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.
Bony Encroachment Causes Lower Back Pain
Bony encroachment: Any condition that results in movement or growth of the vertebrae of the lumbar spine can limit the space for the adjacent spinal cord and nerves. Causes of bony encroachment of the spinal nerves include foraminal narrowing , spondylolisthesis , and spinal stenosis . Spinal-nerve compression in these conditions can lead to sciatica pain that radiates down the lower extremities. Spinal stenosis can cause lower-extremity pains that worsen with walking and are relieved by resting . Treatment of these afflictions varies, depending on their severity, and ranges from rest and exercises to epidural cortisone injections and surgical decompression by removing the bone that is compressing the nervous tissue.
Find Back Pain Relief: Lighten Your Bags
Carrying an overstuffed purse, briefcase, or handbag can strain the low back. If you must carry a heavy load, consider using a wheeled briefcase instead. By reducing the amount of weight you’re carrying, you reduce the amount of pressure on the spine. Help keep your kids’ backs healthy by making sure their backpacks are not overloaded. A heavy backpack could mean future back pain for your little ones.
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Chronic Conditions That Cause Back Pain
Conditions that can lead to chronic low back pain include spinal stenosis, spondylitis, and fibromyalgia. Spinal stenosis is narrowing of the normal spinal canal through which the spinal cord passes. Spondylitis is chronic inflammation of the spine. Fibromyalgia is a muscle disorder that features chronic muscle pain and tenderness.
Hot Or Cold Therapy For Low Back Pain
Hot or cold packs may help ease pain and reduce symptoms. The soothing relief from heat, or the dulling relief from a cold pack, is only temporary and will not treat more serious causes of back pain. However, they may provide greater mobility for people with acute, subacute, or chronic pain, allowing them to get up and get moving.
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How Do Medical Professionals Treat Lower Back Pain
A GP will usually suggest pain medication, exercises or physiotherapy. An osteopath, chiropractor or acupuncturistmay also be able to help.
While lifestyle and exercises are relevant toallpatients, says Fatica, medical professionals may approach your pain differently. For example, at the Mayfair Clinic, we use vibration to reduce muscle dysfunction, a spine adjusting machine to improve spine mobility, laser therapy to improve healing and circulation, and IDD therapy to decompress the spine.
Is It Muscle Strain Or Sciatica
Back pain that occurs after excessive exercise or heavy lifting is frequently a strain injury. However, occasionally these activities cause disc injury and rupture or herniation. When a herniated disc irritates the sciatic nerve, it can cause back pain and, in some people, leg pain.
What is Sciatica?
Sciatica is a form of nerve pain caused by pressure on the sciatic nerve. The sciatic nerve is a large nerve that runs down through the buttocks and extends down the back of the leg. Pressing on or pinching of the sciatic nerve causes shock-like or burning low back pain. Sometimes people feel as if the pain radiates down through the buttocks and down one leg, sometimes even reaching the foot.
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Main Causes Of Morning Back Pain
Why is back pain worst first thing in the morning, and what can you do about it?
I woke up with it is an amazingly common description of how low back pain started.
Why? Is sleeping dangerous? Probably not: waking up with back pain rarely indicates a serious problem. But both mornings and backs are unusually vulnerable to some common minor sources of pain.
This is mostly about chronic back pain thats at its worst in the morning, a common symptom pattern. People who are more or less pain-free during the day may still suffer for a while every day after waking up. But attacks of acute back pain are also much more common in the first few hours of the day see Steffens et al.2 and that phenomenon may be related to why chronic back pain tends to be bad in the morning.
Morning back pain is a tough problem to treat because most of it probably has several subtle chronic causes, but there may be some opportunities for treatment.
Is pain & stiffness your alarm clock? Do you bail out of bed early every morning with low back pain, neck pain & more?
Connecting Inflammaging To The Curse Of Morning Back Pain
This is an interesting topic, but does it have anything to do with morning pain or back pain specifically?
