Low Back Pain Treatment
Epidural Steroid Injection
Epidural steroid injections are most commonly used in situations of radicular pain, which is a radiating pain that is transmitted away from the spine by an irritated spinal nerve. Irritation of a spinal nerve in the low back causes pain that goes down the leg. Epidural injections are also used to treat nerve compression in the neck , referred to as cervical radiculopathy, which causes pain.
Faqs About Pain Creams
How Do Pain Reliever Creams Work?
Creams that relieve pain usually work according to one of four different mechanisms. Arnica is a soothing ingredient used in creams to reduce swelling due to inflammation. While anti-irritating creams rely on ingredients such as menthol and camphor to keep the skin cool.
Trolamine salicylate, a non-steroidal anti-inflammatory drug , is used in some creams to block the enzyme that causes inflammation. Creams that contain max strength lidocaine numb the skin.
During Pregnancy, Can I Apply Analgesic Creams?
Lidocaine-powered pain relief topicals can be used safely, providing you follow the instructions on the package.
The safety of camphor use during pregnancy has yet to be confirmed by research, so if youre pregnant, its best to steer clear of creams containing the substance.
Menthol is not proven to be safe during pregnancy, but the risk is relatively low when a cream contains a low concentration of menthol. It is recommended that you consult your doctor prior to using a cream with maximum strength camphor and menthol.
It is difficult to safely consume arnica orally while pregnant, but it is generally safe to apply arnica gel topically.
You should consult your doctor if you have any concerns about the use of these types of muscle pain relief .
Team Approach To Pain Management
For some, an integrated team of specialists may be best suited to manage the chronic lower back pain from degenerative disc disease. A team will usually comprise some combination of the following health professionals:
- A pain management specialist, such as a physical medicine and rehabilitation physician or anesthesiologist focused on pain management
- A physical therapist or physiatrist focused on rehabilitation
- A psychologist and/or psychiatrist for co-existing mental health issues, such as depression and/or difficulty sleeping
- An occupational therapist to assist with functional rehabilitation
In addition, a specialized nurse case manager or another health professional may work with the team to coordinate the care needed to treat depression, disability, and chronic pain.
Sometimes the combination of treatments is more effective than individual treatments. For example, the use of cognitive behavioral therapy has been shown to improve the benefits of physical therapy3 and reduce sleep problems.
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Scoliosis Is A Lateral Curvature Of The Spine
Scoliosis is a curvature of the spine that can occur for anyone at any age, but is most common for kids aged 5-13. This is quite a normal condition but treatment isn’t necessary in all cases, but there’s some excersices and products that can help you improve your curved spine and remove something that could become a problem in the future.
There’s diffrent types of scoliosis that can affect diffrent parts of your back.
Thoracic Scoliosis: This affects the upper part of your back, the thoracic spine.This type of scoliosis can cause pain in shoulders, upper back and sometimes even your head.
Lumbar Scoliosis:Is when your scoliosis is affecting your lower back. If left untreated lumbar scoliosis can lead to osteoarthritis and degenerative changes in the spine, hips and knees. You can also damage your internal organs if you do not do anything about it.
Thoraco-Lumbar Scoliosis:This is when the area that is curved is both the upper lumbar and lower thoracic.
Combines Scoliosis: This is when both you whole lumbar region and thoracic region is curved like an S.
Choosing The Best Topical Pain Relief Creams
The active ingredients used in different pain creams differ. Ensure that the cream you choose is suitable for your specific type of pain. It would be best if you also were cautious with salicylate or lidocaine-based creams because it is possible to overdose on them.
Lidocaine or diclofenac contains NSAIDs, which are substances that reduces inflammation can provide relief in your discomfort. In addition to these ingredients, there are others that provide a distraction:
Cooling Sensation: Camphor, Menthol, Methyl salicylate
Warming Sensation: Capsaicin
Depending on the type of pain relief you want, all of these methods can be effective.
Find Relief Through Ice And Heat
Break out that bag of frozen peas for the first 48 hours after the pain sets in, and put it to use for 20 minutes a session, several sessions per day. After those two days are behind you, switch to 20-minute intervals with a heating pad.
Localized cooling shuts down capillaries and reduces blood flow to the area, which helps ease the swelling, says Lisa DeStefano, DO, an associate professor at Michigan State Universitys College of Osteopathic Medicine in East Lansing. Cold also thwarts your nerves ability to conduct pain signals. Heat, on the other hand, loosens tight muscles and increases circulation, bringing extra oxygen to the rescue.
