Treatment Options For Acute Lower Back Pain
Most low back pain is due to muscle strain and spasm and does not require surgery. To treat the pain, medications such as acetaminophen , nonsteroidal anti-inflammatory agents , gabapentin or pregabalin can be used. NSAIDs suppress inflammation, pain and fever by inhibiting certain inflammation-causing chemicals in the body. Acetaminophen reduces pain and fever, but does not inhibit inflammation. Gabapentin and pregabalin, medications that have been used for antiseizure activity, also have the ability to block pain. Opioids provide pain relief and may at times be prescribed to manage severe back pain. However, opioids have many problems, such as habituation, constipation and lightheadedness, and are avoided when possible and used for the shortest possible duration. Epidural injection is an option if the back pain does not respond to these treatments. Each person is different in terms of response to medication.
Other nonsurgical treatments for lower back pain include Intradiscal electrothermal therapy , nucleoplasty, and radiofrequency lesioning.
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:
When Should I See A Doctor If I Have Lower Back Pain
In many cases lower back pain stops on its own. But if it doesnt, here are some guidelines on when you may want to start seeking professional help:
- If the pain lasts four weeks or longer
- If the pain keeps getting worse as time goes by
- If you are experiencing other symptoms, such as fever, major weight loss or weight gain, loss of function or weakness in extremities, bladder problems, etc.
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What Are The Symptoms Of Lower Back Pain
Symptoms of lower back pain can come on suddenly or appear gradually. Sometimes, pain occurs after a specific event, such as bending to pick something up. Other times, you may not know what caused the pain.
Pain may be sharp or dull and achy, and it may radiate to your bottom or down the back of your legs . If you strain your back during an activity, you may hear a pop when it happened. Pain is often worse in certain positions and gets better when you lie down.
Other symptoms of lower back pain include:
- Stiffness: It may be tough to move or straighten your back. Getting up from a seated position may take a while, and you might feel like you need to walk or stretch to loosen up. You may notice decreased range of motion.
- Posture problems: Many people with back pain find it hard to stand up straight. You may stand crooked or bent, with your torso off to the side rather than aligned with your spine. Your lower back may look flat instead of curved.
- Muscle spasms: After a strain, muscles in the lower back can spasm or contract uncontrollably. Muscle spasms can cause extreme pain and make it difficult or impossible to stand, walk or move.
Other Treatments Of Lower Back Pain
NSAIDs which include medications such as ibuprofen and naproxen, as well as acetaminophen, can be very beneficial for pain in PD, as they are for the general population. These medications do not typically have neurologic side effects, so they are well tolerated in people with PD. They can have other side effects though, so as always, discuss all medications that you are taking, including over-the-counter medications, with your doctor. If these medications do not provide sufficient back pain relief, your doctor may prescribe a pain medication. In addition, he/she may refer you for a procedure such as an epidural injection to help with lower back pain. Rarely, surgery may be recommended if a specific structural reason for pain is identified.
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Dysfunction Of Sacroiliac Joints
Dysfunction of the sacroiliac joints is also called sacroiliitis. You have two sacroiliac joints, one on each side of your spine where it connects with the top of your pelvis. Sacroiliitis is inflammation of this joint. It can affect one or both sides.
Pain in your lower back and buttocks is the most common symptom. The pain is usually made worse by:
- standing
- unexplained weight loss
- pain after a fall or injury
If you need help finding a primary care doctor, you can browse doctors in your area through the Healthline FindCare tool.
How To Fix Lower Back Pain In Women
The treatment of low back pain depends on the underlying cause, which is yet another reason why you should schedule an appointment and see the doctor for symptoms you experience. The doctor evaluates each patient, assesses your health status and physical activity level and recommends different tests to rule out other conditions with similar symptoms in order to make an accurate diagnosis.
In cases when lower back pain is associated with other health conditions, then treatment for that problem can also help alleviate pain and discomfort. Depending on the diagnosis, patients have different treatments to try, but a combination of different approaches seems to be the most effective.
When it comes to lower back pain, youre not helpless. There are many things you can do to alleviate pain and discomfort and improve quality of life. Here are some treatment options even your doctor will recommend:
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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.
Whats New In This Article
Seventeen updates have been logged for this article since publication . All PainScience.com updates are logged to show a long term commitment to quality, accuracy, and currency. moreWhens the last time you read a blog post and found a list of many changes made to that page since publication? Like good footnotes, this sets PainScience.com apart from other health websites and blogs. Although footnotes are more useful, the update logs are important. They are fine print, but more meaningful than most of the comments that most Internet pages waste pixels on. I log any change to articles that might be of interest to a keen reader. Complete update logging of all noteworthy improvements to all articles started in 2016. Prior to that, I only logged major updates for the most popular and controversial articles.See the Whats New? page for updates to all recent site updates.
