Low Back Pain Treatment

If you suffer from low back pain, you’re not alone. More than three-quarters of all adults have pain in their lower back at some time over the course of their life and it’s the most frequent cause of disability related to employment. Low back pain is also a significant factor in time missed from work.

Low back pain affects men and women equally. Pain can range from a dull aching sensation to a sharp and sudden stabbing sensation. It can start suddenly due to trauma or an accident or can gradually develop over months and years due to degenerative changes in the spine. The stage is often set for low back pain by sedentary lifestyles, especially when people who spend all week behind a desk spend the weekend engaged in vigorous activity.

Most cases of low back pain are short-term, lasting only a few days or a few weeks. This is called “acute” low back pain. These cases mostly resolve on their own with conservative treatment and there are no lasting ill-effects. Most episodes of acute low back pain are mechanical. This means there is a problem with the way the different parts of the back’s anatomy move and fit together.

Sub-acute low back pain lasts longer than an acute episode; it lasts from 4 to 12 weeks. Chronic low back pain lasts even longer. Chronic pain lasts 12 weeks or longer. Pain can sometimes become chronic, even after the original cause of the problem or initial injury has been treated. Approximately 20% of individuals who have acute lower back pain eventually develop chronic pain in their back and their symptoms are still present at 12 months. In some cases, chronic pain persists despite surgical and medical treatment.

Short-Term Lower Back Pain Treatment

If your back pain has lasted for more than several weeks you may want to consider one of these lower back pain treatments:

• Exercise: Sometimes special exercise classes are organized specifically for people with pain. These are led by qualified instructors and usually include training to help improve the posture, strengthen the muscles and improve flexibility. Sometimes they also include aerobic exercise as part of lower back pain treatment.
• Manual therapy: Various types of manual therapy include mobilization and massage, and spinal manipulation. These lower back pain treatments are usually done by physiotherapists, osteopaths or chiropractors.
• Acupuncture: This is a form of alternative treatment in which very fine needles are placed into the skin at specific points in the body. This lower back pain treatment is based on ancient Chinese beliefs regarding the body’s energy force known as the Chi.

If you have not obtained relief from other lower back pain treatment and your pain continues to be severe, affecting your daily life and activities, your doctor may suggest other procedures such as:

Nerve root blocks

This is sometimes called an epidural injection. In this lower back pain treatment, a medication such as a corticosteroid or an anesthetic, or sometimes a combination of both, is injected near the source of your pain, into your back. Steroids are strong anti-inflammatory medications and can help relieve both pain and swelling. Usually, this lower back pain treatment uses a CT scan or an X-ray to help guide the injection.

Facet joint injections

Corticosteroids or anesthetics can also be injected into the facet joints of the spine as a lower back pain treatment. These are joints that help to keep the spine in alignment by holding one vertebra to the next. These joints are sometimes painful due to arthritis and steroids may help reduce the arthritic inflammation.

Counseling

Counseling is sometimes offered as a lower back pain treatment to help deal with the psychological effects of chronic pain. Pain is a very real condition, and your emotional health is very important in dealing with it. Sometimes a treatment known as cognitive behavioral therapy (CBT) is effective in helping people change the way they think of their pain. Research shows that patients who receive CBT later report decreased pain levels. These patients also were more like to participate regularly in exercise and stay active. This reduced the severity of their symptoms even further.

Surgery for Lower Back Pain Treatment

Surgery, as a lower back pain treatment, is typically only suggested when other options for treatment have been unsuccessful. Your doctor may recommend surgery if your pain is so severe that it interrupts your daily activities or disrupts your sleep on a regular basis. The procedure that is recommended will depend on what is causing your pain. One example is if you have a herniated disc, your surgeon may perform an operation called a discectomy.

