Persistent Low Back Pain
Nonspecific low back pain is classed as chronic if it lasts for longer than six weeks. In some people it lasts for months, or even years. Symptoms may be constant. However, the more usual pattern is one in which symptoms follow an irregular course. That is, reasonably long periods of mild or moderate pain may be interrupted by bouts of more severe pain.
What Is Lower Back Pain
Low back pain can result from many different injuries, conditions or diseases most often, an injury to muscles or tendons in the back.
Pain can range from mild to severe. In some cases, pain can make it difficult or impossible to walk, sleep, work or do everyday activities.
Usually, lower back pain gets better with rest, pain relievers and physical therapy . Cortisone injections and hands-on treatments can relieve pain and help the healing process. Some back injuries and conditions require surgical repair.
Complementary And Alternative Techniques Include:
- Acupuncture is moderately effective for chronic low back pain. It involves inserting thin needles into precise points throughout the body and stimulating them , which may cause the body to release naturally occurring painkilling chemicals such as endorphins, serotonin, and acetylcholine.
- Behavioral approaches include:
- Biofeedback involves attaching electrodes to the skin and using an electromyography machine that allows people to become aware of and control their breathing, muscle tension, heart rate, and skin temperature people regulate their response to pain by using relaxation techniques
- Cognitive therapy involves using relaxation and coping techniques to ease back pain
Spinal injections include:Trigger point injections can relax knotted muscles that may contribute to back pain. An injection or series of injections of a local anesthetic and often a corticosteroid drug into the trigger point can lessen or relieve pain.
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How To Get Into Bed
To get into bed safely:
Seeking Help For Lower Back Pain
You may not need to seek help from a health professional for lower back pain. Most people find their lower back pain improves by itself within a few weeks. But if there’s no improvement after two to three weeks or the pain is getting worse, seek advice from a GP or physiotherapist. It’s also worth seeking help if your back pain is stopping you from doing normal activities, or if it goes on longer than six weeks.
Physiotherapists are often best placed to help with back pain. In some areas, you may be able to self-refer to a physiotherapist on the NHS, whereas in others you need a referral through your GP. You can also choose to pay for private physiotherapy.
There are some circumstances when you should always see a doctor straightaway for back pain though. These include if:
- you have numbness or tingling around your bottom or genitals
- you cant control your bladder or bowels
- youre unsteady when you walk, or your legs or feet feel weak, you have sudden, severe lower back pain
- youve been in a major accident, such as a traffic collision or fall
- you have osteoporosis
- theres a visible deformity in your back
- the pain continues when youre lying down or overnight, disturbing your sleep
- you have a history of cancer or have had a recent bacterial infection
- you also have a fever, chills or unexplained weight loss
These can be signs of more serious problems.
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When You Should Go To The Er For Back Pain
If your back pain is accompanied by any of the following symptoms, head to your closest emergency room because you could be dealing with a more serious condition or injury:
- Sudden spike in pain, discomfort, weakness or numbness
- Loss of bladder function
- Unexplainable weight loss
- The pain results from a fall or severe blow to your back
If you experience any of these symptoms, its a good idea to talk to your doctor so you can determine next steps for managing pain.
Common Causes Of Back Pain
The most common causes of back pain are strain and wear and tear over time, Blazer says. In most cases, back pain has to do with the small muscles around the vertebrae which are the small bones that form the spine being strained or tense, she says.
“In some cases, can also have to do with the discs in between the vertebrae becoming a little bit shorter over time or becoming displaced over time,” Blazer says. “That can cause some back pain.”
Inactivity can also raise your risk of back pain, especially as you get older, Blazer says. “We do find that, as people become a little bit less active and have that long-term pressure on the back, they can have more and more back pain,” she explains.
Back pain can even be caused by arthritis, a chronic illness that causes pain, stiffness and swelling around the joints, Blazer says. While there are different forms of arthritis, osteoarthritiswhich is caused by the wear and tear and changes in the joints and connective tissuesis the most common.
Back pain is generally categorized into lower and upper back pain, with Blazer noting that lower back pain is the most common. “We walk on two feet upright as humans and so, over time, we can have more strain and pressure on that lower back,” Blazer says. Upper back pain can happen for similar reasons, she says, but it’s also often due to injuries.
