Treatments For Back Pain From A Specialist
A GP, specialist or physiotherapist may recommend extra treatments if they do not think your pain will improve with self-help measures alone.
These may include:
- group exercise classes where you’re taught exercises to strengthen your muscles and improve your posture
- manual therapy treatments, such as manipulating the spine and massage, which are usually done by a physiotherapist, chiropractor or osteopath
- psychological support, such as cognitive behavioural therapy , which can be a useful part of treatment if you’re struggling to cope with pain
Some people choose to see a therapist for manual therapy without seeing a GP first. If you want to do this, you’ll usually need to pay for private treatment.
Surgery is generally only considered in the small number of cases where back pain is caused by a specific medical condition.
Two Back Pain Situations You Should Take Seriously Right Away No Delay
These two back pain scenarios might be medical emergencies. They do not necessarily mean something horrible is wrong, but its important to make sure.
Isnt it rather obvious that a potential spinal fracture is an emergency?
Youd think so. But consider this story of a motorcycle accident: many years ago, a friend hit a car that had pulled out from a side street. He flew over the car & landed on his head. Bystanders showed their ignorance of spinal fracture by, yikes, carelessly moving him. In fact, his thoracic spine was significantly fractured yet the hospital actually refused to do an X-ray because he had no obvious symptoms of a spinal fracture. Incredible! The next day, a horrified orthopedic surgeon ordered an X-ray immediately, confirming the fracture & quite possibly saved him from paralysis.
Pain + weakness in both legs as symptoms of cauda equina syndrome or not
That said, obviously you should be checked out if you are experiencing true saddle numbness.17 Even if its not CES, any significant malfunction of your plumbing should be taken seriously.
Change Up Your Sleep Position Or Mattress
Switching to a more supportive sleep position can reduce lower back pain. Also consider how you can use pillows or invest in a new mattress to support better spinal alignment and relieve lower back pain.
Research suggests medium firm mattresses are the best mattresses for back pain. In one study of people with low back pain, those who slept on medium firm mattresses reported lower pain scores both during sleep and upon getting up in the morning.
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Pain That Feels Better When Changing Positions
Depending on the underlying cause of pain, some positions will be more comfortable than others. For example, with spinal stenosis walking normally may be difficult and painful, but leaning forward onto something, such as a shopping cart, may reduce pain. How symptoms change with shifting positions can help identify the source of pain.
See Spinal Stenosis Symptoms and Diagnosis
Sensations That Might Indicate A Medical Emergency
1. Sharp pain rather than a dull ache: This could indicate a torn muscle or ligament, or a problem with an internal organ in the back or side.2. Radiating pain: This pain “moves” or shoots to the glutes or legs, which could indicate a nerve compression condition.
3. Sudden weakness in the legs: Limb weakness can be caused by compressed nerves in the spine due to conditions like sciatica or spinal stenosis. However, sudden leg weakness could also indicate a stroke.4. Incontinence: Back pain paired with inability to control the bowels or bladder might be a sign of serious nerve compression or a spine infection, such as discitis or meningitis.5. Numbness or pins and needles in the groin or glutes: This is known as saddle anesthesia and is also a sign of a serious nerve or spine condition.
If you have leg weakness, incontinence, and numbness together, you might have cauda equina syndrome, a serious illness characterized by spinal cord nerve damage. This is a medical emergency, and patients usually need surgery immediately to decompress the nerves and reduce permanent damage.
Related reading: Get help for back, neck, and leg pain caused by spinal stenosis
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Unexplained Acute Low Back Pain
Unexplained low back pain means chronic pain that comes on gradually, over time, with no specific injury, event, or illness causing it.
- Prolonged sitting and lack of fitness can weaken back muscles and cause pain from lack of support.
- Ankylosing spondylitis, a form of arthritis.
- Spinal stenosis, a narrowing of the spinal column that puts pressure on the spinal cord.
- Certain types of cancer, in rare cases.
Those most susceptible are over 30, overweight and/or pregnant, and not physically fit. Smoking interferes with healing after any sort of stress to the back.
If there are additional symptoms, medical care should be sought: fever, unexplained weight loss, leg weakness or numbness, or trouble urinating.
An exact diagnosis is made through blood tests and through imaging such as x-rays, CT scan, or MRI.
Once more serious causes are ruled out, treatment may include medications to ease pain, swelling, and inflammation. Steroid injections are useful in some cases.
Overall, exercise and maintaining a healthy weight can be very helpful with easing chronic low back pain.