The morning connection isnt much of a reach: for whatever reason, inflammatory diseases are notoriously morning-o-centric , and so its reasonable to assume that less serious inflammation has a thing for the morning too. We also know only just recently that the body can suppress inflammation at night, pumping out an anti-inflammatory protein on a schedule,11 which probably accounts for some morning pain and stiffness as the suppression wears off. No one knows anything about how to actually control that effect, but at least we know it exists.
The back connection is trickier. Being overweight is less of a risk factor for back pain than most people think,12 so theres no obvious association with metabolic syndrome. If there is a connection, it might be that the spinal joints are among the first structures to be affected by inflammation and not necessarily because they are more fragile or harder working than, say, knees, but perhaps because the brain is quite over-protective about the back, and more likely to raise the alarm sooner.13 Also, we do know that metabolic syndrome is associated with at least some common pain problems, like neck pain.14
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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.
Symptoms Of Back Pain
Symptom-wise, acute pain and chronic pain can be very similar. Back pain symptoms can include:
- Shooting, burning or aching pain that doesnt go away or returns after using home remedies like icing or over-the-counter medications, or massage or physical therapies
- Regular tightness or stiffness, especially after laying, sitting or standing for long periods
- Trouble sleeping
- Lower extremity weakness
So, how do you tell the difference between acute and chronic back pain?
It can be hard to tell the difference between acute back pain and chronic back pain, but timeframe is the biggest indicator.
The most common symptom of acute back pain is a shooting, burning or aching pain that comes on suddenly. With a little time and at-home remedies such as over-the-counter pain relief medications, cold and heat therapy, acute pain can start going away quickly as soon as two weeks.
But with chronic back pain, your symptoms can come on quickly or build over time, but they last for more than six weeks or are recurrent.
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How Is Lumbar Strain Diagnosed
In addition to a complete medical history and physical exam, diagnosing low back pain may include the following. However, specialized tests aren’t often required.
- X-ray. A diagnostic test that produces images of internal tissues, bones, and organs onto film.
- CT scan. This is an imaging test that uses X-rays and a computer to make detailed images of the body. It shows details of the bones, muscles, fat, and organs.
- MRI. This test uses a combination of large magnets, radiofrequencies, and a computer to make detailed images of organs and structures in the body.
- Radionuclide bone scan. A nuclear imaging technique that uses a very small amount of radioactive material, which is injected into your blood to be detected by a scanner. This test shows blood flow to the bone and cell activity in the bone.
- Electromyogram . A test to evaluate nerve and muscle function.
Your Posture Could Be Causing The Pain
The way you hold your body when walking can play a major role in your comfort level and ease of walking. While good posture can result in little to no pain or stress, bad or inefficient posture can cause lower back pain and postural stress.
What are the Symptoms of Postural Stress?
Beyond lower back pain, if youre suffering from postural stress, you may also experience:
- Aches and pains in other parts of the body, such as the neck, shoulders, and knees
- Slumped or rounded shoulders
- Looking down at a cell phone while walking4
Can Correct Posture While Walking Prevent Lower Back Pain?
Maintaining good posture while walking may help prevent pain in the lumbar spine. Study the way you hold your body when you are walking. Are you following these steps?
Stand up straight, without leaning forward or back.Pull in your stomach and rotate your hips forward with your buttocks in.Keep your eyes forward with your chin parallel to the ground.
It is also a good idea to increase strength in your hamstrings and back muscles to help maintain good posture. Stress management may also help decrease postural stress.5
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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.
How To Treat Lower Back Pain At Home
Ice it
If pain starts after an injury such as a fall, knock, sprain or strain, apply an ice pack for 10 minutes several times a day. Alternate with a hot-water bottle to encourage blood flow, but start and finish with ice to ease inflammation.
Keep moving
Stay active and carry on as normal, as much as possible. Start slowly, with a gentle activity like walking, and increase gradually.
Dont take to your bed
Extended bed rest causes muscles to seize up and weaken. If you must life down, restrict yourself to one to two hours over the first couple of days. Place apillowunder your knees to ease strain, or between your knees if youre lying on your side.