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When To Get Help For Low Back Pain
Pain from ruptured discs and arthritis doesnt have to flatten you. There are a variety of ways to ease lower back pain discomfort and reduce disability, often without drugs.
Spinal problems are the price we pay for walking upright. Wear and tear on our backbones and the constant pull of gravity on our vertebrae take their toll over time. Nearly every adult has had a stiff or sore back at some time.
Sciatica is a term youve probably heard people use for pain in the lower back, radiating to the buttocks and down one or both legs. When patients tell me they have sciatica, they could have one of two conditionsa leaking disc or spinal stenosis , says Dr. Steven Atlas, associate professor of medicine at Harvard Medical School. These conditions in turn can put pressure on the sciatic nerve, which emerges from the lumbar spine, separates just above the buttocks, and runs down each leg.
Maintain Correct Posture When Sitting
You can avoid lower back pain by maintaining proper posture when sitting. If you have a desk job, keep your feet planted on the floor and use a chair that provides lower back support. Also, avoid hunching forward to see your computer screen and reaching far in front of you to use your mouse or keyboard.
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Managing Low Back Pain
Manage back pain with regular exercise and professional help as requiredIf you have an attack of lower-back pain that is severe, continuous and not improving, assessment and treatment by a health care professional who focuses on the back or other musculoskeletal problems may help. These practitioners may use both active and passive techniques to help you feel better. Examples of passive techniques that may be used to get you moving include:
An active approach, like walking or water aerobics is usually the most effective. Exercise is often the best way to relieve lower-back pain.
Check with your health care provider before starting an exercise program.
Work with an expert. It may help to work with a health professional who can explain which activities are right for you.
Choose exercises you enjoy. Many activities can help relieve back pain. Try to include activities that strengthen the muscles around your trunk, your abdominal muscles as well as those in your lower back. Studies show the following activities help relieve back pain:
- Lifting light weights
Which Lifestyle Factors Contribute To Lower Back Pain
There are three major lifestyle factors that may affect your chances of developing lower back pain:
- Multiple studies have established a link between smoking and lower back pain. Smoking raises inflammation inside the body and hinders the body from healing itself.
- Obesity is also associated with several types of chronic pain, including lower back pain. In people with high body mass index , the stress on the spine increases, contributing to even more wear and tear.
- Your level of physical activity can also play a role in your lower back health. While a sedentary lifestyle could increase your risk of developing lower back pain, so can excessive or strenuous physical activity. Check with your doctor if you are unsure about your ideal level of physical activity.
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Ready To Address Your Back Pain
The University of Maryland Spine Network can help you put your pain behind you. With convenient locations throughout the state, the UM Spine Network is home to the region’s leading spine surgeons and specialists that can help you identify the source of your pain and put an end to it for good.
Put an end to your back pain. Find a spine specialist near you.
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Waking Up With Stomach Pain Here’s What Your Body’s Trying To Tell You
Waking up with stomach pain is not only uncomfortable, but possibly anxiety-inducing. You may find yourself spiraling as you try to determine whether the cause is merely something you ate or a sign that something is seriously wrong.
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If you’ve ruled out the usual causes â an urge to relieve yourself, an empty stomach signaling it’s time for breakfast, gas and ordinary heartburn â another condition may be at play.
Here, Ronald Omino, MD, a gastroenterologist at UCLA Health Services, explains why you might wake up with abdominal pain, and what to do when it happens.
Talk to a doctor right away if your morning stomach pain is accompanied by other symptoms like fever, nausea, vomiting, severe pain or rigidity or the inability to pass gas or a bowel movement. These can be signs of life-threatening GI conditions, Dr. Omino says.
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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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Lower Back Pain Causes
Nonspecific low back pain means that the pain is not due to any specific or underlying disease that can be found. It is thought that in some cases the cause may be an over-stretch of a ligament or muscle. In other cases the cause may be a minor problem with a disc between two spinal bones , or a minor problem with a small facet joint between two vertebrae. There may be other minor problems in the structures and tissues of the lower back that result in pain. However, these causes of the pain are impossible to prove by tests. Therefore, it is usually impossible for a doctor to say exactly where the pain is coming from, or exactly what is causing the pain.
