What Research Is Being Done
The mission of the National Institute of Neurological Disorders and Stroke is to seek fundamental knowledge of the brain and nervous system and to use that knowledge to reduce the burden of neurological disease. NINDS is a component of the National Institutes of Health , the leading supporter of biomedical research in the world.
As a primary supporter of research on pain and pain mechanisms, NINDS is a member of the NIH Pain Consortium, which was established to promote collaboration among the many NIH Institutes and Centers with research programs and activities addressing pain. On an even broader scale, NIH participates in the Interagency Pain Research Coordinating Committee, a federal advisory committee that coordinates research across other U.S. Department of Health and Human Services agencies as well as the Departments of Defense and Veterans Affairs.
Treatment Options For Lower Back Pain
If your GP thinks there may be a specific cause for your back pain, they may refer you to a specialist to treat that specific condition.Usually, lower back pain gets better in a few days or weeks and often you can manage it yourself at home. For some advice about when to seek medical help, see our section on Symptoms.
Your physiotherapist or GP will probably encourage you to try self-help measures. They can also advise you on what exercises you can do to help your back. If the pain doesnt improve, then your GP can help with other options or may refer you to a specialist.
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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Leg Weakness And Back Pain
Another serious condition that you should see a back injury doctor for is cauda equina syndrome. One of the main symptoms of this condition is progressive leg weakness.
What happens when you have this condition is that there is a severe compression of the nerve sac in your lumbar spine.
There are a few ways you could get cauda equina syndrome.
You could have a previously undiagnosed spinal condition. An infection could also be the culprit. And, as usual, you could have injured your spine somehow.
Treatment for cauda equina syndrome involves immediately surgical intervention. Doctors will do what they can to decompress the pressure on your lumbar nerve sac. Get diagnosed quickly at an urgent care clinic to see if thats what you need.
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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When To Visit The Er For Back Pain
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- When to Visit the ER for Back Pain
While many people tolerate occasional aches and pains in their back, severe back pain may indicate a larger problem. But how do you know if your back pain, or that of a loved one, has reached the point that it requires an emergency department visit?
If at any point you feel that your condition is serious enough that it can’t wait for a visit with your primary care physician, you should visit the emergency department. However, if you’re not sure whether your back pain requires emergency care, consider these guidelines.
You’ve Been In Pain For Over A Week
Most back pain will subside after a few days, but if you’ve been experiencing pain for over a week, then it’s time to call a doctor. Your doctor will perform any examinations or tests required to help get to the bottom of your pain before it could become a bigger problem. As is the case with many health conditions, prevention and addressing problems early is key.
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Activity And Back Pain
Back pain is one of the most common reasons for time off work, but staying at work has been shown to improve recovery, although you may need to modify some tasks. When you have back pain, keep as active as you can. Avoid bed rest this does not help and can make symptoms worse. Although you may feel some pain when you are active, it is safe to exercise while you have back pain.
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When To See Your Doctor About Back Pain
You should see your doctor or physiotherapist if you have back pain that is not getting better after a few weeks of trying simple exercises and following the tips for a healthy back.
Although rare, back pain can be a sign of a more serious condition. If you experience any of the following ‘red flag’ symptoms with your back pain then please see a doctor urgently.
| ‘Red flag’ symptoms see a doctor urgently if you have: |
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You should also see your doctor or physiotherapist if:
- your pain is worse in your lower leg than your back and is not easing
- you have weakness and numbness in one of your legs
- you have a rash in the same area as your pain.
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How Is Back Pain Treated
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.
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.
How Your Back Works
The spine, which is also called the backbone or spinal column, is one of the strongest parts of the body and gives us a great deal of flexibility and strength.
Its made up of 24 bones, known as vertebrae, one sitting on top of the other. These bones have discs in between and lots of strong ligaments and muscles around them for support. There are also the bones in the tailbone at the bottom of the back, which are fused together and have no discs in between.
On either side of the spine, running from top to bottom, are many small joints called the facet joints.
The spinal cord passes inside the vertebrae, which protect it.
The spinal cord connects to the brain through the base of the skull and to the rest of the body by nerves that pass through spaces between the bones of the spine. These nerves are also known as nerve roots.
As you grow older, the structures of your spine, such as the joints, discs and ligaments, age as well. The structures remain strong but its usual for your back to get stiffer as you get older.
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What Should You Do Advice From A Physical Therapist
Its unusual to have a Physical Therapist in the Emergency Department. PTs are good at listening, explaining pain and helping you to problem solve what to do at home.
When I see people in the ED, this is what I suggest:
In the absence of trauma or true neurological loss there arent many good reasons to go to the emergency room.
Trauma doctors are not trained in pain management, and with the opioid medication situation causing them to prescribe more cautiously than they used to, there is a good chance you will still leave with your pain unchanged.
Seeking An Explanation: Will You Get Scans And Tests
If you go to emergency, you may have blood and urine tests, because theyre a good way to rule out anything nasty. They can quickly detect markers that tell doctors if you are fighting an infection, or theres a significant change to any of the systems that keep you alive, and if thats why youre hurting. They are there to rule out an emergency.
