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What Should You Take For Lower Back Pain

When To Worry About Low Back Pain

Lower Back Pain? DONâT STRETCH! (What You Should Do Instead)

And when not to! Whats bark and whats bite? Checklists and red flags and non-scary possible explanations for alarmingly back pain

The bark of low back pain is usually much worse than its bite. The pain almost always makes it seem worse than it is. Even when its unusually severe and/or constant, it probably isnt dangerous.

MRI and x-ray for low back pain are surprisingly unreliable,1 because things like bulging discs usually arent a big deal,2 most back pain goes away on its own,3 and trigger points are common and can be worrisomely intense but arent dangerous.4 Most patients are much better off when they feel confident about these things. The power of justified, rational confidence is a huge factor in back pain.5 Sadly, many healthcare professionals continue to perpetuate the idea of fragile backs,6 which undermines that valuable confidence.

When Is Lower Back Pain An Emergency

Most episodes of lower back pain eventually resolve on their own, but there are times when you should seek urgent medical attention. Some of these situations include:

  • Patient is a child
  • Pain is severe, constant, suddenly or progressively worsens, and/or doesnt go away
  • Pain interrupts sleep

While some situations may warrant immediate intervention, most cases are not urgent and can be scheduled at a time convenient for the patient.

Or You Could Be Dying What Are The Odds That Back Pain Is Something Scary

Of course there are cases of low back pain that have alarming causes, but its reassuringly rare. Once in a while back pain is a warning sign of cancer, autoimmune disease, infection, or a handful of other scary culprits.7 Over the age of 55, about one in twenty cases turns out to be a fracture, and one in a hundred is more ominous.8 The further you are from 55, the better your odds.

But how can you tell? It can be tricky. This is a concise, readable guide to symptoms that need better-safe-than-sorry investigation with your doctor. In other words, this article explains the difference between dangerous and just painful as clearly as possible. Tables, checklists, and examples ahead.

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Tips For Dealing With Lower Back Pain

By Robert Greenleaf, MD, Spine Surgeon

Lower back pain is extremely common and one of the top reasons for missed workdays. Thats because the lower back supports the weight of the upper body and is subject to a lot of stress and strainespecially during everyday movements like lifting and twisting.

One of two things typically causes lower back pain: a sudden injury or the wear and tear of aging, arthritis and physical activity. No matter the cause of your lower back pain, here are 10 recommendations that can help you relieve it and prevent future problems.

How Is Back Pain Treated

InfoGraphic on Back Pain

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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    Don’t Rest An Achy Back

    Doctors used to prescribe bed rest for back pain. But now we know that lying still is one of the worst things you can do. It can make back pain worse and lead to other complications. Don’t rest for more than a day or two. It’s important to get up and slowly start moving again. Exercise has been found to be one of the most effective ways to relieve back pain quickly. Try swimming, walking, or yoga.

    Back Exercises And Stretches

    Simple back exercises and stretches can often help reduce back pain. These can be done at home as often as you need to.

    For information about exercises and stretches that can help, see:

    A GP may be able to provide information about back exercises if you’re unsure what to try, or you may want to consider seeing a physiotherapist for advice. Read about how to get access to physiotherapy.

    Doing regular exercise alongside these stretches can also help keep your back strong and healthy. Activities such as walking, swimming, yoga and pilates are popular choices.

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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.

    All Of The Worst Possible Causes Of Back Pain And Their Major Features

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    None of these are common. All of them usually cause serious symptoms that are easy to take seriously. Some of them can fly under the radar in early stages, but usually not for long. The names of the conditions link to carefully chosen articles from good sources.

    The worst possible causes of back pain

    what is it?

    Finucane LM, Downie A, Mercer C, et al. International Framework for Red Flags for Potential Serious Spinal Pathologies. J Orthop Sports Phys Ther. 2020 Jul 50:350372. PubMed #32438853

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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.

    Maintain Correct Posture During Activities

    To protect your lower back from injury, its important to maintain proper posture when performing physical activitiesespecially if you play sports or have a job that requires repetitive motions. Avoid slouching as much as possible and aim to keep your spine erect. When lifting, bend and straighten from the knees, not the waist. And be sure to move your hips when twisting from side to side.

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    Avoid Rushing Into The 2 Most Common Mistakes For Treatment

    MISTAKE #1. Do not to rush into basic strengthening exercises such as sit-ups, crunches or lower back extensions. This may help for some, but in most cases, these areas are already tight, short and strong. Tightness and overly strong muscle conditioning is usually the case with the lower back and hamstrings.