Top Symptoms: lower back pain, back pain that shoots to the butt, fever, back pain
Symptoms that always occur with unexplained acute low back pain:lower back pain
Symptoms that never occur with unexplained acute low back pain:buttocks numbness, thigh numbness, involuntary defecation, fever
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.
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Herniated Disk In The Lower Back
The backbone, or spine, is made up of 26 bones called vertebrae. In between the bones are soft disks filled with a jelly-like substance. These disks cushion the vertebrae and keep them in place. Although people talk about a slipped disk, nothing actually slips out of place. The outer shell of the disk ruptures, and the jelly-like substance bulges out. It may be pressing on a nerve, which is what causes the pain.A slipped disk is more likely to happen due to strain on the back, such as during heavy lifting, and older individuals are at higher risk.
Top Symptoms: lower back pain, moderate back pain, back pain that shoots down the leg, back pain that gets worse when sitting, leg weakness
Urgency: Primary care doctor
Back Pain Culprit: Chronic Conditions
Several chronic conditions can lead to low back pain.
- Spinal stenosis is a narrowing of the space around the spinal cord, which can put pressure on the spinal nerves.
- Ankylosing spondylitis inflames the joints of the spine, and sometimes the shoulders, hips, ribs, and other areas too. It causes chronic back pain and stiffness. In serious cases, spinal vertebrae start to fuse .
- Fibromyalgia causes widespread muscle aches, including back pain.
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When Should I Call My Healthcare Provider
- Can’t stand or walk
- Temperature over 101.0°F
- Frequent, painful, or bloody urination
- Severe belly pain
- Pain or numbness in your leg
- Pain in a new area of your back
- The pain isnt decreasing after more than a week
- Pain radiating down the leg.
- Pain that is accompanied by fever or chills, leg weakness, or loss of control of the bladder or bowels.
Or You Could Be Dying What Are The Odds That Back Pain Is Something Scary
Of course there are cases of low back pain that have alarming causes, but its reassuringly rare. Once in a while back pain is a warning sign of cancer, autoimmune disease, infection, or a handful of other scary culprits.7 Over the age of 55, about one in twenty cases turns out to be a fracture, and one in a hundred is more ominous.8 The further you are from 55, the better your odds.
But how can you tell? It can be tricky. This is a concise, readable guide to symptoms that need better-safe-than-sorry investigation with your doctor. In other words, this article explains the difference between dangerous and just painful as clearly as possible. Tables, checklists, and examples ahead.
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What Is A Muscle Strain
A muscle strain is an injury to one of your muscles that causes it to tear. Theyre one of the most common injuries, especially among athletes.
Strains are classified with three grades to indicate how severe they are. Most people can recover by resting their muscle and using at-home treatments like ice and over-the-counter medicine. If youre feeling pain for a few weeks after your injury or have severe symptoms, see your healthcare provider.
What Causes Low Back Pain
It might develop suddenly, like after you lift something heavy. Or it might come on slowly.
As you get older, the structure of your back begins to show wear and tear. Doctors call it âspondylosis,â which means your spineâs joints, disks, and vertebrae get worse over time. This slow decline can lead to many problems, like the following:
- Strains. This means you overstretch or tear your tendons or muscle. You can do this by twisting, lifting something thatâs too heavy, or lifting something the wrong way.
- Degenerated disks. When these are healthy, they cushion your back as you bend, flex, and twist. As disks begin to wear out, they no longer absorb the shock of these movements well.
- Herniated or ruptured disks. Normal disks are rubbery. When they become squeezed, a portion bulges out between your vertebrae.
- Radiculopathy. A spinal nerve can become pinched or inflamed. This can cause low back pain to travel down your legs. It can also cause numbness or tingling.
- Sciatica. This is the type of radiculopathy that affects the sciatic nerve, which runs from your butt down the backs of your legs. When itâs inflamed, you may feel burning or pain like an electrical shock that may go all the way down to your feet.
- Spondylolisthesis. In this condition, a vertebra slips out of place and pinches spinal nerves.
- Spinal stenosis. Your spinal column may narrow over time, putting pressure on your nerves. Your legs may feel numb and grow weaker.
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Why Does My Back Hurt 10 Common Causes Of Back Pain
Jul 8, 2019 | Chiropractic Care
If you wake up each morning and find yourself asking why does my back hurt? youre not alone. Chronic back pain is a major issue affecting more than 29 percent of the population ages 18 and over.
Unfortunately, pinpointing what causes your back pain can be tough. Its rare that anyone can identify precisely what causes their back pain to flare up. But if you can recognize the common causes, youll be better able to prevent that pain from coming back.
