Back Pain Expert Philip Sell On The Questions To Ask
We asked Philip Sell, consultant orthopaedic and spinal surgeon, what he would want to know if he was suffering from back pain.
What is the cause of my back pain?In 85% of cases, were unable to be precise about why people have back pain. This can be frustrating. It may be more helpful to think about what you can do to make your back better quicker. Research has shown that occupational factors or physical factors only play a small part in back pain. Your genes are probably the most significant factor in back pain.
When should I visit my GP with back pain?See your GP as soon as possible if the back pain is combined with difficulty in passing urine or numbness between the legs or around the bottom. For people over the age of 55 with new back pain, a previous history of cancer surgery or loss of weight should also be medically checked as soon as possible.
Should I be resting?You may feel its the wrong thing to do, but keep mobile and active. Resting, bed rest in particular, can prolong the duration of an episode of back pain. Most acute episodes of back pain will settle on their own, often within days rather than weeks. Taking pain relief and keeping active will stop stiffness setting in and keep muscles in good condition.
Injections For Low Back Pain Relief
Epidural steroid injections are a commonly used short-term choice for treating low back pain and sciatica. These injections work by reducing inflammation to relieve pain. Injections are intended for short-term use and should not be utilized for an extended period of time as they may worsen pain in the long run.
For those with chronic pain or sever spinal injury, a nerve block may be utilized to prevent nerve conduction in a certain area. This essentially blocks all feeling from nerves. Nerve blocks are typically only used in extreme cases of severe pain.
Medication From The Store
There are two kinds of over-the-counter pain relievers that frequently help with back pain: nonsteroidal anti-inflammatory drugs and acetaminophen. Both have some side effects, and some people may not be able to take them. Talk to your doctor before taking pain relievers. And don’t expect medication alone to solve your pain problem. Studies show you’ll probably need more than one type of treatment.
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Can I Prevent Lower Back Pain
You cant prevent lower back pain that results from disease or structural problems in the spine. But you can avoid injuries that cause back pain.
To reduce your risk of a back injury, you should:
- Maintain a healthy weight: Excess weight puts pressure on vertebrae and disks.
- Strengthen your abdominal muscles: Pilates and other exercise programs strengthen core muscles that support the spine.
- Lift the right way: To avoid injuries, lift with your legs . Hold heavy items close to your body. Try not to twist your torso while youre lifting.
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Stretch Your Hamstrings Twice Daily
One often overlooked contributor to lower back pain is tight hamstrings. If your hamstring muscleslocated in the back of your thighsare too tight hamstrings your lower back and sacroiliac joints will be stressed, leading to more pain. Hamstring stretching should be done carefully and at least twice per day for 15-30 seconds each time.
There are many gentle stretching exercises that should not hurt.
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Debora Wayne Pain Emotions And Energy
Debora is the founder and director of the Biofield Healing Institute, but before she became an internationally known energy healer and pain relief specialist, she faced her own health crisis. She experienced physical, mental and emotional pain.
Debora had mysterious pains and when she would seek help from practitioners, nothing would show up on medical tests. Or they would find something and then the remedies didnt work, but her hair was falling out, she had ulcers, and couldnt sleep. She developed depression and anxiety. And then one day, she found herself unable to get up, get dressed and get to work. So she found professional help and began exploring the mind, her beliefs, and energy. She had never approached her pain from that perspective before. And to her surprise, things started to get much better.
How Is Back Pain Diagnosed
Most people who develop low back pain that comes on suddenly have nonspecific low back pain. If there are no other associated symptoms and the pain is not too bad, many people are confident to just ‘get on with it’ and treat it themselves – and indeed most get better quickly. However, if in doubt, see your doctor for a check-over and advice.
A doctor will usually want to ask questions about your symptoms and to examine you. Basically, the symptoms are usually as described above, with no other worrying symptoms to suggest anything serious or another cause of back pain . The examination by a doctor will not detect anything to suggest a more serious cause of back pain. Therefore, a doctor can usually be confident from his or her assessment that you have nonspecific back pain.
As a general guide, if any of the following occur then it may not be nonspecific low back pain, and there may be a more serious underlying cause. But note: the vast majority of people with low back pain do not have any of the following symptoms or features. They are included here for completeness and as an aid to what to look out for and to tell your doctor should they occur.
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Low Back Pain Fact Sheet
If you have had lower back pain, you are not alone. Back pain is one of most common reasons people see a doctor or miss days at work. Even school-age children can have back pain.
