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What Is The Best Treatment For Lower Back Pain

When To Seek Medical Attention For Back Pain

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It can be difficult to know when to go to the doctor for back pain. Generally, there are two major indicators of when its time to visit a doctor:

1. If your back pain doesnt go away after a week or two, you should see your doctor. While its more likely your pain isnt a sign of a serious medical emergency, your doctor can give you an accurate diagnosis and start treatment.

2. If you have other symptoms that accompany your back pain, you might require medical attention. See your doctor immediately if youre experiencing back pain with symptoms like:

  • Increasing weakness in your legs
  • Severe stomach pain

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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.

When To See A Doctor

People can often treat back pain with home remedies and some patience. However, a person should speak with a healthcare professional about chronic or severe back pain.

A healthcare professional may recommend physical therapy, medication, or other treatments. People with existing health conditions or who take regular medications should speak with a medical professional before trying herbal medications or supplements.

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Why Choose Atrium Health For Pain Management Care

  • Convenient care and quick relief. With same-day and next-day appointments at 12 locations around Charlotte, NC, its easy to get the care you need, when you need it.
  • Expert care and experience. Our highly trained and caring experts know how to treat pain. Weve been helping patients for over 30 years.
  • Your partner to find relief. Our pain specialists treat every condition from new aches to chronic pain. We listen, help you understand treatment options and create a care plan just for you.
  • Complete pain support. We care for the whole you, including your physical and mental health. If more specialized care is needed, we offer fast access to Atrium Healths award-winning team of specialists.

How Is Low Back Pain Treated

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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.

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Youre Running A Fever

The flu can definitely make you run a fever and achiness, including in your back. However, if the fever is unresponsive to standard OTC medications, you could have a serious infection that needs treatment immediately. If you go to a doctor and they find an infection, they may prescribe antibiotics and a few days rest.

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Holistic And Osteopathic Specialists

In the event of chronic or severe back pain, many individuals tend to prefer to see osteopathic or holistic specialists. These types of doctors and professionals include osteopathic physicians and chiropractic specialists.

Osteopaths are put through the same training and licensing/certification processes that all medical doctors must obtain to practice medicine, but they tend to do additional studies of the musculoskeletal system. They then will prefer to treat pain problems medically, but with an additional emphasis on the potential lifestyle and environmental factors which may be contributing to the pain problem.

Chiropractors are trained in the proper alignment of the spine and may be able to provide some of the most immediate relief to back pain problems. This is done through periodic adjustments and treatments that attempt to maintain alignment and prevent further pain issues.

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Example Progression Of Treatment Regimens For Lumbar Degenerative Disc Disease

Treatments need to be individualized. However, as a general rule, lumbar degenerative disc disease treatments start with basic pain control and non-invasive treatments and progress, if needed, to more extensive and/or invasive treatments.

One example of how treatment approaches may progress over time would be:

  • Bed rest, or reduced activity, for the first 1 to 2 days after onset of severe pain, combined with anti-inflammatory medication such as ibuprofen, and ice and/or heat therapy
  • Prescription muscle relaxant medications, as needed, for up to 1 week
  • Gentle stretching and aerobic exercise, for at least 3 times a week
  • Physical therapy if after 3 weeks there is no improvement in pain
  • An epidural injection if after 3 to 6 weeks there is little to no improvement in pain
  • Spinal surgery if after 6 to 12 months the pain is severe, ongoing and significantly limits daily activities

Bed rest beyond the first 2 days of sharp, severe pain is not usually advised, because regular movement improves blood circulation and muscle strength and helps the body to heal more quickly than bed rest.

The above is just one example of a typical progression of treatments, and additional therapies or a different type of progression of care is not uncommon based on the patientâs condition and the treating physicianâs preferences as well as other variables.