Treatment Of Nonspecific Pain
Approach to the Treatment of Nonspecific Acute Low Back Pain
Reassure the patient that the prognosis is often good, with most cases resolving with little intervention
Advise the patient to stay active, avoiding bed rest as much as possible, and to return to normal activities as soon as possible
Advise the patient to avoid twisting and bending
Initiate trial of a nonsteroidal anti-inflammatory drug or acetaminophen
Consider a muscle relaxant based on pain severity
Consider a short course of opioid therapy if pain is severe
Consider referral for physical therapy if it is not the first episode
Consider changing to a different nonsteroidal anti-inflammatory drug
Consider referral for physical therapy if not done at initial visit
Consider referral to a spine subspecialist if pain is severe or limits function
*Two to four weeks after the initial visit, if the patient has not significantly improved.
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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.
Release Your Inner Endorphins
Endorphins are hormones made naturally in your body. What many people dont know is that endorphins may help block pain signals from registering in your brain. Endorphins also help alleviate anxiety, stress, and depression, which are all associated with chronic back pain and often make the pain worse.
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Ideas For Maintaining Ones
Exercise frequently to maintain muscles strong and also flexible. Get in touch with a physician for a checklist of low-impact, age-appropriate exercises that are specifically targeted to reinforcing lower back and additionally abdominal muscle.
Maintain a healthy and balanced mass and additionally eat a healthy diet plan with enough everyday consumption of calcium, phosphorus, and also vitamin D to advertise new bone growth.
Usage ergonomically produced furniture as well as equipment in your home as well as at the office. Make certain job surface areas go to a comfortable height.
Switch over resting settings commonly along with occasionally stroll the work environment or very carefully stretch muscular tissues to eliminate tension.
A cushion or rolled-up towel placed behind the small of the back can provide some lumbar assistance. Put your feet on a reduced feces or a stack of magazines when sitting for a very long time.
Sleeping on ones side with the knees formulated in a fetal positioning can aid open up the joints in the spine and likewise get rid of stress by reducing the curvature of the spine. Frequently sleep on a firm surface area.
Dont try to lift things that are as well heavy. Raise from the knees, draw the stomach muscles in, and likewise maintain the head down as well as according to a right back. When training, maintain things near to the body. When hauling, do not turn.
Degenerative Disc Disease Treatment For Low Back Pain
Most people with degenerative disc disease respond well to nonsurgical treatments.
- Research indicates that 90% of patients report improvement in back pain and radicular leg pain within 3 months of nonsurgical treatments.1
- Surgical intervention may be extensive, so most people are well-served making a concerted effort with nonsurgical treatment regimens.
The long-term outlook for this condition is usually favorable, especially when coupled with lifestyle modifications and the correct use of ergonomics.1
This article describes the various treatments available to manage the symptoms of degenerative disc disease, including addressing both painful flare-ups as well as longer-term pain management and rehabilitation.
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Bonus Tip: Soothe The Pain With Cold And/or Hot
Don’t underestimate the pain reduction of simply applying cold packs and/or hot packs to help reduce your lower back pain.
- Cold therapy helps reduce inflammation and pain. Some examples include wrapping ice in a cloth, a pack of frozen peas from the freezer, or a cold gel pack. Always keep at least one layer between your skin and the ice/cold pack.
- Heat therapy helps improve blood flow, relaxation, and pain relief. Heat therapy can come in many forms. It’s best to try several to find what works best for you. Taking a warm bath or shower, soaking in a hot tub, or using a heating pad or heat wrap are all ways to bring warmth to your lower back.
Whether applying ice or a heat pack, limit applications to 15 or 20 minutes with at least 2 hours of rest in between to protect your skin. Never sleep with a heating pad or frozen pack as this can lead to permanent skin damage.
Hopefully these overlooked remedies can help you try some new approaches to better manage your lower back pain and find lasting relief.
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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Acupuncture For Low Back Pain Relief
Acupuncture can be moderately effective for chronic low back pain. With acupuncture, fine needles are inserted into various points around the body.
Acupuncture practitioners hypothesize that when these thin needles are inserted into the skin and then stimulated by twisting or tapping, naturally occurring chemicals such as endorphins, serotonin, and acetylcholine are released to relieve pain.
Anecdotal evidence suggests acupuncture can be an effective pain reliever. Further scientific and clinical studies are underway to prove the efficacy of acupuncture therapy.
Initial Treatments For Low Back Muscle Strain
Most cases of a pulled back muscle are treated using standard self-care or non-invasive treatments. Some typical first-step treatments for a pulled low back muscle include:
- Anti-inflammatory medicines such as ibuprofen, aspirin, and naproxen reduce inflammation, which often contributes to pain. Anti-inflammatory medicines are available over-the-counter or with a prescription.
- Over-the-counter pain medicines, such as acetaminophen, minimize pain by interfering with the way the brain interprets pain signals. Acetaminophen may also be included as an active ingredient in prescription medications, such as in combination with an opioid.
