Learn More About Back Pain
With back pain, it's not a question of "if," it's more a question of "when." Around eight out of every ten people will experience back pain at some point in their lives. Some of this pain is sharp and abrupt while other times, the pain is a dull and persistent ache. Some back pain only shows up during specific movements or sitting in certain positions. Other times, it will be constant, and no position will provide relief.
In most cases, back pain goes away on its own, if given sufficient time. Dulling pain with appropriate use of over-the-counter analgesics and resting can provide relief. However, when you rest for more than a day or two, it can make back pain worse. Doctors now know that it is important to keep as close to your normal routine when you are suffering from back pain. Move around a little bit every hour, using slow and gentle motions. By keeping moderately active, you can avoid the stiffness that can lead to long-term back issues.
Lower back pain is the most common form. However, some individuals will develop mid or upper back pain. Pain in these areas is usually not normal and may be a sign of a more serious issue. It is not necessary to just suffer through the pain. With the right diagnosis and treatment, you can find relief and get back to your normal, active life.
Who Is at Risk for Back Pain?
Nearly everyone will experience some form of back pain at some point. Usually, it starts during the era when you are working age. However, some people experience back pain much earlier in life, at ages as young as eight and 10. Both men and women are affected by back pain in roughly equal numbers.
While anyone can develop back pain, some factors that can dramatically increase your risk. You are much more likely to develop back pain if any of the following is true:
- You're getting older. The older you are, the more likely you are to develop back pain. Most people experience it first when they are in their 30s and 40s.
- You are overweight or obese. Excess weight can put pressure on the structures in and around your spine, making back pain more likely.
- You are in poor physical condition. If you lack strength and flexibility, your back is more likely to be injured. Balance is also a considerable factor since poor balance makes falls more likely.
- You smoke. Smokers' bodies are less able to absorb the nutrients needed for healthy bones and tissue. Disc pain can be a result. Plus, smoker's cough is a very common trigger for back pain. When an injury does occur, a smoker's body heals more slowly, meaning that back pain lasts longer.
- You are African American. Black women are two to three times as likely as white women to have issues with discs in their lower back.
- You have a job that puts a strain on your back. If you spend all of your time seated, poor posture can lead to back pain over time. Back injuries are more common at jobs where you are repeatedly lifting, pushing or twisting throughout the day. Learning proper body mechanics from a physical therapist can make back pain less likely.
Preventing Back Pain
Back pain is divided into two types: acute pain, which is the pain of a sudden injury like a fall and chronic pain, which lasts three months or more, with chronic pain being the less common type of pain. Most back pain resolves within around six weeks.
To keep your back healthy, strong and pain-free, incorporate these tips into your daily life:
Work on strength and flexibility.
These two characteristics are the most likely to keep you from injuring yourself and experiencing back pain. Experts recommend a combination of back and abdominal exercises to strengthen your core. These exercises help your muscles work together to keep your center stronger; think of them as a natural back brace or corset. Flexibility can increase your range of motion and improve how your back feels. Talk to your physical therapist or your doctor about the best set of moves for you.
Make time for cardio.
Low impact aerobic exercise should be performed on a regular basis to keep yourself fit. These exercises help build endurance so that your posture and movements are healthier. They also increase blood flow to keep muscles and other tissues oxygenated. Swimming and walking are both great choices.
Maintain a healthy weight for your height.
The closer you are to your ideal weight, the less excess pressure you are putting on joints, ligaments, and bones.
Learn proper body mechanics.
Often, we injure ourselves because we are moving incorrectly or using poor posture. Maintaining good mechanics can make injury less likely.
When you are sitting, choose a seat and a position that does not put excess strain on your back. The right seat is one with good lower back support, a swivel base, and armrest. You may want to buy a pillow or support to keep your spine in its normal curved position. Knees and hips should be level when you are seated. Get up every so often and walk around.
If you need to stand often, make sure that you are standing in ways that are not harming your back. Whenever possible, use floor cushioning to reduce impact. Standing with one foot on a low stool can help reduce the pressure on your lower back. Alternate from one foot to the other.
Lifting is one of the activities that are most responsible for acute back injuries. Never lift something that is too heavy for you to manage on your own. When you lift, always keep your back straight. Take the weight in your legs and do not twist or bend your back.
