Which Health Care Specialties Treat Low Back Pain
Physician specialties that evaluate and treat low back pain range from generalists to subspecialists. These specialties include emergency medicine physicians, general medicine, family medicine, internal medicine, gynecology, spine surgeons , rheumatology, pain management, and physiatry. Other health care providers for low back pain include physical therapists, chiropractors, massage therapists, psychologists, and acupuncturists.
Is It Possible To Prevent Low Back Pain
Avoiding injury to the low back is a method of preventing low back pain. Additionally, conditioning exercise programs designed to strengthen the lumbar area and adjacent tissues can help to minimize risk of injury to the low back. Specific programs to relieve and prevent back pain can be designed with the help of physical therapists and other treating health care professionals.
Can Further Bouts Of Back Pain Be Prevented
Evidence suggests that the best way to prevent bouts of low back pain is simply to keep active and to exercise regularly. This means general fitness exercise such as walking, running, swimming, etc. There is no firm evidence to say that any particular back strengthening exercises are more useful to prevent back pain than simply keeping fit and active. It is also sensible to be back-aware. For example, do not lift objects when you are in an awkward twisting posture.
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Stressful Living Conditions And Poor Work Habits
This may exacerbate the symptoms of low back pain and may even create a flare-up of pain following periods of increased tension. Stress does affect your spine and can lead to pain, so here are some ways to reduce stress in your life:
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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Other Types Of Diagnosis
- A chiropractor will diagnose through touch, or palpation, and a visual examination. Chiropractic is known as a direct approach, with a strong focus on adjusting the spinal joints. A chiropractor may also want to see the results of imaging scans and any blood and urine tests.
- An osteopath also diagnoses through palpation and visual inspection. Osteopathy involves slow and rhythmic stretching, known as mobilization, pressure or indirect techniques, and manipulation of joints and muscles.
- A physical therapist focuses on diagnosing problems in the joints and soft tissues of the body.
Lower Back Pain Causes: 8 Reasons For Sudden & Chronic Pain
Sometimes, you know exactly why your back is hurting. Maybe you lifted something awkwardly and felt the pain right away. Or maybe your doctor has been warning you for years that your bad posture would lead to lower back pain.
But other times, the source of back pain can feel like a mystery.
“Your lumbar spine, located in your lower back, plays a crucial role in supporting the weight of your upper body. It’s also responsible for everyday movements, such as bending, twisting and coordinating the muscles in your hips, pelvis legs and feet,” says Dr. Kenneth Palmer, orthopedic surgeon specializing in spine surgery at Houston Methodist. “Due to heavy use, the bones, muscles, ligaments, disks and nerves found in your lumbar spine are quite susceptible to both injury and wear and tear over time causing pain in the lower back.”
Lower back pain symptoms include:
- Dull ache in your hips and/or pelvis
- Muscle spasms or tightness
- Sharp, tingling pain that starts in your lower back and travels down one leg
- Pain that worsens with sitting and quickly improves while walking
- Pain that is noticeably worse in the morning
“Typically, a person experiences some combination of these symptoms, which can develop suddenly or over time. In some cases, lower back pain can feel like it comes and goes flaring up now and then, but generally getting progressively worse over time,” explains Dr. Palmer.
Speaking of the various causes of lower back pain…
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It Could Be Your Sorry Old Pillows Fault
If your pillow is too thin or soft, your back will bend downward at an awkward angle. Conversely, if its too thick, your spine might bend unnaturally upward. Both situations can cause pain.
If your head is supported at the correct level, the muscles in your neck and back will be able to to completely relax. Pressure on your discs and muscles will be diminished and, as a result, your back pain reduced.
Most of us westerners are acclimated to traditional soft pillows containing down or polyester fibers. Traditional soft pillows will collapse under pressure and can not support your head consistently throughout the night. In fact, many find themselves using two pillows or folding their pillow in half in an attempt to support their head at the proper level. Fiddling with pillows in the middle of the night is not conducive to good sleep!
We are huge fans of buckwheat pillows due to their adjustable and malleable nature. The buckwheat hull fill is really uniqueit will perfectly conform to the space between your head and the mattress eliminating potentially pain-causing pressure points in your neck and back. Most buckwheat pillows are adjustable you can add or remove fill to dial in the loft so that your spine is straight rather than bent upwards or downwards.
