Lower Back Pain
Lower back pain can range from annoying to disabling. Anyone who has woken in the morning, groaned to a halt halfway out of bed, and wondered how they will make it through the day knows how immobilizing severe lower back pain can be. It can be a dull constant ache or a sudden, shooting sharp pain. It can limit your mobility and make certain postures or positions painful. Sprain or strain is usually the cause.
Swelling and stiffness generally accompany lower back pain; all these combine to seriously interfere with your ability to move as normal and affect your overall quality of life. In fact, back pain can be so severe that people often suspect they’ve broken something. The good news is that in most cases this isn’t true.
Not every episode of lower back pain is a sprain or strain. If back pain is acute, persistent, or worsens, contact the Ainsworth Institute of Pain Management for an appointment. The staff can offer you state-of-the-art treatment options not available anywhere else in New York.
Lower Back Pain Basics
If you suffer from lower back pain you are certainly not alone. Nine out of 10 American adults will experience back pain in their lives, making it the 5th most common cause for visits to the doctor. Generally speaking, back pain is due either to traumatic injury or the normal wear and tear of age.
Low back pain is the most prevalent back pain complaint. Although spinal stenosis, a herniated disc, or other conditions may cause low back pain, sprain or strain is the most common diagnosis.
A common cause of a sprain or strain is excessive physical demand on the spine’s ligaments or muscles. Although pain can be severe, and even temporarily disabling, most low back sprains and strains are easy to treat and do not require spine surgery.
The reason back pain is so prevalent has to do with the lower back’s function in your body. The lumbar spine begins about 6 inches under your shoulder blades where the spine curves toward the abdomen. It consists of the five largest and strongest vertebrae in your spinal column. The lumbar spine is your body’s primary weight-bearing structure. The large vertebral bodies and inward curve (lordosis) make it uniquely designed to carry and distribute stress during movement and at rest. Along with bearing most of your body weight, the lumbar also provides the most flexibility. This combination makes it particularly susceptible to injury due to the wear and tear that comes with age.
Sharp or stabbing pain
Pain with movement
Dull or aching sensation
Inability to stand up straight
A decreased range of motion
Inability to flex the back
If strain or sprain is the culprit, back pain is usually short lived, lasting for days or weeks. Chronic back pain, however, occurs when symptoms persist for more than three months. It is important to understand that although continuous chronic back pain may not be as painful as an acute episode, it might be an indication of a more serious spinal problem. In this sense the level of pain does not always “match up” with the degree of injury.
A spasm can be excruciating and incapacitating, whereas a herniated disc may only cause a moderate amount of pain. If you are experiencing persistent or worsening back pain, immediately consult with a physician who has expertise in the care of spinal problems. The following symptoms can be warning signs of more serious problems:
Back pain after injury, such as a fall
Sudden unrelenting or disabling back pain
Pain that travels into the arms and/or legs
Leg numbness, tingling sensations, weakness
Buttock and/or genital area numbness and/or tingling
Back pain accompanied by fever
Bowel or bladder dysfunction
Much like neck pain, back pain seems to have an endless series of potential causes. Work-related & motor vehicle accidents, slip & falls, sports, and arthritis are frequent offenders, but the list goes on:
Poor posture while sitting
Repetitive stress activity
As mentioned above, this can lead to sprains and strains, i.e. soft tissue injuries. Soft tissues include tendons, ligaments, and muscles. Sprains are limited to tendons and ligaments, whereas strains affect muscles. Injury can occur when these tissues are stretched beyond their normal limits. Examples are:
Excessive flexion (bending forward)
Excessive extension (bending backward)
Excessive force to the spine (i.e. lifting or carrying a heavy object)
A variety of conditions unrelated to overuse, injury, or lifestyle can also associated with back pain. Bone disease (e.g., osteoporosis), metastatic cancer, and degenerative spine disorders can cause stiffness and pain. Some other conditions include:
Any of these factors can lead to disc rupture/herniation, inflammation of the spinal cord or facet joints, fracture, narrowing of the spinal canal, etc. In other words, pain.
Diagnosis of back sprains and strains should be made by a physician with special expertise in spinal conditions. In most cases the doctor will be able to diagnose with nothing more than your medical history and a thorough physical examination to test your range of motion, balance problems, reflexes, etc. If needed, an x-ray is obtained to rule out other problems, such as a spinal fracture.
Spinal surgery is rarely needed to treat the majority of back complaints. The most common course of treatment is medication combined with physical therapy. The doctor/therapist can also educate the patient about preventative actions they can incorporate into their daily lives going forward.
Medication – A short-term course of medication can be highly effective at relieving pain and muscle spasm. Medication may include an anti-inflammatory, muscle relaxant, and pain killer (non-narcotic or narcotic). A narcotic may be prescribed if pain is severe or if a non-narcotic agent fails to relieve pain.
Physical Therapy – A tailored physical therapy program may include active and so-called inactive treatments. Inactive treatments include ultrasound, massage, heat or ice packs, electrical stimulation and so on. Inactive treatments can help to reduce inflammation, muscle spasm, and pain, while increasing circulation. Active treatments include more traditional therapies such as stretching and strengthening movements and exercises.
Prevention Steps – During physical therapy, patients learn basic body mechanics, posture pointers, and ergonomic tips to use at rest and during movement to prevent sprain and strain. Lifestyle changes may also help heal back injuries and prevent their recurrence. Eating healthy foods and maintaining a healthy weight can be pivotal in diminishing back pain as obesity increases the load the lower back must handle.*Other treatment options include chiropractic care and acupuncture.
Lumbar Epidural Steroid Injection – This procedure is considered by many to be the “gold-standard” treatment for sciatica. This procedure is basically the same as what a woman will receive during childbirth to eliminate pain. Under fluoroscopic guidance, your physician will place a small needle into the epidural space and inject a small amount of medication to eliminate the pain
Transforaminal Epidural Steroid Injection – This procedure is similar to the one above, however instead the medication is focused directly onto the nerve fibers that make up the sciatic nerve – the result is more medication on the affected area.
Radiofrequency Ablation (RFA) – radio waves are applied to a nerve, subsequently stunning it and preventing from transmitting pain
Spinal Cord Stimulation (SCS) – In some cases, the inflammation in and around the affected nerves is too great for an epidural injection. In these cases, SCS is an excellent and effective means to treat the pain without the need for surgery.
Schedule an Appointment Today
Our doctors at the Ainsworth Institute of Pain Management are experts in using the most cutting edge and advanced methods for treating lower back pain. Call and schedule an appointment today with one of our board-certified pain management doctors and find out what treatment options would best suit your symptoms.