Back Pain Treatment
Back pain is extremely common in society and can range from mid back pain all the way down to lower back pain. Back pain can also range from a dull, constant ache to a sudden, sharp pain that makes it hard for patients to move. Pain can start on its own or it could be a result of lifting something too heavy and it can continue to get worse.
What Causes Back Pain?
Some genetic and environmental factors that can lead to back pain include:
- Poor physical fitness – Patients who are in poor physical shape tend to have a higher chance of back pain.
- Obesity – If a patient is overweight or tends to be in poor physical health, they may be at a higher risk of back pain.
- Heredity -With certain conditions, back pain, unfortunately, tends to be hereditary, though not for all causes.
- Smoking – Tobacco use degenerates the intervertebral discs, which can be a cause of back pain. Smoking slows down healing, leading to a greater chance that back pain can become chronic.
- Occupation – Jobs that involve heavy lifting, bending or twisting have a higher chance of leading to back pain for the employees.
Types of Lower Back Pain
Over 80 percent of the population will suffer from lower back pain during their lives. The lower back consists of the lumbar spine, vertebrae numbers L1 through L5. The construction is complex; the loads this area of the spine supports are large. The area is ripe for injury.
The type of onset and the duration of the pain usually describe back pain.
- Acute pain — This type of pain comes on suddenly (for instance, when you lift something incorrectly) and lasts for a few days or weeks. The pain gradually subsides as the body heals.
- Subacute pain — This type of pain is still usually from mechanical causes (i.e. a muscle strain or joint pain), but it is prolonged, lasting from 6 weeks to 3 months.
- Chronic back pain — This is lower back pain that lasts over 3 months. This type of pain is usually severe, doesn’t respond to initial treatments, and needs medical intervention to locate the exact source of the pain.
Lower back pain can also be categorized into two main types:
- Mechanical pain — The most common cause of lower back pain is mechanical pain. The muscles, ligaments, joints, or bones in and around the spine are to blame. This type of pain tends to be localized in the lower back, the buttocks, and sometimes the top of the legs.
- Radicular pain — This type of pain usually results when a spinal nerve root is compressed or otherwise inflamed. This pain may follow the nerve, radiating down into the buttock and/or leg. The pain is sharp and burning. It can be accompanied by numbness and weakness. It occurs typically on only one side of the body.
What Are the Symptoms of Lower Back Pain?
Lower back pain often starts as acute pain in reaction to an injury. This pain can become chronic if the initial acute pain is not managed. While pain is the obvious symptom, the types and areas described will be helpful in diagnosing the exact cause/origin.
There are typical symptoms, which may be a combination of the following varying types of pain:
- Dull, aching pain. This kind of pain usually remains localized in the low back. It isn’t sharp or burning. It may include muscle spasms and mobility may be limited.
- Radiating pain. Also called sciatica, this pain moves down the thighs and into the low legs and feet, usually on one side only. It is caused when the sciatic nerve is irritated.
- Pain that worsens with sitting. After sitting, this kind of pain can make it difficult to simply rise and stand up. Sitting puts pressure on the discs, which makes the pain worse. Walking can alleviate the symptoms, only to have them return after sitting.
- Pain that lessens with changing positions. This pain will show itself in certain positions, but will feel better in others. If you have compression and spinal stenosis, walking will be painful, but leaning on something could make the pain subside.
- Pain that is worse when first waking, but lessens. Low back pain is worst in the morning for many people. It decreases after the person gets up and moves about. This is because the long periods of rest, decreased blood flow during sleep, and the positions or pillows/mattress involved with sleep.
How Do You Diagnose Lower Back Pain?
At DFW Center for Spinal Disorders, any diagnosis starts with the patient’s medical history. From there, we’ll begin with questions about your current symptoms, your activity level, your sleep habits, your posture, and any recent injuries you may have had. This could even have been a past injury that you didn’t associate with your current pain. This history and your answers to these questions can be the most important tool in our diagnosis.