What Are The Most Important Prognostic Indicators For Chronicity

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Early identification of patients with low back pain at risk for long term disability and sick leave is theoretically and practically important because early and specific interventions may be developed and used in this subgroup of patients. This is of special importance because recovery for people who develop chronic low back pain and disability is increasingly less likely the longer the problems persist.

The transition from acute to chronic low back pain seems complicated, and many individual, psychosocial, and workplace associated factors may play a part. In this respect, increasing evidence indicates the importance of psychosocial factors.w7 A recently published systematic review of prospective cohort studies found that distress, depressive mood, and somatisation are associated with an increased risk of chronic low back pain.13

Table 1 shows a list of individual, psychosocial, and occupational factors, which have been identified as risk factors either for the occurrence of low back pain or for the development of chronicity. Yellow flags have been developed for the identification of patients at risk of chronic pain and disability. A screening instrument based on these yellow flags has been validated for use in clinical practice.14 The predictive value of the yellow flags and the screening instrument need to be further evaluated in clinical practice and research.

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Know Your Otc Medications

Nonprescription pain relievers can help with muscle aches and stiffness. The two main types of over-the-counter options are nonsteroidal anti-inflammatory drugs and acetaminophen. NSAIDs include aspirin, ibuprofen, and naproxen.

True to their name, NSAIDs help lower inflammation that can lead to swelling and tenderness. But acetaminophen does not relieve inflammation. You can reach for either type of pain reliever for occasional back pain. NSAIDs may work a bit better, Hemani says, if you have arthritis of the spine or other inflammatory conditions.

Common Causes Of Back Pain

Two of the most common reasons for back pain are muscle strains or ligament sprains. Obesity and bad posture can put strain on your back and make it hurt. Arthritis and other changes in your spine as you get older can cause back pain. More serious causes of the condition include a ruptured disc or fractured vertebrae. Possible causes of back pain include:

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How Is Low Back Pain Diagnosed

Along with a complete medical history and physical exam, tests for low back pain may include:

  • X-ray. This test uses electromagnetic energy beams to make images of bones onto film.
  • CT scan. This imaging test uses X-rays and computer technology to make detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general X-rays.
  • MRI. This test uses large magnets and a computer to make detailed images of organs and structures in the body.
  • Radionuclide bone scan. This imaging technique uses a very small amount of radioactive material that is injected into the patient’s bloodstream to be detected by a scanner. This test shows blood flow to the bone and cell activity within the bone.
  • Electromyogram . This test checks nerve and muscle function.
  • How Is Lower Back Pain Diagnosed

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    Your provider will ask about your symptoms and do a physical exam. To check for broken bones or other damage, your provider may order imaging studies. These studies help your provider see clear pictures of your vertebrae, disks, muscles, ligaments and tendons.

    Your provider may order:

    • Spine X-ray, which uses radiation to produce images of bones.
    • MRI, which uses a magnet and radio waves to create pictures of bones, muscles, tendons and other soft tissues.
    • CT scan, which uses X-rays and a computer to create 3D images of bones and soft tissues.
    • Electromyography to test nerves and muscles and check for neuropathy , which can cause tingling or numbness in your legs.

      Depending on the cause of pain, your provider may also order blood tests or urine tests. Blood tests can detect genetic markers for some conditions that cause back pain . Urine tests check for kidney stones, which cause pain in the flank .

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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.

    Remedies To Relieve Lower Back Pain Fast

    by North Texas Medical Center | Jan 28, 2020 | Physical Therapy

    We all want to know the best way to relieve lower back pain fast. At best, backache can be frustrating, perhaps draining. At its worst, this kind of discomfort can be utterly debilitating. If you have ever awakened with a terrible backache, you may have also learned how quickly such an ailment can derail your day, your week, or even several months or years.

    Fortunately, there are remedies to combat that ache. From exercising to getting better sleep to reducing your stress levels, you can choose from a variety of strategies. The next time you have a backache , consider the following methods of back pain relief. Remember to discuss at-home back pain remedies with your doctor before you make use of them.