2020 New section, Poor quality sleep and insomnia are probably major causes of morning back pain. Also made some minor improvements to the introduction and article summary.
2020 Comprehensive editing. Re-wrote the summary. Refined advice on treating inflammation. Explained fibromyalgia more clearly and accurately. Added more about mattresses. Improved organization, in-document navigation, and added a few sprinkles of humour.
2018 Significant science update: cited Steffens on back pain risk factors, a fascinating study that adds some important data to this article.
2007 Publication.
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Chronic Or Acute Pain
- Acute pain starts suddenly and lasts for up to 6 weeks.
- Chronic or long-term pain develops over a longer period, lasts for over 3 months, and causes ongoing problems.
If a person has both occasional bouts of more intense pain and fairly continuous mild back pain, it can be hard for a doctor to determine whether they have acute or chronic back pain.
Back pain usually resolves with rest and home remedies, but sometimes medical treatment is necessary.
Injections And Other Procedures
Depending on the source of your pain for example, if you have sciatica epidural injections may be helpful. Injections in the spine arent recommended for non-specific lower back pain though. If your back pain is chronic and other treatments havent helped, there is a procedure called radiofrequency denervation that uses a needle to treat the pain. This is only suitable for some people and you may need to have other tests beforehand. Speak to your specialist for advice.
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Is It Muscle Strain Or Sciatica
Back pain that occurs after excessive exercise or heavy lifting is frequently a strain injury. However, occasionally these activities cause disc injury and rupture or herniation. When a herniated disc irritates the sciatic nerve, it can cause back pain and, in some people, leg pain.
What is Sciatica?
Sciatica is a form of nerve pain caused by pressure on the sciatic nerve. The sciatic nerve is a large nerve that runs down through the buttocks and extends down the back of the leg. Pressing on or pinching of the sciatic nerve causes shock-like or burning low back pain. Sometimes people feel as if the pain radiates down through the buttocks and down one leg, sometimes even reaching the foot.
Symptoms Of Lower Back Pain When Walking
If youre experiencing pain in your lower back when walking, you may have felt some of these symptoms already.
Pay attention to what your back is telling you. What type of discomfort are you feeling? Is it dull pain? Is it shooting pain? Identifying the type of pain will help your doctor figure out whats going on.
Also, pay attention to where you feel the pain. Is it in one specific area? Is it acute pain that radiates across your lower back?
The type of pain and its location may help you and your doctor determine whats going on.
If you are experiencing lower back pain when walking, here are some pain symptoms you may be feeling:
- Stiffness
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Prevention Of Lower Back Pain
If you know how to look after your back, you can greatly reduce your risk of getting back pain. It can help to do the following.
- Exercise regularly walking, swimming or using an exercise bike are all things you can do even if your back feels a bit sore. Take time to build up your fitness if youre trying new activities.
- Use your legs to lift objects by bending your knees and hips, not your back.
- Keep a good posture if you work at a desk, make sure your chair, desk and computer screen are set up correctly. It will help if your employer assesses your work station.
- Move regularly dont sit in the same position for long periods of time.
Unexplained Acute Low Back Pain
Unexplained low back pain means chronic pain that comes on gradually, over time, with no specific injury, event, or illness causing it.
Common causes:
- Prolonged sitting and lack of fitness can weaken back muscles and cause pain from lack of support.
- Ankylosing spondylitis, a form of arthritis.
- Spinal stenosis, a narrowing of the spinal column that puts pressure on the spinal cord.
- Certain types of cancer, in rare cases.
Those most susceptible are over 30, overweight and/or pregnant, and not physically fit. Smoking interferes with healing after any sort of stress to the back.
If there are additional symptoms, medical care should be sought: fever, unexplained weight loss, leg weakness or numbness, or trouble urinating.
An exact diagnosis is made through blood tests and through imaging such as x-rays, CT scan, or MRI.
Once more serious causes are ruled out, treatment may include medications to ease pain, swelling, and inflammation. Steroid injections are useful in some cases.
Overall, exercise and maintaining a healthy weight can be very helpful with easing chronic low back pain.