Most Common Back Pain Causes
Many things can lead to back pain. Sometimes a sudden move or fall is responsible for a sharp and immediate pain. Sometimes you just wake up with a back that is sore and stiff. Much of the back pain we see does not seem to have any direct and identifiable cause. However, with testing, we can determine what factors in your back are causing pain. In most cases, it comes down to the ways that your bones, muscles, tendons, ligaments, and discs all work together.
There are conditions that will cause similar types of pain despite different causes. Some of the most common back pain causes include:
Strains and sprains
A strain is an injury to a muscle that is caused by overextension. Sprains are overextensions of ligaments. Together, these factors make up the most common back injuries. They are far more likely when you are out of shape. A strain may be felt as ongoing back spasms.
Arthritis can strike anywhere in the body, but the lower back is one of the most common targets. Rheumatoid arthritis is caused by an autoimmune disorder and can affect any area. Osteoarthritis is the result of chronic wear and tear on joints. When it occurs in the spine, it is called facet syndrome and can affect the lumbar, thoracic or cervical regions. Over time, spinal arthritis can cause a narrowing of the channel around the spinal cord. This painful condition is known as spinal stenosis.
In between each of the bones in your spine are rubbery discs that cushion any impacts. Sometimes, these discs can bulge or even rupture, which puts pressure on nearby nerves. While the name is a misnomer, this condition is sometimes called a "slipped disc." The result is frequently back pain. In some cases, you can have a ruptured or bulging disc without pain. These are often caught during an x-ray for an unrelated reason.
As we age, our bones are more likely to become brittle and porous. When they weaken, this can lead to painful compression fractures.
Scoliosis and other skeletal issues
If there are issues with the curvature of your spine, back pain can be the result. Testing can reveal whether the issue is scoliosis that is putting your back out of alignment.
Sacroiliac joint dysfunction
The sacroiliac (SI) joints connect your spine and your hips. These joints are large and mobile, which makes them very vulnerable to issues.
Anyone who has suffered from sciatica is familiar with the shooting pain, numbness, tingling, and weakness. This condition occurs when there is pressure on the large nerves that run down the back of each leg.
Ways to Find Relief from Back Pain
Not all back pain requires medical care. Often, it will resolve itself on its own over time. Employing the methods below can reduce the severity of your back pain and its duration. With the guidance of your doctor, you can also use these back pain relief techniques along with medical treatment.
Heat and cold therapy
In the time immediately after an injury, cold can be the best remedy. Using ice packs on a painful area for 15 minutes at a time two to three times a day can reduce swelling and pain. Do not apply ice directly to your skin, as this can cause skin irritation or damage.
Heat can help increase blood flow and relax muscles. A hot pain, a heating pad or a hot water bottle can all be effective.
Engage in relaxation techniques
Muscle tension can exacerbate back pain. Using meditation, visualization and other relaxation techniques can help. Studies show that people who are able to stay positive and lower their stress levels feel less pain and recover faster after an injury.
Improve your sleep position
Sometimes the way that we sleep has an impact on our backs. People who sleep on their backs should place a pillow under their knees to maintain their back's normal curvature. When sleeping on your side, draw your legs up toward your chest and place a pillow between them for proper alignment.
Keep moving during recovery
Total rest can prolong back pain instead of helping you heal. Doctors recommend trying to move around as soon as possible after an injury and keeping moving a least a few times a day. It's normal to feel some discomfort, but you should take it easy if you experience a lot of pain. Gentle stretching before activity can help keep muscles from tensing up. Avoid heavy lifting or movements that require extreme exertion until your back is feeling better.
Back Pain Treatments
The right treatment for your back pain will depend on the degree of injury and how long your pain lasts. Back pain treatment usually starts conservative and will employ more varied approaches if these methods do not provide adequate relief.
The first two things to do while you are waiting for back pain to abate is to move around and try an over-the-counter pain medication. NSAIDs or acetaminophen can provide relief.
When someone is suffering from chronic back pain, we will first try non-surgical or minimally invasive treatments before exploring the possibility of surgical treatment.The first line of nonsurgical back pain treatment involves heat and cold therapy paired with exercise. Our physical therapist can teach you exercises that will help relieve back pain.
There is a range of both over the counter and prescription medications that can help ease back pain. Pain relievers can be taken by mouth or applied directly to the skin for targeted relief. Muscle relaxants and antidepressants can be effective if you are suffering from painful spasms that cause chronic back pain. Your doctor may also recommend steroids or numbing shots to reduce back pain.