Your old pillow is probably pretty gross anyway! Toss it out and treat yourself to a new one.
All Of The Worst Possible Causes Of Back Pain And Their Major Features
None of these are common. All of them usually cause serious symptoms that are easy to take seriously. Some of them can fly under the radar in early stages, but usually not for long. The names of the conditions link to carefully chosen articles from good sources.The worst possible causes of back pain
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Finucane LM, Downie A, Mercer C,et al. International Framework for Red Flags for Potential Serious Spinal Pathologies. J Orthop Sports Phys Ther. 2020 Jul 50:350372. PubMed #32438853
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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.
Can Lower Back Pain Be Related To Weather
If you feel like your lower back pain worsens on days when its cold or the weather is changing, you are not imagining things. Back pain can indeed be related to barometric pressure and outdoor temperature. Changes in pressure can sometimes cause pain in arthritic joints, including the spine. Muscles and joints in general react to the environment, which can make them stiffer and more likely to suffer an injury.
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Should I See A Chiropractor For My Back Pain
Spinal manipulation is used by chiropractors and osteopathic physicians to treat low back pain in selected patients. Spinal manipulation applies hand pressure to areas of the low back to relax irritated muscle and lessen the intensity of the pain.
Traction, using pulleys and weights to lengthen and stretch the spine can result in temporary relief. Both techniques will not treat any underlying causes of back pain, but rather offer a temporary relief from lower back pain.
When Should I See My Healthcare Provider About Lower Back Pain
Lower back pain usually gets better with rest and pain relievers. Back pain that doesnt go away may be a sign of a more serious condition.
See your provider if you have:
- Pain that doesnt get better after about a week of at-home care.
- Tingling, numbness, weakness or pain in your buttocks or legs.
- Severe pain or muscle spasms that interfere with your normal activities.
- Fever, weight loss, bowel or bladder problems or other unexplained symptoms.
A note from Cleveland Clinic
Millions of people live with low back pain. Stiffness, pain and limited movement can have a major impact on quality of life. But you may be able to avoid lower back pain by maintaining a healthy weight and staying active. Talk to your provider if back pain doesnt go away or if youre unable to do the activities you enjoy. Several treatments can relieve pain, help you move better and get more out of life.
Last reviewed by a Cleveland Clinic medical professional on 01/18/2021.
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Why Your Back Is Hurting
Figuring out whats behind your back painisnt always easy to start, there are a lot of confusing back-ailment terms , so it helps to understand a bit more about your anatomy.
An adults spine consists of a stack of 24 bonescalled vertebrae plus the bones of the sacrum and coccyx. These bones support the body and protect the spinal corda major column of nerve fibres connected to the brain that runs through the vertebrae via the spinal canal. A disc, made of cartilage and filled with a gel-like material that acts like a shock absorber, is found between each vertebra. Ligaments, muscles, tendons and small joints called facets hold the vertebrae together.
With that information in mind, weve broken down eight possible sources of your back pain.
Understanding The Lower Back
The lower back is also called the lumbosacral area of the back. It is the part of the back between the bottom of the ribs and the top of the legs.
Most of the lower back is made up from muscles that attach to, and surround, the spine. The spine is made up of many bones called vertebrae. The vertebrae are roughly circular and between each vertebra is a disc. The discs between the vertebrae are a combination of a strong fibrous outer layer and a softer, gel-like centre. The discs act as shock absorbers and allow the spine to be flexible.
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Lower Back Pain Causes
Nonspecific low back pain means that the pain is not due to any specific or underlying disease that can be found. It is thought that in some cases the cause may be an over-stretch of a ligament or muscle. In other cases the cause may be a minor problem with a disc between two spinal bones , or a minor problem with a small facet joint between two vertebrae. There may be other minor problems in the structures and tissues of the lower back that result in pain. However, these causes of the pain are impossible to prove by tests. Therefore, it is usually impossible for a doctor to say exactly where the pain is coming from, or exactly what is causing the pain.
To some people, not knowing the exact cause of the pain is unsettling. However, looked at another way, many people find it reassuring to know that the diagnosis is nonspecific back pain which means there is no serious problem or disease of the back or spine.
