Supports And Orthoses For The Back
Supports and orthoses are medical aids specifically designed for the treatment of muscle, tendon, joint and back pain. They adapt perfectly to the anatomical conditions of the body, can relieve pain and contribute to mobility. Depending on the type of disease, various aids are used. Supports for the lower back can stabilise and relieve the lumbar spine.
More stable supports, so-called orthoses, can straighten the lumbar spine and provide more intensive support and relief. These aids can offset physical limitations, allowing for greater freedom of movement, activity and a better quality of life.
How Is Low Back Pain Treated
There are many treatment options for acute, subacute, and chronic low back pain.
- Medicine: Your health care professional may suggest a medicine to reduce pain and swelling or to relax your muscles.
- Most medicines are taken by mouth, but some are given as a shot or through an IV tube in your arm.
- Some medicines are available over the counter, and for some you need a prescription.
Low back pain often improves in 4 weeks or less. In some cases, it may take 12 weeks or more for low back pain to improve. For many people, low back pain improves without specific treatment.
The tables below list some treatments for acute low back pain and subacute low back pain . The tables also list what researchers have found about how well the treatments work to reduce pain. For some of the treatments, there is also research on how well the treatments help you return to your daily activities.Nonmedicine Treatments for Acute and Subacute Low Back Pain
|Acetaminophen||A type of medicine to reduce painNote: Acetaminophen is different from NSAIDs in that it only reduces pain and does not reduce swelling.||Acetaminophen does not appear to reduce pain, but more research is needed to know this for sure.|
What about other treatments that are not listed in this summary?
Herniated Disk In The Lower Back
The backbone, or spine, is made up of 26 bones called vertebrae. In between the bones are soft disks filled with a jelly-like substance. These disks cushion the vertebrae and keep them in place. Although people talk about a slipped disk, nothing actually slips out of place. The outer shell of the disk ruptures, and the jelly-like substance bulges out. It may be pressing on a nerve, which is what causes the pain.A slipped disk is more likely to happen due to strain on the back, such as during heavy lifting, and older individuals are at higher risk.
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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When Do You Need A Doctor For Back Pain
if you have any of the following symptoms along with your back pain, see a doctor immediately:
- Numbness in an arm or leg
- Trouble with bowel or bladder control
- Weakness in an arm or leg
When the team assesses patients with severe back pain, we often recommend physical therapy and pain medication then we dont see the patients again because their back pain got better on its own. Staying or getting active with guidance from your doctor can provide ample relief for severe back pain.
Will Bed Rest Help Back Pain
Doctors often recommend continuing your usual activities of daily living as soon as possible. Studies suggest that strict bedrest can often prolong or worsen low back pain. Bed rest can also lead to secondary complications such as depression, decreased muscle tone, and blood clots in the legs. You should try and keep moving while avoiding activities that noticeably aggravate or worsen back pain. By staying active, those who suffer from low back pain can gain greater flexibility and quicker recovery.
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Hot Or Cold Therapy For Low Back Pain
Hot or cold packs may help ease pain and reduce symptoms. The soothing relief from heat, or the dulling relief from a cold pack, is only temporary and will not treat more serious causes of back pain. However, they may provide greater mobility for people with acute, subacute, or chronic pain, allowing them to get up and get moving.
Heat And Ice For Back Pain
A hot water bottle or heat pad may help ease muscle spasm and pain. Make sure your skin is protected dont put heat pads directly on your skin. You can buy pads that you put over your clothing on the area that hurts. These are available from pharmacies and last for several hours.
Ice packs may also be helpful, especially in the first few days of any injury. Make sure you wrap the ice pack in a towel to protect your skin. You can apply the pack to the area that hurts for 15 minutes at a time.
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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.
Diagnosing Low Back Pain
Diagnosis is made by a neurosurgeon based on history, symptoms, physical examination and results of diagnostic studies. Some patients may be treated conservatively if conservative treatment is ineffective, the physician may order imaging studies of the lower back and other tests, which may include:
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What Are Possible Side Effects Of Medicines To Treat Low Back Pain
The U.S. Food and Drug Administration lists the following possible side effects for medicines to treat low back pain. Just because a side effect is possible does not mean you will have it.Possible side effects of medicines to treat low back pain
You May Need To See Your Doctor For These Potential Underlying Illnesses
Dont just treat a back spasm as temporary discomfort. It may not merely be muscular in nature as they are often a big warning sign.
There may be something more serious that you are not aware of. This may be what your body could be reacting to.
In cases where treatment does not help, it is possible that you may have a disc issue such and a bulge or herniated disc. It is important to know when you should see a doctor to diagnose any serious injury that may be an underlying cause.
- Herniated Disc
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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.
What Are Some Common Lower Back Pain Causes
The causes of lower back pain are sometimes viewed as being mechanical, organic or idiopathic. Sometimes spinal conditions are congenital or acquired meaning the disorder develops later in life.
- Mechanical lower back pain is often triggered by spinal movement and involves spinal structures, such as the facet joints, intervertebral discs, vertebral bodies , ligaments, muscles or soft tissues.
- Organic lower back pain is attributed to disease, such as spinal cancer.
- Idiopathic refers to an unknown cause.
These are some of the things your doctor might look for or rule out when you schedule a visit for back pain.
The common symptoms of lower back pain.
Sprains and strains. Ligament sprains and muscle or tendon strains are the most common causes of lower back pain. Theyre often related to overuse.