Traction is another option for severe back pain. This treatment uses pulleys and weights to stretch the back and relieve pressure, allowing it to move back into natural alignment. Many people experience relief while in traction, but find that pain returns between treatments until they heal.
Alternative and Complementary Therapies
Acupuncture, chiropractic manipulations and transcutaneous electrical nerve stimulation (TENS) can all be used alone or with other therapies to relieve back pain. During spinal manipulations, the doctor will apply pressure to the spine to bring it back into alignment. Acupuncture involves the insertion of needles to interrupt pain signals. TENS units use mild electrical pulses to stimulate nerves and interfere with pain. Many patients find these helpful for augmenting other treatments.
When these non-invasive treatments have been exhausted or when back pain is from a source that cannot be treated with those above, there are minimally invasive treatments that are the next line of offense against back pain.
Medial Branch Diagnostic Blocks
These treatments, which can be performed in the lumbar, thoracic or cervical regions of the spine, involve small injections to identify the source of back pain. Using x-ray guidance, your doctor will inject a pain reliever directly into a nerve by your spine. If you experience relief, you have found the nerve that is causing pain. After this, a therapeutic dose of medication may be ordered. More than eight out of every ten patients who receive therapeutic medial branch blocks report pain improvement two years after their treatments.
Epidural Steroid Injections
This treatment combines steroids with pain-relieving medication. These work together to relieve inflammation, aid healing and provide long-term pain relief. This treatment is often used in the treatment of spinal stenosis, bulging or herniated discs, degenerative this problems and other issues that cause chronic back pain.
Sacroiliac Joint Injections
Similar to the epidural injections above, this treatment involves injecting steroids and/or painkillers into the SI joints. It is used for SI joint dysfunction treatment and in the treatment of sciatica. If your SI joint injection is used for diagnosing your condition, you will be asked to move in ways that typically cause you pain. Therapeutic injections may be employed for long-lasting relief.
Spinal Cord Stimulation
Also called neuromodulation, spinal cord stimulation (SCS) interrupts the pain signals and keeps them from traveling from your nerves to your brain. SCS involves implanting a small device that sends electrical signals. When the device is in use, it will produce a small current. The current will often be felt as a mild tingling sensation. Many people find this an effective option when other pain treatments fail.
Medial Branch Neurotomy
In some people who are suffering from facet joint syndrome, there is painful compression of the medial branch nerves. This treatment destroys the nerves that carry pain signals to the brain without disturbing the nerves that are responsible for normal sensation and movement. Multiple procedures may be necessary to see full relief. After treatment is completed, most people report a dramatic improvement in their pain levels.
Stellate Ganglion Block
The stellate ganglion nerves are located in your neck on either side of your voice box. When you are experiencing pain in your neck, head, upper arms or chest, an injection to block the nerves there can help. This treatment is also effective against pain from complex regional pain syndrome, shingles, phantom limb pain and other chronic pain conditions. Treatment can provide relief for several weeks or months.
Ultrasound Guided Injections
This relatively novel treatment has been found to provide more targeted and effective relief than blind injections. When ultrasound is used, healthcare providers can be more precise so that medication goes exactly where it is needed. It is an effective treatment for tendonitis, arthritis and other painful conditions. It can also be used for removing fluid from an area. These treatments can be administered in the back, neck, hips and other areas to manage back pain.
When to See PRM
While most back pain resolves on its own, there are times a doctor's care is needed. Get in touch for advice and help if any of the following is true:
- You are experiencing back pain that lasts more than six weeks.
- You have pain that is not managed through appropriate use of over the counter medications.
- You have developed numbness or weakness in your foot, leg or buttocks.
If you lose control of your bowels or bladder, it is important to seek emergency medical care. This can be a symptom of a serious medical condition called cauda equina syndrome. Without immediate treatment, paralysis can result.
Performance & Regenerative Medicine is here to help with conditions that include:
- herniated and bulging discs or degenerative disc disorders.
- facet syndrome
- SI joint dysfunction
and other back pain problems.
Request a Consultation
Dr. Mike Harris and his staff have years of experience in pain management. We are dedicated to finding the source of our patients' pain and helping them find a program that provides lasting relief and healing.
Are you experiencing unexplained or lingering pain? We believe that you do not have to suffer. Pain is a symptom that shouldn't be lived with or ignored. Finding the right diagnosis is the first step toward relief. Get in touch today for a consultation.