People almost always expect that they will get a scan or x-ray. The expectation that these tests will explain your pain, and why its severe today is not correct. Unless youve had a fall, a car accident, or some other trauma, or there are red flag symptoms present, you likely wont get scans, and probably wont gain much from a trip to the ED.
Emergency departments have limited resources, like MRI scanners, and they need to be available for emergencies. If someone comes into the ED with a possible stroke, and the scanner is being used by someone with back pain, theres a 30-60 minute wait for someone who is in a life and death situation.
What scans and x-rays tell doctors about pain is usually minimal. Its unusual for someone with back pain to have something thats found on a scan that changes the treatment and advice we usually give people.
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Where Can I Get More Information
For more information on neurological disorders or research programs funded by the National Institute of Neurological Disorders and Stroke, contact the Institute’s Brain Resources and Information Network at:
Office of Communications and Public LiaisonNational Institute of Neurological Disorders and StrokeNational Institutes of HealthBethesda, MD 20892
NINDS health-related material is provided for information purposes only and does not necessarily represent endorsement by or an official position of the National Institute of Neurological Disorders and Stroke or any other Federal agency. Advice on the treatment or care of an individual patient should be obtained through consultation with a physician who has examined that patient or is familiar with that patient’s medical history.
All NINDS-prepared information is in the public domain and may be freely copied. Credit to the NINDS or the NIH is appreciated.
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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Less Common Causes Of Low Back Pain
Inflammation of the joints of the spine sometimes causes back pain. Osteoarthritis is the common form of arthritis and usually occurs in older people. Ankylosing spondylitis is another form of arthritis that can occur in young adults and which causes pain and stiffness in the lower back. Rheumatoid arthritis may affect the spine but you are likely to have other joints affected too.
Various uncommon bone disorders, tumours, infection and pressure from structures near to the spine occasionally cause low back pain .
The rest of this leaflet is mainly about nonspecific low back pain – the common type of low back pain.
% Of People Will Experience Back Pain At Some Time But There Are Ways To Find Relief
As people enter middle age, they are more likely to experience bouts of low back pain. In fact, according to the Harvard Special Health Report Men’s Health: Fifty and Forward, back pain affects about four in five Americans at some point in their lives and equally strikes men and women.
Age is often the culprit. Over time, the bones and joints in your lower back begin to change. Your discs tend to wear out and sometimes become fragmented. These structural alterations sometimes cause pain.
Another cause of low back pain, although it occurs less often, is a herniated disc. Sometimes, a disc pushes outside the space between the bones and compresses a nerve at the point where it branches off the spinal cord. When the sciatic nerve that leads into the buttocks and leg is affected, the pain is called sciatica.
Yet, most cases of low back pain stem from strain or sprain due to simple overuse, unaccustomed activity, excessive lifting, or an accident. In most cases the best move is to wait and see if the pain resolves on its own. If the pain does not improve after three to four days, then it’s time to see a doctor.
However, depending on the source of your back pain and its severity, you might try a few home remedies for low back pain to help ease the pain until your back returns to normal. Here are several options to consider:
Complementary therapies. Several types of complementary therapy may be helpful for relief from low back pain. These include:
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Can I Prevent Lower Back Pain
You cant prevent lower back pain that results from disease or structural problems in the spine. But you can avoid injuries that cause back pain.
To reduce your risk of a back injury, you should:
- Maintain a healthy weight: Excess weight puts pressure on vertebrae and disks.
- Strengthen your abdominal muscles: Pilates and other exercise programs strengthen core muscles that support the spine.
- Lift the right way: To avoid injuries, lift with your legs . Hold heavy items close to your body. Try not to twist your torso while youre lifting.
Types Of Doctors That Might Treat Your Back Pain
Back pain seems to be a problem that plagues so many, so it can be easy to operate under the assumption that treatment is relatively interchangeable. There are actually many different types of doctors that specialize in more specific areas of treatment when it comes to back injury or chronic pain.
It is important that you seek help from the correct type of doctor if you want your pain addressed in the most expedient and thorough fashion. Here is a more in-depth look at the most common types of spine doctors and how they might be able to help you with your pain.
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Injections And Other Procedures
Depending on the source of your pain for example, if you have sciatica epidural injections may be helpful. Injections in the spine arent recommended for non-specific lower back pain though. If your back pain is chronic and other treatments havent helped, there is a procedure called radiofrequency denervation that uses a needle to treat the pain. This is only suitable for some people and you may need to have other tests beforehand. Speak to your specialist for advice.
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 Should I See A Doctor If I Have Lower Back Pain
In many cases lower back pain stops on its own. But if it doesnt, here are some guidelines on when you may want to start seeking professional help:
- If the pain lasts four weeks or longer
- If the pain keeps getting worse as time goes by
- If you are experiencing other symptoms, such as fever, major weight loss or weight gain, loss of function or weakness in extremities, bladder problems, etc.
