Low Back Pain

By Joseph Oppong, Jr, MD

Innovative Pain Solutions Center

. https://innovativepainmd.com/

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Low Back Pain

Eighty percent of adults will experience significant low back pain sometime during their lifetime. There are multiple causes of low back pain

Muscle strain. The muscles of the low back provide the strength and mobility for all activities of daily living. Strains occur when a muscle is overworked or weak.

Ligament sprain. Ligaments connect the spinal vertebrae and provide stability for the low back. They can be injured with a sudden, forceful movement or prolonged stress.

Poor posture. Poor postural alignment (such as slouching in front of the TV or sitting hunched over a desk) creates muscular fatigue, joint compression, and stresses the discs that cushion your vertebrae. Years of abuse can cause muscular imbalances such as tightness and weakness, which also cause pain.

Age. “Wear and tear” and inherited factors may cause degenerative changes in the discs (called degenerative disc disease), and joint degeneration of the facet joints of the spine (called degenerative joint disease). Normal aging causes decreased bone density, strength and elasticity of muscles and ligaments. These effects can be minimized by regular exercise, proper lifting and moving techniques, proper nutrition and body composition, and avoidance of smoking.

Disc bulge, or herniation, can cause pressure on a nerve, which can radiate pain down the leg. This generally responds well to a strengthening and stretching program and rarely requires surgery.

Other causes of low back pain include bladder/kidney infection, endometriosis, cancer, or ovarian problems.

Treatment

Rest Rest from aggravating activity. Avoid prolonged sitting, driving, bending, heavy lifting and twisting.

Ice Ice applied to the low back for 15 minutes every 1-2 hours is helpful in reducing pain and spasm. Avoid using heat for the first 48 hours of an acute injury.

Medications Your doctor may recommend medications that may include NSAIDs (Aspirin, Advil/Ibuprofen, Aleve), muscle relaxants (Flexeril, Tizanidine, Robaxin) and other medications as appropriate.

Other Therapies Early exercise, positioning, as well as guided physical or aquatic therapy may be recommended by your physician after the physical exam and assessment.

Advanced Procedures If indicated, more advanced therapies such as trigger point injections, X-ray-guided epidural or facet joint injections will be considered.

See a health care provider if you have significant pain that persists beyond a week, unexplained fever, unexplained weight loss, redness or swelling on the back or spine, pain/numbness/tingling that travels down the leg(s) below the knee, leg weakness, bowel or bladder problems, or back pain due to a severe blow or fall.