If you suffer from low back pain you are not alone. It is estimated, at any given time approximately 15% of all Americans have recurrent low back pain. By definition acute low back pain is severe, sudden in onset and short term. Chronic low back pain lasts longer than six months. Low back pain can be disabling, by not allowing sufferers to sleep, enjoy recreational activities, to take care of the household or go to work.
Diagnosis
About 90% of all low back pain is because of poor body mechanics. This may contribute to or be a result of arthritis, muscle tears or ligament strains. However, 10% of the time low back pain may indicate a serious underlying medical problem such as an infection or severe inflammatory arthritis. The most important factor in determining the diagnosis is the history and physical. Low back pain coming from a problem with the lumbar spine tends to be sudden in onset, worse during the day when we are weight bearing and relieved when we lay down. The serious medical causes of low back pain tend to be more gradual in onset, develop slowly and are usually worse during the night.
Ninety percent of the time back pain will go away on its own with education, mild pain relievers and a little bit of rest. When back pain is severe and chronic, the diagnostic tests are not always revealing. We are not always sure why the back is hurting despite the use of today’s best technology.
There are four structures in the back that cause pain: nerves, muscles, ligaments and joints. The Pain Management Center uses diagnostic injections to determine the cause of pain. When the physician does an injection, the following may occur: 1.) The patient may get good long-term relief, in which case the problem is identified and solved. 2.) The patient may get short-term relief, in which case a diagnosis is made. 3.) The patient may receive no relief, in which case the next structure is injected. Up to four injections are made into the different structures until a diagnosis can be determined.
Treatment
Is determined by the duration of the back pain and the diagnosis.
- Acute: In the event of acute onset of low back pain, the best therapy is rest for 48 hours
- Onset: along with anti-inflammatory medicine such as Motrin. It is important to note
lying or sleeping position and to take pressure off the stained back muscles. Lumbar pillows are beneficial and help keep the back in neutral alignment, thereby relieving pressure. After the 48-hour period, gradually resume normal activities. Some residual discomfort may persist, but should subside. Oral medications should only be used for short periods as they can lead to high blood pressure, kidney or liver problems and ulcers in the stomach or small intestine. Usually within four weeks 90% of patients with low back pain will improve to the point where they have minimal or no discomfort. Proper posture and strength training can help reduce further incidence. - Persistent Discomfort: If you have persistent discomfort, see your doctor. He/She may initiate an examination or diagnostic tests to rule out a medical cause for low back pain.
- Chronic: The pain doctor may inject one of the four structures to determine a diagnosis.
Physical therapy may be used concurrently or as a follow-up to help reduce or prevent further pain. Physical therapy focuses on body alignment, mechanics and awareness, as well as flexibility and exercise.
Oral medications should only be used for short periods as they can lead to high blood pressure, kidney or liver problems and ulcers in the stomach or small intestine.
It is important to note lying or sleeping position in order to take pressure off the strained back muscles. Lumbar pillows are beneficial and help keep the back in neutral alignment, thereby relieving pressure.
Prevention
- Note sleep posture
- Consider a lumbar support pillow
- Maintain an ideal body weight
- Maintain proper posture for all daily activities (e.g.) walking, sitting or driving
- Do proper strength training
- Do proper flexibility training
- Avoid smoking
- Reduce stress
