Key Points About Low Back Pain
- Specific treatment for low back pain depends on the cause of the pain and the severity. But it often includes pain medicines and muscle relaxers, physical therapy, and assistive devices such as a back support. It also may include lifestyle changes such as stress reduction, weight loss, and increased physical activity.
- A back rehab program may be used as part of the treatment for low back pain.
- Measures to prevent back pain include using safe lifting techniques, maintaining correct posture, staying at a healthy weight, not smoking, and reducing stress.
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.
What Should I Know About Back Pain
Back pain is a very common problem and will affect many of us at some point during our lives.
The good news is that in most cases it isnt a serious problem, and it might just be caused by a simple strain to a muscle or ligament.
As far as possible, its best to continue with your normal everyday activities as soon as you can and to keep moving.
Being active and exercising wont make your back pain worse, even if you have a bit of pain and discomfort at first. Staying active will help you get better. Taking painkillers can help you do this.
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Degenerative Disc Disease Treatment Goals
The vast majority of people with degenerative disc disease experience low back pain symptoms that flare up periodically, but do not get worse over time. For those people, the main goals for managing lower back pain caused by degenerative disc disease are usually:
- Achieving enough pain relief to be able to engage in lower back pain exercises and a rehabilitation program
- Trying to manage the low back pain and maintaining an ability to function at home and at work.
Once a disc has degenerated, the degenerative process cannot be reversed. Instead of trying to rehabilitate the disc itself, treatment focuses on improving the health of surrounding structures, such as the spinal nerves, vertebral bones and joints, and supporting muscles and ligaments.
The main goals of the rehabilitation program include a therapist-guided and individual approach, which aim to2:
- Increase, restore, and/or maintain the range of motion in the affected spinal segment
- Build physical strength, flexibility, coordination, balance, and endurance in the lower back and legs
- Guide patients to make ergonomic changes in their workspace and home to support the spine and prevent recurrence of pain
- Teach the correct use of posture while sitting, walking, sleeping, and lifting to promote maximum function with lesser pain
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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The Importance Of An Accurate Diagnosis
The physician will need to take a careful medical history and do a physical exam to look for certain red flags that indicate the need for an X-ray or other imaging test. In most cases, however, imaging such as X-ray, MRI , or CT scan is unnecessary.
There may also be certain clues in a patients medical history. Low back, nonradiating pain is commonly due to muscle strain and spasm. Pain that radiates into the buttock and down the leg may be due to , a condition in which a bulging disc presses on the sciatic nerve, which extends down the spinal column to its exit point in the pelvis and carries nerve fibers to the leg. This nerve compression causes pain in the lower back radiating through the buttocks and down one leg, which can go to below the knee, often combined with localized areas of numbness. In the most extreme cases, the patient experiences weakness in addition to numbness and pain, which suggests the need for quick evaluation.
A persistent shooting or tingling pain may suggest lumbar disc disease. A pain that comes and goes, reaching a peak and then quieting for a minute or two, only to reach a peak again, may suggest an altogether different cause of back pain, such as a kidney stone.
When tumor or infection are suspected, the doctor may order blood tests, including a CBC and sedimentation rate .
Diagnosis Of Lower Back Pain
Your physiotherapist or GP will usually be able to diagnose lower back pain from your symptoms and by examining you. A physiotherapist is a healthcare professional who specialises in maintaining and improving movement and mobility. You may want to go straight to see a physiotherapist if a self-refer service is available in your area. If its not, you can see your GP who can advise and refer you.
Usually further tests wont help. But if you have other symptoms, your GP may recommend tests including:
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When To Get Medical Help And Advice
Nine out of 10 people find their lower back pain improves within four to six weeks. You may find that you feel better sooner than this, in a few weeks. But contact your GP if the pain is severe, getting worse over time or isnt improving after four to six weeks. Also, contact your GP urgently if you feel unwell or have a high temperature. And if you have had cancer or osteoporosis, your GP may want to check that there isnt a more serious cause.
Seek medical attention right away if you:
- have numbness or tingling around your bottom or genitals
- cant control when you pee or cant go at all
- lose control of your bowels
- are unsteady when you walk, your legs feel weak or your foot is dropping or dragging
These may be signs that the nerves at the bottom of your spine are being squashed. This is called cauda equina syndrome and needs urgent treatment.
Try To Boost Your Mood
No, the lower back pain isnt in your head, but obsessing over it could be making it worse. Fear, anxiety, and catastrophizing can amplify pain, says Dr. Mackey. Because brain circuits that process pain overlap dramatically with circuits involved with emotions, panic can translate into actual pain. Start by accepting that you have pain, Dr. Mackey says. Then say to yourself, it will get better. If you struggle with overall mental wellbeingsay, you have anxiety or depressionin addition to your physical aches, it could be worth seeing a therapist to manage negative thought processes while exploring other lower back pain treatments.
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What Causes A Compressed Nerve
A few common causes for lumbar pinched nerves are:
1. Repetitive motion
4. Arthritis of the spine.
But when we look at these causes through the holistic approach, we see that all of these causes have the same root cause: muscle Imbalances.
