotonin, and acetylcholine.
  • Behavioral approaches include:
  • Biofeedback involves attaching electrodes to the skin and using an electromyography machine that allows people to become aware of and control their breathing, muscle tension, heart rate, and skin temperature people regulate their response to pain by using relaxation techniques
  • Cognitive therapy involves using relaxation and coping techniques to ease back pain
  • Transcutaneous electrical nerve stimulation involves wearing a battery-powered device which places electrodes on the skin over the painful area that generate electrical impulses designed to block or modify the perception of pain
  • Physical therapy programs to strengthen core muscle groups that support the low back, improve mobility and flexibility, and promote proper positioning and posture are often used in combination with other interventions
  • Spinal injections include:Trigger point injections can relax knotted muscles that may contribute to back pain. An injection or series of injections of a local anesthetic and often a corticosteroid drug into the trigger point can lessen or relieve pain.

    Can Back Pain Be Prevented

    Recurring back pain resulting from improper body mechanics may be prevented by avoiding movements that jolt or strain the back, maintaining correct posture, and lifting objects properly. Many work-related injuries are caused or aggravated by stressors such as heavy lifting, contact stress , vibration, repetitive motion, and awkward posture.Recommendations for keeping ones back healthy

    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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    Chronic Lower Back Pain Treatment

    Through years of experience, weâve figured out that good and long-lasting chronic lower back pain relief doesnât work unless all bases are covered.

    The best lower back pain management combines pain-reducing treatments combined with other selected therapies like physical and psychological rehabilitation treatment.

    TYPES OF TREATMENT

    Weight Loss Exercise And Diet

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    Think about the extra pounds people carry every day due to their being overweight. This puts added pressure and strain on the back and stomach muscles, causing those muscles to stretch and weaken. Weak back and stomach muscles cannot support the back properly. Poor posture can shift your body out of balance. This forces only a few muscles and joints to do all the work. Without proper exercise, muscles become weak and tire easily. Exercise is necessary to keep the back strong and limber. A good conditioning exercise program led by a trained instructor can be particularly helpful. An effective program includes a warm-up period about 30 minutes of aerobic activity isolated muscle group work and a cool-down period. Over a period of time, the rewards of regular aerobic workouts can include a slimmer waistline and healthier back.

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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.

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    Non-prescription discomfort relief medicine, typically nonsteroidal anti-inflammatory drugs , such as advil, can ease pain. Using a hot compress or an ice bag to the agonizing location may likewise minimize discomfort.

    Resting from difficult task can help, but moving around will certainly alleviate tightness, minimize discomfort, and protect against muscular tissues from weakening.

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    How Is Low Back Pain Treated

    Treatment may include:

    • A prevention program
    • Assistive devices

    Rehabilitation is often a part of treatment for low back pain. Generally, there are 3 phases of low back pain rehab.

    • Acute phase. During this initial phase, the physiatrist and treatment team develop a plan to reduce the initial low back pain and source of inflammation. This may include using ultrasound, electrical stimulation, or specialized injections.
    • Recovery phase. Once the initial pain and inflammation are better managed, the rehab team focuses on helping you return to normal daily activities while starting a specialized exercise program to regain flexibility and strength.
    • Maintenance phase. In this phase, you will learn ways to prevent further injury and strain to the back. You will also learn how to start a fitness program to help further increase strength and endurance.

    What Are The Risk Factors For Developing Low Back Pain

    Low back pain- The most common causes of lower back pain

    Anyone can have back pain. Factors that can increase the risk for low back pain include:

    Age: The first attack of low back pain typically occurs between the ages of 30 and 50, and back pain becomes more common with advancing age. Loss of bone strength from osteoporosis can lead to fractures, and at the same time, muscle elasticity and tone decrease. The intervertebral discs begin to lose fluid and flexibility with age, which decreases their ability to cushion the vertebrae. The risk of spinal stenosis also increases with age.

    Fitness level: Back pain is more common among people who are not physically fit. Weak back and abdominal muscles may not properly support the spine. Weekend warriorspeople who go out and exercise a lot after being inactive all weekare more likely to suffer painful back injuries than people who make moderate physical activity a daily habit. Studies show that low-impact aerobic exercise can help maintain the integrity of intervertebral discs.

    Weight gain: Being overweight, obese, or quickly gaining significant amounts of weight can put stress on the back and lead to low back pain.

    Genetics: Some causes of back pain, such as ankylosing spondylitis , have a genetic component.

    Smoking: It can restrict blood flow and oxygen to the discs, causing them to degenerate faster.

    Backpack overload in children: A backpack overloaded with schoolbooks and supplies can strain the back and cause muscle fatigue.

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    Lower Back Pain Causes

    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 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:

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    How Is Lumbar Strain Treated

    Treatment will depend on your symptoms, age, and general health. It will also depend on how severe the condition is.

    Treatment may include:

    • Stretching and strengthening exercises
    • Learning how to use and wear appropriate protective equipment

    Medicines, such as anti-inflammatories, muscle relaxants, and spinal injections, may also be used to ease pain and inflammation.

    When Should I See My Healthcare Provider About Lower Back Pain

    20 Interesting Infographics On Back Pain

    Lower back pain usually gets better with rest and pain relievers. Back pain that doesnt go away may be a sign of a more serious condition.