Back pain can range in intensity from a dull, constant ache to a sudden, sharp or shooting pain. It can begin suddenly as a result of an accident or by lifting something heavy, or it can develop over time as we age. Getting too little exercise followed by a strenuous workout also can cause back pain.
There are two types of back pain:
- Acute, or short-term back pain lasts a few days to a few weeks. Most low back pain is acute. It tends to resolve on its own within a few days with self-care and there is no residual loss of function. In some cases a few months are required for the symptoms to disappear.
- Chronic back pain is defined as pain that continues for 12 weeks or longer, even after an initial injury or underlying cause of acute low back pain has been treated. About 20 percent of people affected by acute low back pain develop chronic low back pain with persistent symptoms at one year. Even if pain persists, it does not always mean there is a medically serious underlying cause or one that can be easily identified and treated. In some cases, treatment successfully relieves chronic low back pain, but in other cases pain continues despite medical and surgical treatment.
Symptoms Of Lower Back Pain
Sometimes a pain may develop immediately after you lift something heavy, or after an awkward twisting movement. Sometimes it can develop for no apparent reason. Some people just wake up one day with low back pain.
Although nonspecific back pain is sometimes called simple back pain, simple does not mean that the pain is mild. The severity of the pain can range from mild to severe. Typically, the pain is in one area of the lower back but sometimes it spreads to one or both buttocks or thighs. The pain is usually eased by lying down flat. It is often made worse if you move your back, cough, or sneeze. So, nonspecific low back pain is mechanical in the sense that it varies with posture or activity.
Most people with a bout of nonspecific low back pain improve quickly, usually within a week or so, sometimes a bit longer. However, once the pain has eased or gone it is common to have further bouts of pain from time to time in the future. Also, it is common to have minor pains on and off for quite some time after an initial bad bout of pain. In a small number of cases the pain persists for several months or longer. This is called chronic back pain .
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How To Relieve Back Pain
The following tips may help reduce your back pain and speed up your recovery:
- stay as active as possible and try to continue your daily activities this is 1 of the most important things you can do, as resting for long periods is likely to make the pain worse
- try exercises and stretches for back pain other activities such as walking, swimming, yoga and pilates may also be helpful
- take anti-inflammatory painkillers, such as ibuprofen remember to check the medicine is safe for you to take and ask a pharmacist if you’re not sure
- use hot or cold compression packs for short-term relief you can buy these from a pharmacy, or a hot water bottle or a bag of frozen vegetables wrapped in a cloth or towel will work just as well
Although it can be difficult, it helps if you stay optimistic and recognise that your pain should get better. People who manage to stay positive despite their pain tend to recover quicker.
Back pain usually gets better on its own within a few weeks or months and you may not need to see a doctor or other healthcare professional.
But it’s a good idea to get help if:
- the pain does not start to improve within a few weeks
- the pain stops you doing your day-to-day activities
- the pain is very severe or gets worse over time
- you’re worried about the pain or struggling to cope
If you see a GP they will ask about your symptoms, examine your back and discuss possible treatments.
They may refer you to a specialist doctor or a physiotherapist for further help.
Stomach Pain Goes Away When Lying Down
Stomach or abdominal pain is a common ailment caused due to a myriad of reasons. Gallbladder disease, stomach ulcer, food poisoning, diverticulitis, appendicitis, cancers, intestinal disorders, and vascular problems. During pregnancy, lower abdominal cramps are more common. Depending on the severity of your condition, the pain down your stomach can be sharp as well as dull. Lying down on the back is an ideal position to soothe your stomach pain, helping you feel relaxed. Whereas laying down on the left side may also relieve your abdominal pain. But when the irritation becomes totally uncontrollable, its best to seek medical help.
You enjoyed a delicious cheese pasta last night delivered to your doorstep from your favorite restaurant in town. Now, as you lay down to sleep, your stomach began to make those strange snarling sounds, then comes the cramp, and now you are sitting up with your tummy tightly clutches into your hands, feeling the worse pain in your abdomen.
Digestive issues are more common in people of all ages. In fact, more than 72% of Americans alone suffer from digestive conditions such as diarrhea, gas, and abdominal pain.