Get medicinal help
Take ibuprofen or aspirin every four to six hours. For more severe pain, take codeine. Paracetamol can be added for greater relief but always stick within the maximum recommended daily dose. You can also combine medication with a drug-free Deep Heat Pain Relief Patch that offers up to 16 hours relief.If that doesnt help, your GP can prescribe a stronger painkiller or muscle relaxant.
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Symptoms Of Sudden Lower Back Pain
Sudden lower back pain can be presented as sudden acute pain in the lower region of the back, during a particular activity, bending, lifting weight or travelling. Some symptoms associated with sudden lower back pain varying with the underlying cause are
- Inability to stand, walk or difficulty in movement of body parts.
- Radiating pain from the lower back to buttocks, back of thighs and legs.
- Pain that radiates from middle or lower back to the groin in front.
- The area of pain may be sore and tender to touch.
What to Watch for?
If lower back pain is severe and the person is unable to move, immediate medical care is needed. Sudden lower back pain, if accompanied with sudden weakness of lower limbs, loss of control of bowel and bladder, it can be a medical emergency.
Know The Source Know The Solution: Treating Back Pain And Hip Pain
Once your pain is identified as truly originating in your hip or in your low back, your doctor will work with you to craft a treatment plan to address it. In many cases, this regimen will include medication to reduce inflammation and pain, and a specially designed physical therapy program to teach you movements, stretches, and physical activities to help alleviate symptoms and prevent them from returning. Depending on the nature of your pain, your doctor may also recommend lifestyle modifications to treat your pain. For both spine pain and hip pain, surgery is rarely necessary and viewed as a last-resort treatment option.
Jones HR, Burns TM, Aminoff MJ, Pomeroy SL. Pain. Chapter: Diagnosis of Low Back, Buttock, and Hip Pain. Netter Collection of Medical Illustrations: Spinal Cord and Peripheral Motor and Sensory Systems, Section 8, 201-224.My Hip Hurts: Or Is It Back Pain? UPMC HealthBeat. https://share.upmc.com/2014/09/hip-hurts-back-pain/. Published September 8, 2014. Accessed July 8, 2019.Nall R. What causes lower back and hip pain? Medical News Today. https://www.medicalnewstoday.com/articles/325433.php. Last reviewed June 10, 2019. Accessed July 8, 2019.Oh, My Aching Back Or Is It My Hip? Cleveland Clinic. https://health.clevelandclinic.org/oh-my-aching-back-or-is-it-my-hip/. Published August 25, 2015. Accessed July 8, 2019.
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Myofascial Pain Syndrome And/or Fibromyalgia
There are two common causes for widespread moderate body pain, both somewhat mysterious and controversial, both known for affecting the back more than other areas, and both known for their morning hijinks:
Theres likely lots of overlap between these conditions. Fibromyalgia isnt really an explanatory diagnosis it just labels a common pattern of symptoms that could have several different causes. MPS is a hypothetical problem with muscle tissue that is a possile explanation for some body pain, and that type of pain is extremely common in fibromyalgia patients.
Fibromyalgia is associated with morning back pain because:
A Herniated Or Slipped Disc
If you feel severe, sharp pain shooting through your lumbar region when walking, you might be experiencing sciatica from a slipped disc.
The bones that make up your spine are cushioned by small discs. These discs absorb shock and help protect the spinal cord. If a disc slips out of place, it can press on the spinal nerve and cause severe pain.9
What are the Symptoms of a Herniated Disc?
Symptoms may vary depending on the location and size of the injured disc. If the disc is pressing on a nerve, the symptoms may be more severe, as with sciatica.
Sciatica may cause a shooting pain, burning, tingling or numbness that occurs anywhere along the sciatic nerve from the buttocks to the legs.
Other symptoms may include:
- Lumbar spinal pain
- Severe, electric shock-like pain
- A sedentary lifestyle11
What To Do If You Think You Have A Herniated or Ruptured Disc
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