- Muscle relaxants may be prescribed on a short-term basis to reduce muscle spasm. Most muscle relaxants do not affect muscles directly, but rather dampen pain receptors in the central nervous system. These medications have many side effects, and muscle relaxants also carry risk of addiction.
- Ice packs reduce inflammation that can occur shortly after a muscle is injured. Typical recommendations include applying a cold or ice pack for 10 – 20 minutes at regular intervals throughout the day, and using a towel or other barrier between the ice and the skin to prevent an ice burn.
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What Are The Warning Signs Of A Serious Problem
Very rarely back pain or pain that travels down the leg is a sign of a serious problem.
If you have any of the following symptoms, you should seek urgent medical attention:
- difficulty controlling or passing urine
- loss of control of your bowels
- numbness around your back passage or your genitals
- serious weakness in your legs so you find standing really difficult
- severe and ongoing back pain that gets worse over several weeks.
The above symptoms could potentially be linked to a rare but serious condition that needs urgent medical attention.
You may be sent for tests if:
- youve had an injury to your back, for example a bad fall
- your doctor suspects that there may be an underlying cause for your pain
- the pain has lasted for an unusually long time.
In this case a magnetic resonance imaging scan or computerised tomography scan may be needed.
X-rays are much less commonly used because back pain is often caused by problems with soft tissues, such as ligaments and muscles, which cant be seen on x-rays.
Changes to the spine as a result of spondylosis can show up on x-rays. These common changes that happen to us all can appear on x-rays without people having any pain or problems. Because of this, x-rays arent particularly helpful.
Remember that sometimes even after a thorough investigation it might not be possible to say for certain what is causing back pain.
When Surgery Is Necessary
When conservative treatment for low back pain does not provide relief or neurologic symptoms are worsening or severe, surgery may be needed. Candidates for surgery present any of the following:
- Reasonably good health
- Back and leg pain limits normal activity or impairs quality of life
- Progressive neurologic deficits develop, such as leg weakness, numbness or both
- Loss of normal bowel and bladder functions
- Difficulty standing or walking
- Medication and physical therapy are ineffective
If surgery is recommended, neurosurgeons have a variety of options available to help relieve pressure on the nerve roots. If several nerve roots and discs are causing the pain or if degeneration and instability exist in the spinal column, the neurosurgeon may choose: a minimally invasive approach a more open decompression or fusing the vertebrae together with bone grafts and stabilizing them with instrumentation, including metal plates, screws, rods and cages, depending on the extent of disease. After such surgery, patients may gain restored mobility in the back, including the ability to bend over. In addition, patients may require postoperative physical therapy.
The benefits of surgery should always be weighed carefully against the risks. Although a large percentage of patients with low back pain report significant pain relief after surgery, it is not guaranteed that surgery will help.
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What Can Cause Lower Back Pain
Most acute low back pain is mechanical in nature, meaning that there is a disruption in the way the components of the back fit together and move. Some examples of mechanical causes of low back pain include:
- Skeletal irregularities such as scoliosis , lordosis , kyphosis , and other congenital anomalies of the spine.
- Spina bifida which involves the incomplete development of the spinal cord and/or its protective covering and can cause problems involving malformation of vertebrae and abnormal sensations and even paralysis.
- Sprains , strains , and spasms
- Traumatic Injury such as from playing sports, car accidents, or a fall that can injure tendons, ligaments, or muscle causing the pain, as well as compress the spine and cause discs to rupture or herniate.
- Intervertebral disc degeneration which occurs when the usually rubbery discs wear down as a normal process of aging and lose their cushioning ability.
- Spondylosis the general degeneration of the spine associated with normal wear and tear that occurs in the joints, discs, and bones of the spine as people get older.
- Arthritis or other inflammatory disease in the spine, including osteoarthritis and rheumatoid arthritis as well as spondylitis, an inflammation of the vertebrae.
Nerve and spinal cord problems
Rub On Medicated Creams
Skin creams, salves, ointments, or patches may help when your back feels stiff, sore, and tense. Many of these products contain ingredients such as menthol, camphor, or lidocaine that can cool, heat, or numb the affected area.
Put on creams right where you hurt. Ask someone to apply it if you have trouble reaching the spot.
âIt’s not going to be a mainstay at providing significant relief, but it can calm things down,â Ray says.
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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.
Can Back Pain Be Prevented
Recurring back pain resulting from improper body mechanics may be prevented by avoiding movements that jolt or strain the back, maintaining correct posture, and lifting objects properly. Many work-related injuries are caused or aggravated by stressors such as heavy lifting, contact stress , vibration, repetitive motion, and awkward posture.Recommendations for keeping ones back healthy
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