Back pain
Definition :
Back pain is a common complaint. Most people in the United States will experience low back pain at least once during their lives. Back pain is one of the most common reasons people go to the doctor or miss work.
On the bright side, you can take measures to prevent or lessen most back pain episodes. If prevention fails, simple home treatment and proper body mechanics will often heal your back within a few weeks and keep it functional for the long haul. Surgery is rarely needed to treat back pain.
Symptoms:
Symptoms of back pain may include:
Most back pain gradually improves with home treatment and self-care. Although the pain may take several weeks to disappear completely, you should notice some improvement within the first 72 hours of self-care. If not, see your doctor.
In rare cases, back pain can signal a serious medical problem. Seek immediate care if your back pain:
Causes:
Back pain often develops without a specific cause that your doctor can identify with a test or imaging study. Conditions commonly linked to back pain include:
Treatments and drugs:
Most back pain gets better with a few weeks of home treatment and careful attention. Over-the-counter pain relievers may be all that you need to improve your pain. A short period of bed rest is OK, but more than a couple of days actually does more harm than good. Continue your daily activities as much as you can tolerate. Light activity, such as walking and daily activities of living, is usually OK. But, if an activity increases your pain, stop doing that activity. If home treatments aren't working after several weeks, your doctor may suggest stronger medications or other therapies.
Medications
Your doctor is likely to recommend pain relievers such as acetaminophen (Tylenol, others) or nonsteroidal anti-inflammatory drugs, such as ibuprofen (Advil, Motrin, others) or naproxen (Aleve). Both types of medications are effective at relieving back pain. Take these medications as directed by your doctor, because overuse can cause serious side effects. If mild to moderate back pain doesn't get better with over-the-counter pain relievers, your doctor may also prescribe a muscle relaxant. Muscle relaxants can cause dizziness and may make you very sleepy.
Narcotics, such as codeine or hydrocodone, may be used for a short period of time with close supervision by your doctor.
Low doses of certain types of antidepressants — particularly tricyclic antidepressants, such as amitriptyline — have been shown to relieve chronic back pain, independent of their effect on depression.
Education
Right now, there's no commonly accepted program to teach people with back pain how to manage the condition effectively. That means education may be a class, a talk with your doctor, written material or a video. What's important is that education emphasizes the importance of staying active, reducing stress and worry, and teaching ways to avoid future injury. However, it's also important for your doctor to explain that your back pain may recur, especially during the first year after the initial episode, but that the same self-care measures will be able to help again.
Physical therapy and exercise
Physical therapy is the cornerstone of back pain treatment. A physical therapist can apply a variety of treatments, such as heat, ultrasound, electrical stimulation and muscle-release techniques, to your back muscles and soft tissues to reduce pain. As pain improves, the therapist can teach you specific exercises that may help increase your flexibility, strengthen your back and abdominal muscles, and improve your posture. Regular use of these techniques can help prevent pain from returning.
Injections
If other measures don't relieve your pain and if your pain radiates down your leg, your doctor may inject cortisone — an anti-inflammatory medication — into the space around your spinal cord (epidural space). A cortisone injection helps decrease inflammation around the nerve roots, but the pain relief usually lasts less than a few months.
In some cases, your doctor may inject numbing medication and cortisone into or near the structures believed to be causing your back pain, such as the facet joints of the vertebrae. Located on the sides, top and bottom of each vertebra, these joints connect the vertebrae to one another and stabilize the spine while still allowing flexibility.
Surgery
Few people ever need surgery for back pain. If you have unrelenting pain associated with radiating leg pain or progressive muscle weakness caused by nerve compression, you may benefit from surgical intervention. Otherwise, surgery usually is reserved for pain related to structural anatomical problems that haven't responded to intensive conservative therapy measures.
Definition :
Back pain is a common complaint. Most people in the United States will experience low back pain at least once during their lives. Back pain is one of the most common reasons people go to the doctor or miss work.
On the bright side, you can take measures to prevent or lessen most back pain episodes. If prevention fails, simple home treatment and proper body mechanics will often heal your back within a few weeks and keep it functional for the long haul. Surgery is rarely needed to treat back pain.
Symptoms:
Symptoms of back pain may include:
- Muscle ache
- Shooting or stabbing pain
- Pain that radiates down your leg
- Limited flexibility or range of motion of the back
- Inability to stand up straight
Most back pain gradually improves with home treatment and self-care. Although the pain may take several weeks to disappear completely, you should notice some improvement within the first 72 hours of self-care. If not, see your doctor.