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Low Back Pain That Won’t Go Away
If you have lingering low back pain or sciatica that just won’t go away, you’re likely missing an important component.You’ve probably been to an orthopedic physical therapist and done a few exercises for your low back. Or a chiropracter, who cracked and aligned the back. Or maybe massage or acupuncture for pain relief.Many times these treatments don’t stick, and a few days later your low back or sciatica pain returns.You aren’t getting to the underlying “why” of your symptoms for lasting relief, and a big part of that is the pelvic floor.
Diagnosing Cancer And Back Pain
A doctor will consider your symptoms and medical history when diagnosing potential lower back pain causes. Its important to include if you have a history of cancer or a family history of cancer.
Because cancer is a rare cause of lower back pain in those who dont already have cancer, a doctor may recommend other treatments before doing a full cancer work-up.
However, if pain persists after physical therapy or anti-inflammatory medications, a doctor may order imaging studies and blood testing. These tests can help identify if there are potential cancer markers that are causing the lower back pain.
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What Structures Make Up The Back
The lower backwhere most back pain occursincludes the five vertebrae in the lumbar region, which supports much of the weight of the upper body. The spaces between the vertebrae are maintained by round, rubbery pads called intervertebral discs that act like shock absorbers throughout the spinal column to cushion the bones as the body moves. Bands of tissue known as ligaments hold the vertebrae in place, and tendons attach the muscles to the spinal column. Thirty-one pairs of nerves are rooted to the spinal cord and they control body movements and transmit signals from the body to the brain.
Other regions of vertebrate are cervical , thoracic , and sacral and coccygeal segments.
Questions To Ask The Doctor About Medications:
- What will the medication do?
- How long will it take before I notice results?
- What is the name of the medication? Is there a generic brand?
- Are there side effects I should know about?
- How should I take the medication ?
- How often should I take the medication?
- What should I do if I forget to take a dose at the specified time?
- Let your doctor know if you are taking other medications. Sometimes certain medications cannot be taken together.
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Dr Howard Schubiner Pain And Emotions
My next guest is Dr. Howard Schubiner, the director of the Mind, Body, Medicine program at Providence Park Hospital.
You might be surprised when you hear Dr. Schubiner say that most doctors dont actually understand pain. He tells us that all pain is actually generated by the brain, by what is called the danger alarm mechanism. Obviously, an injury can trigger that. But whats very interesting is that the brain can generate pain in the absence of any tissue damage.
For instance, think about the millions of people with migraines and tension headaches. Neurologists all agree a very small percentage of those people have a structural disease in the brain, in their head. Fibromyalgia, experts agree, is a condition where theres no damage in the body, but a very real pain. Irritable bowels syndrome also includes no damage in the gut by definition. 85% of people with chronic neck and back pain dont have a serious, clearly identifiable structural cause for their pain.
On the other hand, the vast majority of adults have abnormal MRIs of their necks and backs, yet no pain. An MRI is going to show you the cause of your pain and you have mild changes that everybody else has when you think that thats the cause of the pain that knowledge generates more fear. So this danger alarm mechanism in the pain is triggered by fear. The more fear, the more pain. The more pain, the more fear. And thats a vicious cycle.
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.
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Is Sleeping On Your Tummy A Good Idea During Stomach Pain
No, it is not at all recommended to sleep on your stomach when it is already upset!
Putting pressure on your tummy when it is already in great pain is surely not a good idea. Besides, the lying on the stomach idea will put more strain on your hips and back. In addition, this increases inflammation, and you will frequently be rushing to the bathroom.
But My Pain Goes Away When I Exercise
This conversation happens way too often in our office at Barefoot Rehab or even outside of the office.
Either because you:
- Run into me at a dinner party and want to tell me about your minor, weird ache you hardly feel, like sitting or getting up from bed in the morning.
- Are a patient in my office and I have to tell you to stop exercising because your pain is getting worse.
Talking about this so often made me wonder, why do so many people let the pain grow until the problem is much harder to fix?
Ive realized two things:
The purpose of this post is to help you understand why its so dangerous to continue working out, especially when you have pain in one of the specific locations well discuss below.
Theres one word you need to learn about: Tendinosis.
Not tendinitis. Tendinosis.
- acute form of
- overload
- that resulted in inflammation .
If there are no other problems and you take stress off of your injury, tendinitis can go away on its own.
Tendinosis is a:
- chronic form of
- overload
- that is resulting in degeneration of the tendon.
A healthy tendon looks like the window in a box of spaghetti. Notice all of the fibers are going straight up and down.
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