Rarity: Common
Top Symptoms: lower back pain, back pain that shoots to the butt, fever, back pain
Symptoms that always occur with unexplained acute low back pain:lower back pain
Symptoms that never occur with unexplained acute low back pain:buttocks numbness, thigh numbness, involuntary defecation, fever
Urgency: Self-treatment
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Lower Back Pain Caused By Infection
Infections of the spine are not common, but they do occur. The doctor will ask about the usual signs and symptoms of infection, especially when back pain is accompanied by fever and/or chills. Dialysis patients, IV drug users, and patients who have recently had surgery, trauma, or skin infections are at risk for infections of the spine. Infections of the spine can be caused by a number of agents, most commonly bacteria. Doctors will first test for the presence of bacteria, then give antibiotics.
Lower Back Pain In People With Parkinsons
In a previous blog, we discussed pain and PD in general and highlighted different types of pain that a person with PD might experience.
PD contributes factors that can cause or worsen lower back pain, such as rigidity of the trunk muscles or dystonia of the trunk muscles. Both rigidity and dystonia can fluctuate with medication timing and correlate with ON and OFF time.
In addition, PD can be associated with central pain, which is poorly understood and thought to be due to abnormalities in the brain itself. Some new research suggests that PD can change how the brain feels pain that the loss of dopamine can make pain feel worse or make a person more likely to feel pain.
We know that:
- there is a higher prevalence of lower back pain in people with PD vs aged-matched controls
- certain features of PD such as increased age, depression, rigidity, and stooped posture are associated with lower back pain
- lower back pain can make it harder to deal with the challenges of PD because it is associated with lower activity levels. This can breed a vicious cycle in which lower back pain leads to decreased activity levels and then lower activity levels conspire to make the lower back pain worse
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Age And Gender Issues
Age and gender are important factors to consider when diagnosing low back pain. In a young patient, a benign tumor of the spine called an osteoid osteoma may be the culprit. Inflammatory bowel disease in young people can be connected with spondylitis and sacroiliitis . Low back pain from disc disease or spinal degeneration is more likely to occur as people get older. Conditions such as abdominal aneurysm or multiple myeloma are also considered in older individuals.
Osteoporosis and fibromyalgia are much more common triggers of back pain in women than in men. Osteoporosis is a progressive decrease in bone density that leaves the bones brittle, porous and prone to fracture. Fibromyalgia is a chronic disorder that causes widespread musculoskeletal pain, fatigue, and multiple tender points in the neck, spine, shoulders, and hips.
Tips To Strengthen Your Back
Flexion and extension exercises are commonly used to prevent low back pain. Be sure to review with the doctor any program you are considering.
Easy Low Back Exercises
- Ankle Pumps: Lie on your back and move ankles up and down.
- Heel Slides: Lie on your back and bend then straighten the knees one at a time.
- Wall Squats: With your back flat against a wall, sit like you would in a chair with your knees lined up over your ankles. Gently press against the wall, keeping your abdominal muscles tight. Hold for five seconds.
- Single Knee to Chest Stretch: Lying down with back flat, pull your knee into the chest.
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Look Into Getting A New Mattress
How old is your bed? You may be surprised to learn that the average life span of a mattress is less than 10 years. Theres no hard-and-fast rule, says Sean Mackey, MD, PhD, chief of the division of pain medicine at Stanford University, but if your mattress is sagging significantly or is more than six to eight years old, Id think about getting a new one.
Something else to consider: A firm mattress may not do your back any favors, says Carmen R. Green, MD, a physician at the University of Michigan Back & Pain Center. A number of studies over the years suggest that people with lower back pain who sleep on medium-firm mattresses do better than those with firm beds, she says.
Bonus Tip: Soothe The Pain With Cold And/or Hot
Don’t underestimate the pain reduction of simply applying cold packs and/or hot packs to help reduce your lower back pain.
- Cold therapy helps reduce inflammation and pain. Some examples include wrapping ice in a cloth, a pack of frozen peas from the freezer, or a cold gel pack. Always keep at least one layer between your skin and the ice/cold pack.
- Heat therapy helps improve blood flow, relaxation, and pain relief. Heat therapy can come in many forms. It’s best to try several to find what works best for you. Taking a warm bath or shower, soaking in a hot tub, or using a heating pad or heat wrap are all ways to bring warmth to your lower back.
Whether applying ice or a heat pack, limit applications to 15 or 20 minutes with at least 2 hours of rest in between to protect your skin. Never sleep with a heating pad or frozen pack as this can lead to permanent skin damage.
Hopefully these overlooked remedies can help you try some new approaches to better manage your lower back pain and find lasting relief.
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