Conditions Of Bone And Joint Causes Lower Back Pain
Bone and joint conditions: Bone and joint conditions that lead to low back pain include those existing from birth , those that result from wear and tear or injury, and those that are due to inflammation of the joints .
Congenital bone conditions: Congenital causes of low back pain include scoliosis and spina bifida. Scoliosis is a sideways curvature of the spine that can be caused when one lower extremity is shorter than the other or because of an abnormal architecture of the spine . Children who are significantly affected by structural scoliosis may require treatment with bracing and/or surgery to the spine. Adults infrequently are treated surgically but often benefit from support bracing. Spina bifida is a birth defect in the bony vertebral arch over the spinal canal, often with the absence of the spinous process. This birth defect most commonly affects the lowest lumbar vertebra and the top of the sacrum. Occasionally, there are abnormal tufts of hair on the skin of the involved area. Spina bifida can be a minor bony abnormality without symptoms. However, the condition can also be accompanied by serious nervous abnormalities of the lower extremities.
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Is Your Job Causing Back Pain
A job that involves pulling, lifting, or twisting with the low back can cause injury and low back pain. Even prolonged sitting in an awkward position can cause low back pain. Standing on your feet for hours on end? That can cause lower back pain too. The best way to prevent back pain is to know if you are at risk.
Jobs That Can Cause Lower Back Pain
- Airline crew
- Office personnel
You Might Be Overdoing That Area
Talk to any personal trainer and theyll stress the importance of varying the specific muscles you train throughout the week. Doubling-down on an area over and over again could be the cause of that pesky, lingering ache, Dr. Dave notes. This is especially true if youre unsure of your actual capabilities and trying to match those who are a bit more prepared than you are.
People overdo a workout by lifting too much weight, doing weight-bearing exercise while overweight, running too much without training, or overusing or overextending low back muscles, he says. Lower back pain can happen when someone tries to max out their lifting when their core and lower back are not strong enough for the stress.
To avoid this, start at a comfortable lifting weight or try bodyweight exercises with the Aaptiv app to avoid back pain due to heavy lifting.
Build your way up by focusing on your abdominals, your biceps, your quads, and every other muscle group. After all, if your middle-body is tough, your back will reap the benefits.
Pay close attention to the sensations you experience in your back. More often than not, it wont be anything serious, but dont push it. If youre concerned about your lower back pain, talk to your doctor who will be able to directly diagnose your discomfort.
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How Is Lumbar Strain Treated
Specific treatment for a lumbar strain will be discussed with you by your healthcare provider based on:
- Your age, overall health, and medical history
- Extent of the injury
- Your tolerance for specific medicines, procedures, and therapies
- Expectation for the course of the injury
- Your opinion or preference
- Ice packs and/or heat and compression applied to the back
- Stretching and strengthening exercises
- Education regarding the use and wearing of appropriate protective equipment
Medicines, such as anti-inflammatories and spinal injections, may also be used to relieve pain and inflammation.
How Is Low Back Pain Diagnosed
Your doctor will likely begin by requesting a complete medical history and conducting a thorough physical examination to determine where youre feeling the pain. A physical exam can also determine if pain is affecting your range of motion.
Your doctor may also check your reflexes and your responses to certain sensations. This determines if your low back pain is affecting your nerves.
Unless you have concerning or debilitating symptoms or neurologic loss, your doctor will probably monitor your condition for a few weeks before sending you for testing. This is because most low back pain resolves using simple self-care treatments.
Certain symptoms require more testing, including:
- lack of bowel control
- weight loss
Likewise, if your low back pain continues after home treatment, your doctor may want to order additional tests.
Seek medical attention immediately if you experience any of these symptoms in addition to low back pain.
Imaging tests such as X-rays, CT scans, ultrasounds, and MRIs may be necessary so your doctor can check for:
- bone problems
- disc problems
- problems with the ligaments and tendons in your back
If your doctor suspects a problem with the strength of the bones in your back, they may order a bone scan or bone density test. Electromyography or nerve conduction tests can help identify any problems with your nerves.
The Healthline FindCare tool can provide options in your area if you need help finding a doctor.
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