Your intervertebral discs are like spongy plates that lie between each pair of vertebrae. They help provide a cushion for your spine. They have a gel-like core and a tough outer rim, like a tire. If the outer rim gets dry, like it often does with age, it can crack or tear. The gel-like center can then leak out. This is known as a herniated or prolapsed disc. A discectomy is a procedure in which the damaged portion of the disc is removed through an incision. Minimally invasive spine surgeries or micro-surgeries can now be used to perform these procedures. These require very small incisions, which limit the amount of surgical pain and shorten a number of time patients need to stay in the hospital.

Spinal fusion: This lower back pain treatment is not as common as a discectomy. In this procedure, a joint that is painful is kept from moving by fusing two or more vertebrae together. The fusion is accomplished by inserting a piece of bone in between the vertebrae. This way, the two bones cannot press on surrounding nerves and symptoms of pain are reduced. This is a complicated surgery and it is not always successful in relieving pain. It causes loss of movement and adds stress to other sections of the spine.

Other surgical procedures for lower back pain treatment sometimes recommended include:

• Foraminotomy: In this lower back pain treatment, more space is made in the spinal canal, taking pressure off the nerves
• IntraDiscal Electrothermal Therapy (IDET):  This lower back pain treatment helps to seal any cracks or tears in the rim of a damaged disc and decreases nerve sensitivity by using heat.
• Nucleoplasty:  In this lower back pain treatment, the disc material is made smaller and removed by using radio waves.
• Radiofrequency lesioning: In this lower back pain treatment, the nerves that are producing pain are destroyed by using radio waves
• Spinal laminectomy: This is also sometimes known as spinal decompression. This lower back pain treatment involves removing the arch portion (lamina) of the vertebra to enlarge the spinal canal.This removes pressure from the spinal cord and nerves.

Other lower back pain treatment options

Some people find other lower back pain treatments to be helpful. These include:

• Low-level laser therapy: This lower back pain treatment involves the use of low-energy lasers to attempt to decrease inflammation and stimulate the healing of tissues
• Interferential therapy (IFT): This uses a device to pass low levels of electrical current to the back to stimulate healing and the body’s production of endorphins (natural pain relievers)
• Therapeutic ultrasound: This lower back pain treatment uses ultrasound waves to speed healing and tissue repair
• Transcutaneous electrical nerve stimulation (TENS): This is a machine that sends small pulsations of electrical current through electrodes attached to the skin. This is thought to stimulate the production of endorphins and interrupt the transmission of pain signals from your spine to the brain to decrease pain.
• Lumbar supports: This lower back pain treatment is the used of supportive devices, such as braces, pillows, and cushions to support the back
• Traction: This involves gentle pulling of the vertebrae, removing pressure from nerves.

Prevention

Standing

• If you need to stand up in the same place for an extended period, try resting one foot on a small stool or step.
• While standing in the office or the kitchen, open the door of a cabinet and rest one foot inside the cabinet. Alternate feet every 5 to 10 minutes.
• Practice good posture when standing by holding your head up. Keep your shoulders straight and your chest forward. Your weight should be evenly balanced on both your feet and your hips should be tucked in.

Sitting

• It is vital that your chair provide adequate support for your lower back. The chair should be curved where the small of your back meets the seat to provide support for your spine.
• Use a small footstool or footrest to keep your knees slightly higher than your hips.
• If you need to turn while you’re sitting, avoid twisting at the waist. Instead, rotate your whole body when you turn.

Sleeping

• Avoid sleeping flat on your back. Lie on your side with your knees bent. Try placing a pillow between your knees.
• Try to avoid sleeping on your stomach.

Lifting

• Before attempting to lift something heavy, make sure you have secure footing. Lower your body to the level of the object by bending your knees. Keep your low back straight. Never bend over from the waist. Tighten your abdominal muscles and lift, using your leg muscles. Use a smooth, consistent motion without jerking.
• When you lift an object off a table or counter, first slide it to the edge. This will enable you to hold it close to your body. Keep your back straight and bend your knees. Lift with your legs and return to a standing position.
• Never lift or carry objects above the level of your waist.
• Hold objects near your body and keep your arms bent.

You might also like to review:

• Interspinous Spacers,
• Inversion Treatment of Low Back Pain.