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    How Effective Are Conservative Treatments In Chronic Low Back Pain

    That exercise and intensive multidisciplinary pain treatment programmes are effective for chronic low back pain is supported by strong evidence. Some evidence supports the effectiveness of behaviour therapy, analgesics, antidepressants, nonsteroidal anti-inflammatory drugs, and back schools and spinal manipulation. No evidence supports using other interventions . For most effective treatments, the effects are usually only small and short term. Unfortunately, many commonly used interventions lack sufficient evidence for clinically relevant long term effects.4

    You Have Unexplained Weight Loss

    The Best Exercise for Quick Lower Back Pain Relief

    If you experience sudden weight loss that canât be explained by diet and lifestyle changes, then you should always pay attention to what your body is telling you. This is especially true when the unexplained weight loss is accompanied by back pain. See your doctor to rule out the possibility of a more severe condition, such as an infection or tumor.

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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.

    Pain Medications To Treat Back Pain

    A wide range of medications is used to treat both acute and chronic low back pain. Analgesic medications are specially formulated to relieve pain. They include over-the-counter acetaminophen and aspirin, as well as prescription opioids such as codeine, oxycodone, hydrocodone, and morphine.

    Nonsteroidal anti-inflammatory drugs can also be used to relieve pain and inflammation. Over-the-counter NSAIDS include ibuprofen, ketoprofen, and naproxen sodium. Several others, including a type of NSAID called COX-2 inhibitors, are available only by prescription.

    There are also many topical creams or sprays that can dull and soothe low back pain. These are applied to the skin and thus stimulate localized nerves to provide feelings of warmth or cold in order to dull the sensation of pain. Topical analgesics can reduce inflammation and increase blood flow.

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    Dont Shortchange Your Sleep

    Sleep is very, very important it helps your body heal, says Dr. Welches. Lack of sleep releases more stress hormones, lowers pain tolerance and worsens existing pain.

    Sleep loss can complicate other health issues, making it harder to control glucose levels when you have diabetes, for example.

    So practice good sleep hygiene. Avoid blue light from smart phones or TV for one hour before bedtime. Go to bed at about the same time every evening and get up at about the same time every morning to keep your internal clock regular, says Dr. Welches.

    Meditation is also a great tool for a better nights sleep. Many meditation apps are available. He suggests starting with five to 10 minutes of meditation before bedtime. If you wish, you can gradually increase to 20 or 30 minutes a night.

    Supplements such as melatonin can also help you sleep at night.

    Structural Or Organic Pain Causes The Following Conditions

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    1. Disk Damage

    Intervertebral disc damage can cause chronic lower back pain that does not resolve after a few days. The reasons for wear and tear of the disk, age, and small tears to the outer region of the disc can form.

    It is unclear why some people experience discomfort while others do not. Some people who suffer from disc herniation have no discomfort, while others may feel the pain for weeks, months, or even years. A tiny proportion of people may experience chronic pain that lasts for years and is very debilitating.

    Let’s look at some of the conditions that cause discomfort in the lower back:

    2. Disk herniation

    When a disc’s jelly-like core presses against the annulus , it herniates out and pushes the exiting nerves, causing pain in the back and lower limbs in the form of radiating and excruciating pain, along with tingling and numbness.

    3. Sciatica

    A herniated disc in the lumbar back frequently places pressure on the leg and foot nerve roots. Discomfort in the buttock and down the leg is also known as sciatica. Classically felt as excruciating pain in either of the legs with tingling and numbness with difficulty in movements. Lifting, tugging, bending, or twisting actions are common causes of disc herniation.

    4. Disk deterioration

    5. Osteoarthritis

    This deterioration of the facet joints is known as osteoarthritis, also called facet arthritis, which causes lower back pain.

    6. Spondylolisthesis

    7. Stenosis of the Spine

    8. Scoliosis

    9. Fracture of Compression

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