Degenerative disc disease. While the name sounds worrisome, it just means you have a damaged disc causing pain. Over time, discs become thinner and flatter due to wear and tear. That leaves them less able to cushion the vertebrae and more likely to tear .
Herniated disc. The protective covering on intervertebral discs can tear over time. When this happens, the soft inner disc tissue may push through the outer layer. A disc that bulges or slips out of place is known as a herniated disc, bulging disc, or slipped disc. The herniation may press on nerve roots, leading to symptoms such as pain, tingling, numbness or weakness in the area that the nerve serves
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Can Lower Back Pain Be Related To Weather
If you feel like your lower back pain worsens on days when its cold or the weather is changing, you are not imagining things. Back pain can indeed be related to barometric pressure and outdoor temperature. Changes in pressure can sometimes cause pain in arthritic joints, including the spine. Muscles and joints in general react to the environment, which can make them stiffer and more likely to suffer an injury.
What Causes Back Pain
Your spine or backbone is a complex structure that is made up of 24 small bones called vertebrae that are stacked on top of each other. Discs sit between each vertebra to act as cushions or shock absorbers and give your spine flexibility. Vertebrae are joined together by small joints called facet joints. These joints allow you to move and bend your back. A mesh of ligaments and muscles hold the spine together and provide structural support, which allows you to move.
Back pain can originate from any of these structures, but in most cases, this pain doesnt result from any significant damage to your spine. This pain usually stems from surrounding muscles, ligaments or joints and occasionally spinal disc problems.
For at least 9 in 10 people, back pain is not caused by any particular condition and is referred to as non-specific back pain.
This type of back pain results from a range of different factors such as:
- poor posture
- an unhealthy weight
Less than 1 in 100 people have back pain that is related to a serious medical problem such as cancer, infection, a spinal fracture or specific conditions such as ankylosing spondylitis. Research has also shown that you actually dont need to know the cause of back pain to treat it successfully.
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What Does It Mean If Lower Back Pain Is Shooting Into Legs
Lower back pain can radiate to other parts of the body: up or down from its place of origin. Sometimes lower back pain can be on one side of the back, which is also normal.
If the pain is shooting from the lower back into one or both legs, it could be sciatica , but its not always the case. There are many parts in the lower back that may cause the pain to radiate into the legs, such as facet joints, sacroiliac joints, muscles or inflammation of the bursa.
Finding The Right Treatment
Most cases of lower back pain are comparable to the common cold.
Depending on each patients unique situation and condition, conservative treatments and over-the-counter pain relievers may not address the underlying problem. In these cases, stronger medications or perhaps surgery might be the answer. Our goal is to provide the right treatment for the right condition, for the right patient, at the right time.
Times have changed, and the practice of medicine changes with time. As we learn more about lower back pain and how it works, well continue to refine our treatment recommendations. But our goal remains the same: using evidence-based medicine to give our patients safe, effective relief from back pain.
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What Is The Outlook
Most of us will have a bout of nonspecific low back pain at some point in our lives. The severity can vary. However, it is difficult to quote exact figures as to outlook . This is partly because it is so common and many people with back pain do not consult a doctor. Roughly, it is thought that:
- Most nonspecific back pains ease and go quickly, usually within a few weeks.
- In about 4 in 10 cases, the pain has completely gone within four weeks.
- In about 7 in 10 cases the pain has completely gone within one year.
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.
I How Common Is Lower Back Pain
Two out of every three adults suffer from low back pain at some time. Back pain is the No. 2 reason adults visit a doctor and the No. 1 reason for orthopedic visits. It keeps people home from work and interferes with routine daily activities, recreation, and exercise. The good news is that for 9 out of 10 patients with low back pain, the pain is acute, meaning it is short-term and goes away within a few days or weeks. There are cases of low back pain, however, that take much longer to improve, and some that need evaluation for a possible cause other than muscle strain or arthritis.
Symptoms may range from muscle ache to shooting or stabbing pain, limited flexibility and/or range of motion, or an inability to stand straight.
What Structures Make Up the Back?
Starting at the top, the spine has four regions:
- The seven cervical or neck vertebrae
- The 12 thoracic or upper back vertebrae
- The five lumbar vertebrae , which we know as the lower back, and
- The sacrum and coccyx, a group of bones fused together at the base of the spine.
Image courtesy of www.SpineUniverse.com
When You May Need Medicine
If non-drug interventions dont help, the ACP recommends first trying non-steroidal anti-inflammatory drugs such as ibuprofen, naproxen, indomethacin or meloxicam. While NSAIDs provide some pain relief, they may put you at risk for GI bleeding or kidney damage.
As second-line drugs, the ACP recommends duloxetine or tramadol .
Due to their serious side effects and addictive nature, opioid medications should be used only as a last resort when patients fail all other therapies, the ACP advises. The rule of thumb: Use the lowest possible dose of opioid for the least amount of time.
If youve been suffering with long-term low back pain, its worth exploring these non-drug treatment options before resorting to pills. Youre likely to find your quality of life improving.
Tips For Easing Back Pain
Use these self-care tips to ease your back ache and pain associated with arthritis.
1. Relief is Possible
2. Get Wet
3. Move and Strengthen It
4. Find Your Zen
5. Cinch It In
6. Trim It Down
7. Visit China
8. Manipulate It
9. Apply Pressure
10. Put It Together
11. Medicate It
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