Next is a physical exam. This will include:
- Palpation. We’ll feel the lower back for areas of tenderness, joint abnormalities, muscle spasms, or areas that are abnormally tight.
- Neurologic exam. A motor exam will check movement of your hips, knees, and feet. We’ll have you flex your toes, ankles, and lower legs. We may test sensory responses to touch, a pin prick, or other stimuli to the lower trunk, buttocks, and legs.
- Range of motion. You’ll be asked to bend or twist in certain positions. We’ll look to see which positions create or worsen pain.
- Reflexes. We’ll check the reflexes of your legs. If they are weakened or you have decreased muscle strength, you could have nerve root compression.
- Leg raise. When lying on your back, you’ll be asked to raise one leg as high as possible, keeping it as straight as you can. If this creates low back pain, a herniated disc can be the cause.
Imaging tests may be necessary if the patient’s pain is severe, hasn’t resolved or lessened within 2-3 months, or is not responding to conservative treatments. We may know exactly what is causing your pain, but not exactly where the problem is originating. Imaging tests can give us this piece of the puzzle.
These are imaging tests we could request:
- X-rays show abnormalities in the spine, such as fractures, arthritis, bone spurs, or tumors.
- Computer tomography (CT) scans provide a cross-section of the spine. X-rays are used to create a 3D image of the spine, allowing viewing from different angles. Dye may be injected around nerve roots to highlight spinal structures.
- Magnetic resonance imaging (MRI) provides a detailed image without the radiation of x-rays. MRIs are effective for detecting abnormalities with soft tissues.
- Injection studies can be used to confirm the sources of pain. Local anesthetic or steroid medications are injected into specific areas to calm the pain, verifying the point of origin.
Back Pain Management Techniques
Back pain can be managed with anti-inflammatories, core building exercises and expectant management including avoiding heavy bending, lifting, and twisting. Typically, back pain lasts for 1-2 weeks or sometimes up to 6 to 12 weeks. If you are a patient experiencing severe pain, it is highly recommended to schedule a consultation at DFW Center for Spinal Disorders to discuss treatment options.
Signs It’s Time To See A Spine Specialist
We recommend seeking the assistance of a medical professional or spinal specialist when the pain fails to improve with light activities for a few days, or is associated with the following:
- Weakness in your legs
- Changes in your bowel/bladder
- Unintentional weight loss
Back Pain Treatment
Once we assess a patient, the doctor will treat them in the best manner that fits their specific issue. While surgery is sometimes a necessity, most of our patients do well with medication and/or a referral to physical therapy. Click Here for more back pain treatment options.
Patients with significant back pain that is causing pressure on either the nerve roots or the spinal canal may be suffering from spinal stenosis. In this case, we may recommend undergoing a series of epidural injections in which a licensed medical provider places steroid medications near the area where the nerves are compressed or irritated.
Another possible treatment for back pain is spinal decompression therapy. Spinal decompression therapy involves stretching the spine, using a traction table or similar motorized device to help relieve back pain. At DFW Center for Spinal Disorders, we offer patients decompressive spinal procedures such as laminectomy, discectomy, foraminotomy, among others.
When Is Back Surgery Necessary?
If the patients back pain has been present for 6-12 weeks and the use of anti-inflammatories and/or exercise does not help to reduce the pain, the doctor may suggest getting an MRI. From the results of the MRI, the doctor will be able to determine if the patient will require surgery.
Generally speaking, most back pain issues can be solved by non-surgical means. But, there may come a time when surgery becomes a necessity. Non-Surgical treatments may not always work for back pain management. Sometimes, patients are suffering from a compressed or pinched nerve, while others may be suffering from a herniated disc that presses on an adjacent nerve. In either of those cases, getting back surgery may be the best option to relieve the pain.
How Can I Prevent a Back Injury?
To avoid a back injury or cause a new injury to occur, we advise:
- A healthy diet
- Minimizing stress
- Regular exercise
- Avoiding heavy lifting, bending and twisting