To some people, not knowing the exact cause of the pain is unsettling. However, looked at another way, many people find it reassuring to know that the diagnosis is nonspecific back pain which means there is no serious problem or disease of the back or spine.
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Ways To Manage Low Back Pain At Home
Back pain is one of the most common physical ailments. Studies show that eight in 10 Americans have back pain at some point in their lives, usually in the lower back.
Sudden or severe back pain should be checked by a doctor or a physical therapist. That also goes for pain that wonât go away.
But sometimes you can treat nagging pain and discomfort on your own.
Wilson Ray, MD, chief of spine surgery for the Department of Neurological Surgery at Washington University School of Medicine in St. Louis, says home remedies â tend to be better when they’re combined than alone.â
You’re Having Problems With Your Bowels Or Urination
If your back pain is paired with a loss of control over your bowels or urination, then it’s time to seek help immediately at a local emergency room. These symptoms point to cauda equina syndrome, where the nerves in the lower spine have become paralyzed. While rare, this syndrome can be permanently damaging to the nerves if left untreated. If you experience these symptoms, especially accompanied by numbness in the legs, then you may need surgery to decompress the nerves and preserve their overall function.
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Can Back Pain Lead To Complications
The good news is that most people recover from back pain within a few weeks.1 See your doctor if you experience additional symptoms, such as:
- loss of bowel and/or bladder control
- severe pain that gets worse instead of better over time
- problems with passing urine or bowel movements
- numbness or a pins-and-needles sensation in your legs, back or elsewhere
- unexplained weight loss
- back redness or swelling
For some people, back pain becomes an ongoing problem. Around 1 in every 2 people who experience back pain will experience it again, and for 1 in 5 people, back pain may last beyond 8 to 12 weeks. Possible complications that result from persistent, long-term back pain include:
- dependence on strong pain medicines, such as opioids
- reduced quality of life
- more difficulty finding work and keeping active
See your healthcare professional if your back pain is unresolved and limits your movement and activities. A health care professional can help you find ways to manage your pain and regain a better quality of life.
What Can I Do To Help Relieve The Symptoms Of Back Pain
If you had an acute injury, use a cold pack for 20 to 30 minutes at a time for the first 48 hours or so. After that , you may find it helps more to alternate a cold pack and a heating pad. Keep one on the area for 20 to 30 minutes, and then switch. Take over-the-counter pain medications like ibuprofen or acetaminophen . Get plenty of rest and fluids.
If you see your provider, make sure you take all medications prescribed, get all of your testing done and attend all of your appointments.
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What Can I Do About Acute Back Or Neck Pain
The key to recovering from acute back or neck pain is restricting your activity and taking over the counter medications, because most back pain is related to muscle strain. In most cases, acute back pain will go away on its own over a period of days. Here are some tips that will help you recover:
1. Take it easy If you think you’ve hurt your back, ease up on the pressure you’re putting on your back. Many people actually have little choice in the mattertheir back pain will force them to drop to their knees or “freeze” in a bent-over position. Others will be able to function somewhat normally, but with uncomfortable pain. Contrary to popular belief, studies on acute back pain actually show that a few days of restricting your activity, and taking the appropriate over-the-counter medication, is all that many people really need to allow the strained muscles to relax and unbind. However, it is important to talk with your health care provider before taking any medication, especially if you are taking other medications or have a chronic medical condition.
2. Ice, then heat Remember this rule: “Ice first for 48 hours, then heat.” Ice and heat can alleviate local pain that comes from muscle and ligament strain. Ice slows swelling and inflammation and acts as a local anesthetic, but after 48 hours, it loses its effect. Using heat afterwards increases blood flow to the deep tissues and relaxes muscle spasms.
Low Back Pain Diagnosis
Getting diagnosed with a specific cause of low back pain is the first step to getting treatment. If you land in your doctors office hoping for back pain relief, theyll use a variety of diagnostic tools and methods, such as:
A thorough medical history including any recent injuries, other diagnoses, family history of disease, and your job, activities and other lifestyle considerations
Physical exams, which may include manipulating the painful area or reflex or other neurological tests
Electromyography, which measures muscle and nerve function
ImagingX-rays can show bone spurs and damage to bone, while CT scans and MRIs can depict damage to soft tissue like discs or ligaments
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