In rare cases, back pain can signal a serious medical problem. Seek immediate care if your back pain:
- Causes new bowel or bladder problems
- Is associated with pain or throbbing (pulsation) in the abdomen, or fever
- Follows a fall, blow to your back or other injury
- Is constant or intense, especially at night or when you lie down
- Spreads down one or both legs, especially if the pain extends below the knee
- Causes weakness, numbness or tingling in one or both legs
- Is accompanied by unexplained weight loss
- Occurs with swelling or redness on your back
Causes:
Back pain often develops without a specific cause that your doctor can identify with a test or imaging study. Conditions commonly linked to back pain include:
- Muscle or ligament strain. Repeated heavy lifting
or a sudden awkward movement may strain back muscles and spinal
ligaments. If you're in poor physical condition, constant strain on your
back may cause painful muscle spasms.
- Bulging or ruptured disks. Disks act as cushions
between the individual bones (vertebrae) in your spine. Sometimes, the
soft material inside a disk may bulge out of place or rupture and press
on a nerve. The presence of a bulging or ruptured disk on an X-ray
doesn't automatically equal back pain, though. Disk disease is often
found incidentally; many people who don't have back pain turn out to
have bulging or ruptured disks when they undergo spine X-rays for some
other reason.
- Arthritis. Osteoarthritis can affect the lower
back. In some cases, arthritis in the spine can lead to a narrowing of
the space around the spinal cord, a condition called spinal stenosis.
- Skeletal irregularities. Back pain can occur if
your spine curves in an abnormal way. Scoliosis, a condition in which
your spine curves to the side, also may lead to back pain, but generally
only if the scoliosis is quite severe.
- Osteoporosis. Compression fractures of your spine's vertebrae can occur if your bones become porous and brittle.
Treatments and drugs:
Most back pain gets better with a few weeks of home treatment and careful attention. Over-the-counter pain relievers may be all that you need to improve your pain. A short period of bed rest is OK, but more than a couple of days actually does more harm than good. Continue your daily activities as much as you can tolerate. Light activity, such as walking and daily activities of living, is usually OK. But, if an activity increases your pain, stop doing that activity. If home treatments aren't working after several weeks, your doctor may suggest stronger medications or other therapies.
Medications
Your doctor is likely to recommend pain relievers such as acetaminophen (Tylenol, others) or nonsteroidal anti-inflammatory drugs, such as ibuprofen (Advil, Motrin, others) or naproxen (Aleve). Both types of medications are effective at relieving back pain. Take these medications as directed by your doctor, because overuse can cause serious side effects. If mild to moderate back pain doesn't get better with over-the-counter pain relievers, your doctor may also prescribe a muscle relaxant. Muscle relaxants can cause dizziness and may make you very sleepy.
Narcotics, such as codeine or hydrocodone, may be used for a short period of time with close supervision by your doctor.
Low doses of certain types of antidepressants — particularly tricyclic antidepressants, such as amitriptyline — have been shown to relieve chronic back pain, independent of their effect on depression.
Education
Right now, there's no commonly accepted program to teach people with back pain how to manage the condition effectively. That means education may be a class, a talk with your doctor, written material or a video. What's important is that education emphasizes the importance of staying active, reducing stress and worry, and teaching ways to avoid future injury. However, it's also important for your doctor to explain that your back pain may recur, especially during the first year after the initial episode, but that the same self-care measures will be able to help again.
Physical therapy and exercise
Physical therapy is the cornerstone of back pain treatment. A physical therapist can apply a variety of treatments, such as heat, ultrasound, electrical stimulation and muscle-release techniques, to your back muscles and soft tissues to reduce pain. As pain improves, the therapist can teach you specific exercises that may help increase your flexibility, strengthen your back and abdominal muscles, and improve your posture. Regular use of these techniques can help prevent pain from returning.
Injections
If other measures don't relieve your pain and if your pain radiates down your leg, your doctor may inject cortisone — an anti-inflammatory medication — into the space around your spinal cord (epidural space). A cortisone injection helps decrease inflammation around the nerve roots, but the pain relief usually lasts less than a few months.
In some cases, your doctor may inject numbing medication and cortisone into or near the structures believed to be causing your back pain, such as the facet joints of the vertebrae. Located on the sides, top and bottom of each vertebra, these joints connect the vertebrae to one another and stabilize the spine while still allowing flexibility.
Surgery
Few people ever need surgery for back pain. If you have unrelenting pain associated with radiating leg pain or progressive muscle weakness caused by nerve compression, you may benefit from surgical intervention. Otherwise, surgery usually is reserved for pain related to structural anatomical problems that haven't responded to intensive conservative therapy measures.
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