The important thing to understand is that a pinched nerve, or Sciatica, is not a condition or a disease.
Its just a symptom of something else.
Much like coughing is a symptom of pneumonia. If you want to stop the coughing, the smart way to go is to cure pneumonia, not just swallow coughing syrup.
Well get to that later, and see how to reverse it easily and at home.
What Can I Do If I Have Acute Low Back Pain
The following advice will benefit a majority of people with back pain. If any of the following guidelines causes an increase of pain or spreading of pain to the legs, do not continue the activity and seek the advice of a physician or physical therapist.
The key to recovering from acute low back pain is maintaining the normal curve of the spine . Supporting the hollow of your back will help decrease your recovery time.
Follow these guidelines for 10 to 20 days after you experience acute low back pain:
- Sit as little as possible, and only for short periods of time .
- Sit with a back support at the curve of your back.
- Keep your hips and knees at a right angle. Your legs should not be crossed and your feet should be flat on the floor.
Here’s how to find a good sitting position when you’re not using a back support or lumbar roll:
Correct sitting position without lumbar support.
Correct sitting position with lumbar support.
- Use a back support at the curve of your back. Your knees should be at the same level or higher than your hips.
- Move the seat close to the steering wheel to support the curve of your back. The seat should be close enough to allow your knees to bend and your feet to reach the pedals.
Stooping, squatting, and kneeling
Sleeping and lying down
Other helpful tips
If you sleep on your back, put pillows under your knees and a small pillow under the small of your back.
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What Are Some Other Causes Of Lower Back Pain
The shape of your spine, and well as spinal diseases, are other culprits in lower back pain. Depending on a range of factors, your doctor may look for:
Abnormal spinal curvature. A normal spine resembles a gently curved letter S when seen from the side. Abnormal curves include:
- Lordosis, in which the spine curves too far inward at the lower back
- Kyphosis, in which the spine is abnormally rounded in the upper back
- Scoliosis, in which the spine curves from side to side, often in a C shape
Normal and abnormal curves of the spineArthritis. There are more than 100 types of arthritis, many of which can cause lower back pain. The most common types include osteoarthritis , rheumatoid arthritis, and ankylosing spondylitis.
Cauda equina syndrome . Compression of the bundle of nerves that forms below the spinal cord in the lumbar spine. It is a rare but serious disorder that requires immediate medical attention and possibly emergency surgery. CES got its name from the fact that the fanned-out bundle of nerves resembles the base of a horses tail.
Discitis or osteomyelitis.Both infections of discs and bone can cause severe pain and require prompt medical attention.
Spinal tumors. When cells divide and multiply unchecked, the result is a tumor. Both benign and malignant tumors can cause lower back pain. They can either originate in the spine or metastasize there, meaning theyve spread from somewhere else in the body.
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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Ways To Treat Chronic Back Pain Without Surgery
Back pain is considered chronic if it lasts three months or longer. It cancome and go, often bringing temporary relief, followed by frustration.Dealing with chronic back pain can be especially trying if you dont knowthe cause.
What Are The Risks
Long bed rest can lead to slower recovery.Staying in bed for any prolonged period can make you stiff and increase pain. When you dont move and bend, you lose muscle strength and flexibility. With bed rest, you lose about 1 percent of your muscle strength each day. And you can lose 20 to 30 percent in a week. It becomes more difficult to return to any activity. As you become weaker and stiffer your recovery takes longer.
Who needs bed rest?Almost no one! The only people who might require time in bed are those with unstable spinal fractures awaiting surgery.
What can I do for the pain?Hot or cold packs often help. Some people can get pain relief from non-prescription analgesics or anti-inflammatory drugs such as ibuprofen or naproxen . But no medication should be taken for an extended period of time.
When should I see a health care provider?You should see your health care provider right away if:
- You have severe continuous back pain that lasts longer than 48 hours.
- You have severe continuous back pain and fever.
- You have back pain with accompanying pain, numbness or weakness in one or both legs or feet. Your leg symptoms are more disabling than your back symptoms.
- You have back pain and the onset of numbness in your private/genital region or changes in your ability to control your bladder and bowel function.
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Living With Back Pain
Living with back pain can be challenging however, most people find relief within 6 weeks. Remember to follow the recommendations of your health care providers. The following may make it easier for you to manage your pain and recover:
- Add exercises gradually and talk to your doctor about the types of exercises that are best for you. There may be certain activities or exercises you should avoid.
- When sitting for a prolonged period get up, move around, and switch positions frequently.
- Wear comfortable shoes with a low heel.
- When driving long distances, try adding some support behind your back, and stop frequently to stand up and walk around.
- Sleep on your side, and place a small pillow between your knees. If you tend to sleep on your back, place a pillow under your knees. If possible, try to avoid sleeping on your stomach.
- Limit the amount you carry. Instead of carrying more items at once, make a few extra trips to avoid carrying too much weight.
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.
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