    MISTAKE #2. Simply resting and returning to your daily whatever. Werent you doing this JUST BEFORE it happened? No, my friend. There needs to be a plan and you are here for actual solutions right?

    Observe the degree of your pelvic tilt. The three common positions are neutral, anterior and posterior. An excessive angle can trigger another spasm.

    Exercises such as sit-ups and crunches can help but should not be done first as they are considered as isolation type exercises. They do not condition the core muscle groups to protect you. If you are in need of some specific exercises, begin with these 10 exercises.

    Lower Back Pain: How To Tell If Its Muscle

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    When a patient visits my office with back pain, its my job to uncover the pain generator. We talk through the patients history, discuss their symptoms, and make a determination as to next steps. If need be, I prepare their case to be looked at by a surgeon, but generally, my goal is to help patients avoid surgery and find relief with more conservative measures.

    Most cases of back pain are not caused by serious conditions. But its important to always rule out the possibility that a patient has another internal issue that mimics back pain . Colitis, kidney stones, gallbladder issues, vascular problems, or an aneurysm are examples of serious conditions that are capable of causing pain to radiate into the back, making it feel like youre experiencing back pain.

    A thorough fact-finding investigation should help determine the cause. When did the pain start? How long did it last? What makes it better or worse? Key to determining the pain generator is the patients description of their condition and their medical history. For example, if a patient describes the pain as having come on suddenly and causing nausea, nearly prompting a trip to the emergency room, then disappearing just as suddenly, they may be suffering from a kidney stone rather than back pain from a spinal condition.

    • Muscle pain
    • Disc pain

    Lets take a look at each type in more detail.

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    Low Back Pain Symptoms: Does Your Back Hurt

    Low back pain symptoms range from sharp and stabbing to a dull ache. The pains can be constant or intermittent and positional. Acute low back pain can appear suddenly after injury. Chronic back pain is defined as pain lasting more than three months. Consult a doctor if you have prolonged back pain longer than 72 hours.

    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.

    What Are Some Complementary Alternative And Emerging Treatments For Lower Back Pain

    Taking Medication for Back Pain Relief: Should you do it?

    In some cases, doctors suggest therapies that are not considered standard of care. They probably wont be covered by insurance, but they may be worth considering. Examples include:

    Platelet-rich plasma . PRP treatments use a small sample of your own blood that has concentrated amounts of blood building blocks known as platelets. Your doctor then injects the PRP directly into a damaged disc. The theory is that PRP injections use your own healing system to accelerate improvement of injured tendons, ligaments, muscles, and joints. PRP treatment has a longer track record in knee osteoarthritis, but a recent review article in the Journal of Spine Surgery suggests it may have a useful role for back pain, too. PRP needs a lot more research before it can be considered a proven technique.

    Stem cells. In this emerging treatment, your doctor injects stem cells harvested from your hip into the intervertebral disc or discs causing your pain. Doing so may lessen pain and the degenerative effects of aging, though, like PRP, more research is needed before stem cells for lower back pain could eventually become the standard of care.

    Acupuncture. Your doctor probably doesnt perform acupuncture , but may support you trying it as a complementary therapy. Acupuncture involves careful insertion of fine, sterile needles into specific points on your body. This may stimulate the release of your natural pain-killing chemicals.

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    Back Pain Can Be The Result Of A Plethora Of Things

    Injury, illness, or even disease can cause your back to be uncomfortable or achey.

    Another reason that not many think of is posture. The way that you sit can have a significant influence on the way that your back feels. If you have lower back pain when sitting down, consider trying some different sitting positions that could prevent low back pain.

    Other Reading On Painsciencecom About Back Pain

    And the big one

    • Complete Guide to Low Back Pain Everything on one mighty page: an extremely detailed guide to the myths, controversies, the nature of the beast and the highlight dozens of detailed, evidence-based reviews of treatment and therapy options. This huge tutorial also focusses on a topic I think is neglected: the role of muscle in back pain.

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    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

    What Type Of Doctor Should I See For Back Pain

    Top 10 causes of lower back pain you should know

    This depends on your condition or symptoms. If you have no obvious injury that would explain your pain, you may want to start by seeing a . This is a specialist in physical medicine who can diagnose back pain and determine whether nonsurgical treatments such as physical therapy may help. Depending on those findings, a physiatrist may also refer you to a , doctor or other type of back specialist, , for additional discussion.

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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.

    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.

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