    See your provider if you have:

    • Pain that doesnt get better after about a week of at-home care.
    • Tingling, numbness, weakness or pain in your buttocks or legs.
    • Severe pain or muscle spasms that interfere with your normal activities.
    • Fever, weight loss, bowel or bladder problems or other unexplained symptoms.

    A note from Cleveland Clinic

    Millions of people live with low back pain. Stiffness, pain and limited movement can have a major impact on quality of life. But you may be able to avoid lower back pain by maintaining a healthy weight and staying active. Talk to your provider if back pain doesnt go away or if youre unable to do the activities you enjoy. Several treatments can relieve pain, help you move better and get more out of life.

    Last reviewed by a Cleveland Clinic medical professional on 01/18/2021.

    References

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    Low Back Pain Symptoms And Signs

    Pain in the lumbosacral area is the primary symptom of low back pain.

    • The pain may radiate down the front, side, or back of your leg, or it may be confined to the low back.
    • The pain may become worse with activity.
    • Occasionally, the pain may be worse at night or with prolonged sitting such as on a long car trip.
    • You may have numbness or weakness in the part of the leg that receives its nerve supply from a compressed nerve.
    • This can cause an inability to plantar flex the foot. This means you would be unable to stand on your toes or bring your foot downward. This occurs when the first sacral nerve is compressed or injured.
    • Another example would be the inability to raise your big toe upward. This results when the fifth lumbar nerve is compromised.

    Herniated Disk In The Lower Back

    A herniated, ruptured, or “slipped” disc means that a vertebral disc one of the soft pads of tissue that sit between each of the vertebral bones has becomes squeezed out of shape. Its cushioning material has been forced against, and possibly through, the ring of fibrous tissue that normally contains it. This causes pain, numbness, and weakness in the legs.

    The normal aging process causes the discs lose moisture and become thinner, making them more vulnerable to “slipping.”

    Most susceptible are men from ages 30 to 50. Smoking, obesity, lack of exercise, and improper lifting are also risk factors.

    Symptoms include pain, weakness, numbness, and tingling in the back, leg, and foot.

    Diagnosis is made through patient history, neurological examination, and MRI scan.

    Treatment begins with rest, nonsteroidal anti-inflammatory drugs, physical therapy, and sometimes epidural steroid injections into the back to ease pain and inflammation.

    Surgery to remove the herniated part of the disc the part that was squeezed out of place can also be helpful.

    Rarity: Common

    Top Symptoms: lower back pain, moderate back pain, back pain that shoots down the leg, back pain that gets worse when sitting, leg weakness

    Urgency: Primary care doctor

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    More Advanced Care Options

    Surgery When other therapies fail, surgery may be considered to relieve pain caused by worsening nerve damage, serious musculoskeletal injuries, or nerve compression. Specific surgeries are selected for specific conditions/indications. However, surgery is not always successful. It may be months following surgery before the person is fully healed and there may be permanent loss of flexibility. Surgical options include:

    Implanted nerve stimulators

    • Spinal cord stimulation uses low-voltage electrical impulses from a small implanted device that is connected to a wire that runs along the spinal cord. The impulses are designed to block pain signals that are normally sent to the brain.
    • Dorsal root ganglion stimulation also involves electrical signals sent along a wire connected to a small device that is implanted into the lower back. It specifically targets the nerve fibers that transmit pain signals. The impulses are designed to replace pain signals with a less painful numbing or tingling sensation.
    • Peripheral nerve stimulation also uses a small implanted device and an electrode to generate and send electrical pulses that create a tingling sensation to provide pain relief.

    How Is Back Pain Treated

    Could back pain be something worse?

    Acute back pain usually gets better on its own. Acute back pain is usually treated with:

    • Medications designed to relieve pain and/or inflammation
    • analgesics such as acetaminophen and aspirin
    • non-steroidal anti-inflammatory drugs such as ibuprofen and naproxen may be sold over the counter some NSAIDS are prescribed by a physician
    • muscle relaxants are prescription drugs that are used on a short-term basis to relax tight muscles
    • topical pain relief such as creams, gels, patches, or sprays applied to the skin stimulate the nerves in the skin to provide feelings of warmth or cold in order to dull the sensation of pain. Common topical medications include capsaicin and lidocaine.
  • Heat and/or ice may help ease pain, reduce inflammation, and improve mobility for some people
  • Gentle stretching upon advice by your healthcare professional
  • Exercising, bed rest, and surgery are typically not recommended for acute back pain.Chronic back pain is most often treated with a stepped care approach, moving from simple low-cost treatments to more aggressive approaches. Specific treatments may depend on the identified cause of the back pain.

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    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.

    Possible Causes For Lower Back And Leg Pain

    According to a study by Georgetown University, around 8% of all American adults experience persistent back pain that affects their quality of life. Most of them have limited movements to avoid aggravating the back in the lower back. In some cases, the intense lower back pain travels down to the buttocks, thighs, and legs.

    Since back pain is also one of the main reasons why American workers miss work days, its important to get the right treatment as soon as possible. Finding out the right treatment starts with determining the root cause of the lower back pain that radiates down to the legs. Here are some of the most common reasons for pain in the lumbar spine:

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