Back Pain Treatments

Is my back pain serious?

Back pain is the most common cause of disability in the U.S. The vast majority of cases resolve quickly and are not serious.

Although generally affecting men and women between the ages of 20 and 40 equally, there are risk factors that increase your chances of back injury or pain, as well as complications and delayed healing.

These risks include:

• Tobacco use
• Excessive consumption of alcohol and drugs
• Poor diet
• Lack of regular physical activity
• Repetitive, stressful motions and movements
• Overweight and obesity

Back pain usually occurs in the lower back but it can occur in the upper back as well. Pain can be sharp and come with movement or it may be a dull ache that is ever-present (or a combination of the two).

Patients may also have limited range of motion or tenderness upon touch. Symptoms may occur with excessive movement after long periods of inactivity. Each person’s back pain is as unique as they are.

What causes back pain?

Most back pain can be attributed to mechanical causes, but a small number of cases are due to more serious illness. Beyond simple wear-and-tear, the most common causes of back pain include:

• Disc degeneration (e.g. osteoarthritis)
• Muscle strain
• Mechanical problems (e.g. a herniated disc)
• Vertebral fractures associated with osteoporosis

In some cases, sciatic pain can also occur. This pain results from the compression of the sciatic nerve and comes with radiating pain across the buttocks and down your hip and leg.

Other rare, more serious causes of back pain can include:

• Cancer
• Infection
• Vascular problems
• Damage to nervous tissues

Certain red flags indicate a more serious condition that may require emergency evaluation or surgery. If you experience back pain accompanied by weakness, numbness, tingling, fever, weight loss, or problems with bowel or bladder control, head to your nearest emergency room.

How do I diagnose the cause of my back pain?

The path to diagnosing the cause of your back pain starts with a comprehensive medical history and physical examination by your doctor. Some causes of back pain are genetic, and a family history can help identify those potential factors.

For patients whose back pain persists beyond several weeks despite conservative treatments, your doctor may recommend supplemental imaging. Depending on your particular back pain symptoms, your doctor may order an X-ray if they suspect a bone infection or tumor or magnetic resonance imaging (MRI) or computed tomography (CT) scan to diagnose disc herniation.

Imaging may also be necessary if your doctor suspects a serious condition based on family or medical history.

Additionally, your doctor may order a full neurological work-up to identify compressed nerves from a herniated disc. While this is not always necessary, it can provide your doctor with valuable information for treatment.

9 back pain treatments that could help

The twin goals of back pain treatments are to relieve symptoms and improve your daily life. There are a variety of treatment options that range from conservative approaches to surgery if pain persists. For most patients, conservative treatments will help them relieve their pain and get back to their lives.

Here are nine back pain treatments that could help.

1. Rest

Rest is suggested only in the most acute phase of back pain, usually three days or fewer. Too much rest can make pain worse.

2. Lifestyle changes

All people will likely benefit from making adjustments to diet and activity to help facilitate weight loss or to help maintain a healthy body-mass index (BMI).

3. Exercise

Most back pain will resolve itself within a few weeks, and exercise can help make this happen. Core exercises and low-impact whole body workouts like swimming and yoga help strengthen the body.

4. Physical therapy

Physical therapy uses individualized exercises to improve range of motion, increase flexibility, and speed recovery of both acute and chronic back pain.

This is a great first-line treatment for many more moderate to severe cases of back pain.

5. Acupuncture and chiropractic care

Acupuncture is gaining traction as a research-based treatment of back pain.

And speaking of traction, chiropractic care offers spinal adjustments that can offer significant relief and improved function.

6. Non-steroidal anti-inflammatory drugs (NSAIDs)

Pain-relieving medications are the initial treatment of choice for acute back pain. These can include over-the-counter pain medicines such as acetaminophen and ibuprofen.

For many, taking these in conjunction with a therapy like physical therapy or chiropractic care can help you get the treatment you need with less pain.

7. Prescription medications

Muscle relaxants can also help ease back spasm and tension for some patients.

In general, opioids are ineffective for long-term management of back pain but may be recommended during the acute phase.

8. Injections

Some types of injections can be helpful to manage back and address its causes, including epidural steroid injections.

Learn more about this treatment approach in the following video.

9. Surgery

Back pain due to disc herniation may require surgical intervention via spinal fusion or discectomy (the removal of herniated tissue). Surgery is only recommended when other more conservative treatments have failed.

Find relief

The most important part of back pain treatment is looking at the whole patient and designing an individualized treatment plan that addresses diet, exercise, the root cause of your back pain, and any other factors that might affect outcomes.

References

1. Jones, R.; et al. (2010). Back Pain. First Consult. MD Consult Web site, Core Collection. Retrieved from http://www.mdconsult.com.ezproxy2.library.arizona.edu/das/pdxmd/body/268245516-3/0?type=med&eid=9-u1.0-_1_mt_1014913.
2. Lin, M. (2009). Upper Back Pain. Marx: Rosen’s Emergency Medicine, 7th Ed. MD Consult Web site, Core Collection. Retrieved from http://www.mdconsult.com.ezproxy1.library.arizona.edu/books/page.do?eid=4-u1.0-B978-0-323-05472-0..00051-7–s0220&isbn=978-0-323-05472-0&sid=1175026577&uniqId=262415626-3#4-u1.0-B978-0-323-05472-0..00051-7–s0220.
3. National Institutes of Health 2003. Low Back Pain Fact Sheet. NINDS. Available at http://www.ninds.nih.gov/disorders/backpain/detail_backpain.htm#167453102. NIH Publication No. 03-5161
4. Nidus Information Services 2010: Low Back Pain – Chronic. Patient Handouts page. MD Consult Web site, Core Collection. Available at http://www.mdconsult.com.ezproxy2.library.arizona.edu/das/patient/body/231440260-4/1104412125/10041/37946.html. Accessed January 14, 2011