Chronic back pain is a very common symptom among healthcare and non-healthcare professionals. More than 70% of time people visit their primary care physicians with a complaint of low back pain. The reason for low back pain varies. It can be wrong posture, work habits, lack of exercise, poor muscle control, to some structural, physiological or psychosocial changes!! a person can complain of pain on the entire back or on one side. The aim of this article is to talk about the common causes of low back pain and some treatment approaches.
Causes of low back pain:
Low back pain can be acute or chronic. It can be a result of medical or clinical pathology. It also common for a person to have back pain due to side effects of injury or trauma happened several years ago.
Muscular pain on the back may be a result of the adverse effects of some medications. For example, statins (common medication for cholesterol) is known to cause muscular pain in weight-bearing joints and back. Systemic disorders like rheumatoid arthritis, degenerative changes in the spine, trauma to the spine, damaged cartilage (herniated disc) can cause acute or chronic back pain. The squeezed sciatic nerve in any region can also cause low back pain.
Frequently encountered causes :
- Poor posture
- Weak back muscles, rupture or tear of muscles or ligaments
- Physiological changes due to age – osteoarthritis, osteoporosis.
- Neurological involvement after trauma or fall – cauda equine syndrome
- Structural changes like scoliosis or increased lumbar lordosis.
- Pathology like a herniated disc
- Low back pain can also be a referred pain from other visceral organs. Like a person with a kidney stone or gallbladder inflammation may complain of low back pain. This kind of low back pain is usually associated with other systemic signs. Some of those are pain and difficulty with urination, feeling of lethargy, malaise, generalized weakness. It is good to consult with your doctor about this kind of systemic disorder.
- Psychosocial factors like the change of job, death of family members, dealing with stress
- Unspecified cause
Treatment options for chronic back pain:
There are several options to treat back pain. The treatment approach also depends on the severity of pain. Treatment for acute back pain varies from chronic back pain. The treatment options can be conservative or surgical. It is better to check with your doctor or consult with a physical therapist before starting any treatment.
Conservative treatment method for back pain:
Drug therapy:
A doctor may prescribe some medications like analgesics, anti-inflammatory and or muscle relaxants in the acute stage of back pain. The medications can also be given if the back pain constantly limiting daily activities. Many times drug therapy is combined with exercise therapy.
Exercises for chronic back pain:
Exercise and stretches can treat as well as prevent the recurrence of back pain. Prescription of exercise varies depending on the severity and chronicity of the pain. A physical therapist may ask a patient to rest for a day in case of severe pain. Research shows a total bed rest for more than a day is actually harmful in the treatment of back pain.
Acute Back pain:
Back pain started within the first 72 hours is known as acute back pain. A person should not have any swelling, no fractures and no other pathological disorders like cancer, open wounds, fractures, etc., in order to start some basic treatment at home. In cases of the above disorders or other pathological disorders, it is best to consult with a primary care physician.
Heat modalities like hot packs, electrical stimulation along with muscle relaxant like Biofreeze can help reduce the symptoms of pain.
Subacute or Chronic pain:
Exercises that concentrate on the strengthening of back extensors, hip abductors, hip extensors and abdominal muscles can help prevent re-occurrence of back pain. Prolonged and gentle stretching of sciatic nerve, calf muscles, as well as hamstrings, can ease the pain.
Splints or brace for chronic back pain:
Some therapists or doctors will prescribe a back brace for temporary or permanent use. These back braces provide external support to the back and thereby reduces the stress on the back. The back brace can be specific to an area of a back or can cover the full-back. Using a brace to relieve pain and or correct the posture, can be a personal choice.
The postural correction braces will cure the back pain for the long term but it takes a lot of effort in beginning. I have patients complaining of an actual increase in pain with postural correction brace in the beginning stage. If that happens to you, just remember that it is only temporary. If the back pain continuously getting worse after the use of a new brace, than you want to discontinue using it and consult your physical therapist.
Here are some examples of posture correction braces for chronic back pain.
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Prevention strategies for chronic back pain:
- Remaining physically active within pain tolerance level usually helps to prevent reoccurrence of back pain.
- Stress management
- Yoga or Thi- Chi for flexibility.
- Meditation can help with stress management
- Regular exercises concentrating on back, hips and abdominal muscles.
- Improving posture via postural correction method. This helps to avoid putting extra load on the back and thereby preventing back pain.
Conclusion:
Low back pain is a very common problem. This article summaries a few issues and some treatment strategies. It is always a good idea to consult with a medical professional to find an exact cause and treat it.
Hope that helps!!
References:
- Macedo L. G., Bostick G. P., Maher C. G.. Exercise for Prevention of Recurrences of Nonspecific Low Back Pain. Physical Therapy; 93 (12), 2013, 1587-1591.
- Rundell S. D., Davenport T. E., Wagner T., Physical Therapists Management of Acute and Chronic Low Back Pain Using the World Health Organization’s International Classification of Functioning, Disability, and Health. Physical therapy; 89 (1), 2009, 82-90.