How to Handle Low Back Pain
According to the American Chiropractic Association (ACA), more than 31 million Americans experience low back pain every year. The Centers for Disease Control and Prevention (CDC) reports that it causes more global disability than any other condition. In one study, it was the most common type of pain reported by patients, with 25 percent of U.S. adults reporting low back pain in the prior three months.
Because low back pain affects so many of our patients, our primary care doctors in Delray Beach want to explain the various causes and let you know about the many alternatives to opioid drugs and surgery.
Different causes of low back pain
Acute back pain lasts less than four weeks. Subacute back pain lasts four to 12 weeks. Chronic back pain lasts longer than 12 weeks.
Because low back issues can stem from so many different causes, they can be difficult to treat. Some of the most common causes of low back discomfort include:
- Muscle and ligament strain—a sudden movement or repeated heavy lifting can strain muscles and ligaments, triggering back spasms
- Pain in the sacroiliac—chronic wear on the joints where the pelvis and lower spine connect can result in inflammation, leading to pain in the buttocks or back of the thigh
- Degenerative arthritis of the spine—gradual thinning of the cartilage inside the spine due to aging or chronic wear
- Spinal stenosis—narrowing of the spinal canal may result in nerve pain anywhere along the spine
- Skeletal irregularity—any type of defect (e.g., abnormal curves or abnormal bone size) can result in back issues
- Myofascial pain syndrome—unexplained muscle tenderness
There are many other possible causes of low backaches, including infection, spinal compression fractures, and tumors, which is why it’s important to see us for a diagnosis.
The CDC reports that opioids are often prescribed to treat low back issues, despite an overall lack of evidence to support its efficacy. They can lead to addiction and often don’t even work very well.
Still, patients continue to request opioids. This is because acute and chronic back pain can be excruciating at times and interfere with normal life activities.
Extended bed rest is another treatment that can cause more harm than good. We know it can be agony to try to move about when the pain is acute, but lack of movement can weaken the back muscles and ultimately make it much worse.
So what can help?
Spine specialists at the Cleveland Clinic and Johns Hopkins recommend the following:
- physical therapy tailored to your specific symptoms and conditions, including retraining your posture, stretching and flexibility exercises, and core strengthening
- acupuncture, massage, biofeedback, laser therapy, and electrical nerve stimulation for pain relief
- progressive relaxation to release tension throughout the body, including the painful area
- yoga and tai chi to improve function, endurance, and posture, which can relieve current pain and prevent a recurrence
- mindfulness, meditation, cognitive-behavioral therapy (CBT), and stress management techniques to help take your mind off the soreness
- diet modification to eliminate such highly inflammatory foods as trans fats, refined sugars, and processed foods, as well as lowering weight to relieve pressure on the spine, muscles, and ligaments
- exercise, especially the type that focuses on strengthening the core to reduce the likelihood of recurrence
Other possibilities to relieve long-term back trouble include such treatments as muscle relaxants, steroid injections, pain relievers, and even surgery when warranted.
But most specialists advise non-drug or noninvasive approaches first.
“Cleveland Clinic spine specialists favor the active, rather than the passive, therapies recommended,” Dr. E. Kano Mayer, says. “We prefer that you do things actively to control pain and improve function, rather than waiting for things to be done to you.”
When to see us
As we noted above, some lower back issues can indicate a serious problem. So please let us know if you’re experiencing low back discomfort along with any of the following:
- changes in bladder or bowel function
- leg weakness
- numbness or tingling that spreads down the legs
Sudden onset of back pain that becomes worse with standing or walking and is partially relieved when lying on the back, especially if it’s accompanied by loss of height, could signal a compression fracture. It’s especially important to have your pain evaluated if you experience these symptoms.
Also, see us if your low back pain is especially severe or doesn’t improve in a few days.