Here are some of the most common causes of back pain.
Complementary And Alternative Techniques Include:
- Acupuncture is moderately effective for chronic low back pain. It involves inserting thin needles into precise points throughout the body and stimulating them , which may cause the body to release naturally occurring painkilling chemicals such as endorphins, serotonin, and acetylcholine.
- Behavioral approaches include:
- Biofeedback involves attaching electrodes to the skin and using an electromyography machine that allows people to become aware of and control their breathing, muscle tension, heart rate, and skin temperature people regulate their response to pain by using relaxation techniques
- Cognitive therapy involves using relaxation and coping techniques to ease back pain
Spinal injections include:Trigger point injections can relax knotted muscles that may contribute to back pain. An injection or series of injections of a local anesthetic and often a corticosteroid drug into the trigger point can lessen or relieve pain.
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Muscle Strain Or Sciatica
Muscle strain is often the cause of back pain from heavy lifting or vigorous exercise. But sometimes itâs due to small jelly-filled disks meant to protect the space between vertebrae. When one of these disks bulges or breaks, it can push on a nerve. When itâs the sciatic nerve, pain runs from the buttock down one leg. This is sciatica.
What Type Of Doctor Should I See For Back Pain
This depends on your condition or symptoms. If you have no obvious injury that would explain your pain, you may want to start by seeing a . This is a specialist in physical medicine who can diagnose back pain and determine whether nonsurgical treatments such as physical therapy may help. Depending on those findings, a physiatrist may also refer you to a , doctor or other type of back specialist, , for additional discussion.
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Other Conditions Causing Lower Back Pain
There are many causes of back pain. Overuse injuries are a very common source of lower back pain and stiffness. However this usually goes away after a few days. Others causes of chronic pain include:
- Disc tear
- Spondylolisthesis. Normal wear and tear makes it hard for your joints and ligaments to keep your spine in the proper position, especially as we age. When a vertebrae moves more than it should, it can slide forward and on top of another. When this happens, bones can press on the spinal nerves and cause lower back pain.
- Vertebral fractures caused by osteoporosis
- Spinal stenosis. A narrowing of the spine space around the spinal cord can put pressure on nerves. The narrowing is typically caused by bone spurs that have developed as a result of osteoarthritis.
- Scoliosis. An abnormal curvature of the spine can cause back pain.
Less commonly, low back pain can be a sign of a serious medical condition, such as diabetes or a pinched nerve. In the case of a pinched nerve, the pain may be accompanied by symptoms like fever, chills, night sweats, or loss of bladder control.
What Causes A Muscle Strain
Muscle strains happen when you tear the fibers of your muscle. Causes of muscle strains include:
- Overuse: Repeating the same motion whether at work or during an activity like playing sports can lead to overuse syndrome.
- Not stretching or warming up before exercise: Stretching before exercise gradually increases how much stress you put on your muscles.
- A lack of flexibility: If youre not very flexible, your muscles are tighter, which makes them more susceptible to strains.
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Sitting With Your Spine Curved Forward
When you sit for a long time, the following changes occur in your spine:
- Increased pressure within each spinal segment3
- Reduced strength in the muscles of your upper and lower back3,4
- Decreased nutrient supply to the spinal tissues3
When you sit on the edge of your chair or hunch towards your computer, the strain on your spine is moreand can cause stiffness and pain.
See Identifying Incorrect Posture
A sedentary lifestyle can exacerbate these changes, causing spinal stiffness to develop within an hour of sitting.4
To avoid back stiffness, use an upright sitting posture. Roll your shoulders back with the ears over the shoulders and the upper arms parallel to your torso. While sitting in an office chair try to avoid constant use of the backrest and sit upright to activate your core muscles.
Bad Habits Contribute To Back Pain When Standing Lifestyle Changes Can Help
Parts of your everyday routine may be contributing to the low back pain you experience when standing. These include:
- Not exercising regularly or doing the wrong exercises
- Having poor posture which interferes with proper weight distribution
- Not wearing supportive shoes or, if necessary, orthotics
- Sleeping on an old or unsupportive mattress
- Lifting heavy objects or weight-lifting as a form of exercise
- Being overweight or obese
Some changes are easier to make than others and some require professional assistance. For example, while it may be easy enough to purchase a new mattress, you are probably better off consulting a doctor who understands which type of mattress is best in your particular case. Similarly, purchasing over-the-counter orthotics is rarely wise. Such products should be customized to serve your unique needs.
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