Who Can Help With Back Pain

When Is The Right Time To Seek Help For Your Pain

Dr. Dowdell says its rare that anyone comes to him after a week of back pain. Its more common that people have been living with pain for months or even years, and finally they decide theyve had enough.

As with many health conditions, though, the sooner you get seen by a doctor, the better. If you get help within the first few weeks or months of having ongoing pain, you might be able to prevent it from becoming a lifelong battle, he says.

Whats more, having spine pain for a long time can create pain pathways from your back to your brain, says Dr. Dowdell. As pain signals travel back and forth, the pathways get more and more well established, which can make pain harder to treat later on.

A final note from Dr. Dowdell: Whenever you decide to seek help, you should understand that treatment may be a bit of a journey.

Youre not going to walk into the doctors office and walk out with a quick diagnosis, he says. When youre in pain, that message can be hard to hear. But treating back pain is something that needs to be done one step at a time.

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

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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What Is The Treatment For Chronic Nonspecific Low Back Pain

Initial treatment is similar to sudden-onset attacks. That is, aim to keep as active as possible. Also, painkillers can help. In addition to the painkillers listed above, your doctor may advise a course of an antidepressant medicine in the tricyclic group – for example, amitriptyline. Tricyclic antidepressants have other actions separate to their action on depression. They are used in a variety of painful conditions, including back pain.

Also, a national guideline , referenced below) recommends one or more of the following treatments should be considered. Each of these treatments has some evidence from research trials to suggest that they will help to ease symptoms in some people :

• Structured exercise programme. This means a programme of exercise supervised by a professional such as a physiotherapist. This is likely to be in a group setting. Exercises may include aerobic activity, movement instruction, muscle strengthening, posture control and stretching. It typically consists of up to eight supervised sessions over 8-12 weeks with encouragement to keep on doing the exercises at home between sessions.
• Manual therapy. Typically this includes several sessions of massage, spinal mobilisation and/or spinal manipulation. With spinal mobilisation the therapist moves the joints of the spine around in their normal movement range. In spinal manipulation, the therapist moves joints beyond the usual range of movement.
• A course of acupuncture. It is not clear how this may work.

Does Swimming Make Your Back Stronger

The good news is swimming will make your back stronger, as it is a resistance exercise. To propel forward you need to push and pull the water with your arms and legs. The main strokes to build your back muscles are the backstroke and butterfly. Swimming also helps strengthen your buttock muscles such as the gluteus maximus and minimus which help with general posture, says Alibhai.

Swimming can help strengthen your back, in particular your paraspinal muscles, as well as your core, shoulder, and glutes, which can lead to improvements in back pain, adds Oluwajana. But dont push yourself too hard. As with any form of exercise, any significant worsening of pain symptoms should be discussed with your GP or a Physiotherapist, says Daurat.

For more on back pain and exercise read up on are exercise bikes good for back pain? Or, try this pilates for back pain routine and test out one of the best yoga mats while you’re at it.

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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.

About Lower Back Pain

Lower back pain is pain in the area of your back from the bottom of your ribs to the top of your legs. It can come from any of the many structures that make up your back. These include bones, joints, muscles, ligaments, nerves and tendons.

Your spine supports your back. Its made up of 24 separate bones called vertebrae stacked on top of one another. The lower section of your spine is called the lumbar spine. Below the vertebrae, at the bottom of your spine, are bones called your sacrum and coccyx. You may hear lower back pain referred to as lumbosacral pain.

Discs of cartilage sit between each vertebra, acting as shock absorbers and allowing your spine to bend. Some lower back pain originates from these discs. Your spinal cord threads through the vertebrae, carrying nerve signals between your brain and the rest of your body. If nerves at the base of your spine become compressed or inflamed, it can cause sciatica. Sciatica is a type of pain that starts in your back or buttocks and spreads down your leg.

Its usually difficult for doctors to say exactly whats causing back pain. This is because there are so many different parts to your back and tissues that surround it. Even tests such as X-rays and magnetic resonance imaging scans arent helpful for most people.

• being depressed

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Urgent Advice: Ask For An Urgent Gp Appointment Or Get Help From 111 If:

You have back pain and:

• a high temperature
• you’ve lost weight without trying to
• there’s a lump or swelling in your back or your back has changed shape
• the pain does not improve after resting or is worse at night
• the pain is made worse when sneezing, coughing or pooing
• the pain is coming from the top of your back , rather than your lower back

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.

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More Advanced Care Options

Surgery When other therapies fail, surgery may be considered to relieve pain caused by worsening nerve damage, serious musculoskeletal injuries, or nerve compression. Specific surgeries are selected for specific conditions/indications. However, surgery is not always successful. It may be months following surgery before the person is fully healed and there may be permanent loss of flexibility. Surgical options include:

Implanted nerve stimulators

• Spinal cord stimulation uses low-voltage electrical impulses from a small implanted device that is connected to a wire that runs along the spinal cord. The impulses are designed to block pain signals that are normally sent to the brain.
• Dorsal root ganglion stimulation also involves electrical signals sent along a wire connected to a small device that is implanted into the lower back. It specifically targets the nerve fibers that transmit pain signals. The impulses are designed to replace pain signals with a less painful numbing or tingling sensation.
• Peripheral nerve stimulation also uses a small implanted device and an electrode to generate and send electrical pulses that create a tingling sensation to provide pain relief.

