Lower 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
Lower back pain treatment depends on what is causing the pain, how severe the pain is and the medical history of the patient. Most cases of low back pain improve within a few weeks without surgical treatment. Lower back pain treatment usually includes:
- Rest: Giving the tissues a little time to rest and heal helps to alleviate low back pain. Stopping activity for more than a few days is not recommended, however, because extended periods of inactivity can lead to muscles weakness. Weakened muscles cannot support the spine adequately, and this will cause even more low back pain and increase the risk of further injury. People who don’t exercise on a regular basis to build endurance, flexibility and muscle strength are more likely to suffer from chronic low back pain.
- Non-prescription pain relievers: Acetaminophen is a pain medication that is available over-the-counter (OTC) that can help to reduce pain but it doesn’t reduce inflammation. OTC nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, aspirin, and naproxen may be better for low back pain because, in addition to relieving pain, they also reduce swelling around nerves that might be contributing to discomfort. These medications can cause bleeding, stomach upset and other side effects in some people, so check with your healthcare provider before using any medications.
- Prescription medications: If OTC medications aren’t effective in relieving your low back pain, your physician may prescribe muscle relaxants to help control muscle spasms, or antidepressants or anti-seizure medications which have been shown to be effective for some types of pain. If your low back pain is extremely severe, you may be given a prescription for narcotics, but these can be addictive and have severe side effects so these are only given for a very short time.
- Hot and cold therapies: Heat can help relieve low back pain by increasing the flow of blood to the area, bringing more oxygen and nutrients to the tissues. Cold helps to reduce swelling and provides relief in some cases by constricting blood vessels. Some people find alternating applications of cold and heat to be effective for low back pain.
- Sleep: It is beneficial to sleep in a position that is therapeutic for your low back. Try to avoid sleeping on your stomach. If you lie on your side to sleep, place a small pillow between your knees. If you lie on your back, maintain the natural curvature of your lower spine by placing a pillow or a rolled blanket under your knees.
- Relax: Getting rid of tension in your muscles is crucial in relieving low back pain. Try deep breathing exercises, meditation, journaling or other activities you find relaxing to relieve muscle tension.
- Get moving: As soon as you can, start moving. Staying in bed, being inactive and lying on the sofa is not good for your mood or your back. It may be difficult to think about moving when you have low back pain, but the longer you are inactive, the harder it will be to get up and going. Try to go for a short walk, and then tomorrow, go a little farther. Activity can help keep your mind off your pain.
- Prevention is essential: Try to eliminate the cause of your low back pain. Some common causes of lower back pain are stress, poor posture and being overweight. See what steps you can take to address these issues and keep your back healthy, strong and pain-free.
Chronic 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 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.
There are many ways to prevent lower back pain. Learning prevention techniques can also help lessen the extent of your symptoms if a lower back injury should occur. Prevention management as lower back pain treatment includes:
- Strengthening your abdominal and back muscles
- Reducing stress on your lower back by controlling your weight
- Practicing safe lifting and carrying techniques: Lift objects correctly by keeping your back straight, bending your knees and lifting with your legs.
- Maintaining good posture when you’re sitting and when standing
- Sleeping on a supportive surface
- Sitting on chairs that are supportive and allow your feet to rest flat on the floor
- Avoiding wearing shoes with high heels
- Trying to stop smoking: nicotine impairs blood flow and also leads to disc degeneration.
- 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.
- 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.
- 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.
- 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.
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