Start With A Physiatrist

Unless you need to see a primary care provider for a referral, Dr. Dowdell suggests visiting a physiatrist as your first step. A physiatrist is the primary care doctor of the back, he explains. are fully focused on diagnosis and non-surgical treatment of musculoskeletal issues, so they may have more specialized knowledge than a PCP. Even if youve already told your family doctor about your back pain, its a good idea to talk to a physiatrist nextespecially if whatever youve been trying isnt working.

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Nonspecific Low Back Pain

This is the most common type of back pain. The majority of cases of sudden-onset low back pain are classed as nonspecific. This is the type of back pain that most people will have at some point in their lives. It is called nonspecific because it is usually not clear what is actually causing the pain. In other words, there is no specific problem or disease that can be identified as the cause of the pain. The severity of the pain can vary from mild to severe. This type of back pain is discussed further below.

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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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.

Your might have sprained it while working in the yard or cleaning house. Or your back might hurt from an old sports injury or a chronic condition such as arthritis or ankylosing spondylitis.

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

What If I Dont Want Surgery For My Back Pain

Fortunately, most people with back pain dont need surgery. We usually take a conservative approach first, using a wide variety of nonsurgical spine treatments, said Dr. Guo. For example, I might send you to physical therapy or chiropractic therapy. I might recommend medications such as anti-inflammatories, muscle relaxants, or some nerve-pain medications. We offer injection therapy, including epidural injections, joint injections, and nerve blocks and ablation if your back pain fails to improve with the conservative treatments. Chances are, one of these approaches will help reduce your back pain and improve your function and quality of life.

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The Changing Face Of Spinal Surgery

Only a small percentage of patients with back pain are candidates for surgery, but for these patients, advances in techniques have made recovery a much easier road, says Boden of The Emory Orthopaedics and Spine Center.

Fifty years ago, a spine fusion meant a two-week hospital stay, a body cast or brace for months, and a minimum of six months away from normal activities. A spinal fusion is performed by fusing the vertebrae together with bone grafts to eliminate motion between two adjacent vertebrae where motion is causing lower back pain.

Today, minimally invasively techniques allow for smaller incisions, less blood loss, and faster recovery time, Boden says. Some spine fusion techniques can be done on an outpatient basis.

Fifty years from now, Boden predicts that disc replacement will be an alternative to spinal fusion. Moreover, gene therapy will be able to prevent or reverse disc degeneration, and genetic research will help discover genetic sources of back pain, he says.

“Gene therapy for disc regeneration may be more than five years off, but less than 20,” he predicts.

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Fall Asleep Faster And Sleep Longer

When you have a restful nights sleep, your back will feel less sore during the day.7 A night of restorative sleep can have healing benefits and make you feel refreshed, rejuvenated, and less stressed.

Watch Video: 11 Unconventional Sleep Tips: How to Get to Sleep and Stay Asleep

Try these natural sleep aids, one at a time, to see which one works best for you:

• Vitamins C and B6. The natural steroids in your body control your metabolism and promote good sleep.8,9 Supplements of vitamins C10 and B611 are known to help the body produce and regulate natural steroid hormones.
• Melatonin. Your natural sleep hormone, melatonin can be taken as a supplement to improve your sleep cycle.
• L-theanine. An amino acid found in tea leaves, L-theanine may help some people feel relaxed and get better sleep.
• Valerian. Supplements made from the root of the valerian plant may help you sleep faster and stay asleep longer.

Another option is cherry juice or cherry extractscherries contain certain enzymes that help promote better sleep.4

See Natural Remedies and Herbal Supplements as Sleep Aids

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Iliac Crest Pain Symptoms

Lower back pain. This pain can spread to other areas of the body, including down your legs and through the buttocks into your groin. You may feel pain while walking or bending.

Inflammation. Tenderness and swelling along the iliac crest can also be signs of iliac crest problems caused by physical trauma.

Strenuous activities. Iliac crest pain can occur when you involve yourself in activities like running, kicking, or jumping.

If Youre Still Not Better Youll Likely Get An Mri

If youve finished your PT but your pains not improved, your physiatrist will likely send you for an . This type of test looks at whats going on inside your body using a high-powered magnet. An MRI can help doctors see if a nerve is being pinched, if theres wear-and-tear on the cartilage or bones, or if theres another physical problem that might be at the root of your pain.

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How Is Back Pain Treated

You can do several things to manage back pain. A conversation with your doctor or physiotherapist can help address any concerns you may have and help you to better understand your treatment. Remember that not all information is trustworthy, so let your healthcare team know about treatments you are considering before you begin them.

Ways to manage back pain include the following:

Strong pain medication is not recommended for back pain. Research shows strong pain medication provides little benefit and can cause side effects such as drowsiness, sedation and/or dependence.

If you have severe back pain and your current medication is not adequately managing it, talk to your doctor about a suitable treatment plan. In some cases, your doctor may suggest an injection that can numb the pain such as an epidural injection, or a surgical procedure, such as a laminectomy to help manage your pain.

There are many other treatments to manage back pain, but they have not been well proven. These include:

• herbal medicines
• laser therapy
• heat and cold therapy
• electrotherapy

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