spinal stenosis
The back pain is on the rise due the lifestyles we are living in. The back pain affects about 90% of Americans in their life at some point. But that is a matter of time as the pain resolves on its own after a few days to weeks. There are other back pains that do not resolve but becomes lifelong pains. The former is called acute back pain while the latter one is chronic back pain. The pain can be of the upper or the lower region of the back.
SYMPTOMS OF LOWER BACK PAIN
The warning signs that indicate the presence of back pain and there severity depends on the type of conditions that causes it, but essentially the symptoms are similar. Persistent back pain that more often has been present for than a few days. Back pain that wakes the person at night is indicative of the disorder. The pain makes the control of the bowel or bladder difficult in many instances. Presence of a fever, chills, sweats, or other signs of infection or any other unusual symptoms also warns of a back strain or disorder. The lower limbs are also affected by the lower back pain as the pain sensations radiate in many cases down the leg. Pain may worsen while bending the back.
CAUSES
There are many causes of the back pains we often experience. The short term or acute back pain is usually caused by arthritis or injured lower back structures. The pain of chronic nature is usually caused by the inflamed joints, muscles or ligaments of the back region. More often the pain is due the person's lifestyle. Poor posture, obesity, lifting anything the wrong way, sitting or standing in the same posture for a long time can also be the causes. Other factors include physical and mental stress on the person.
Many diseases can also cause severe back pain. Herniated disc, sciatic nerve compression or spinal stenosis may also be the cause of severe backaches as the symptoms of these disorders are generally associated with back pain.
TREATMENT APPROACHES
The treatment of these pains is usually available as over-the-counter (OTC) medications. In many cases the physicians prescribe the drugs for specific conditions as well. The basic function is to relieve pain and reduction of the severity of inflammation. The medications that are used for the treatment of back pains are available as Pain relievers, Muscle relaxants and steroidal medications. In some cases it also requires Physical therapy or even Surgery in severe conditions.
There are many pain killers or pain relievers that are used for back aches. The most common OTC pain killers available are aspirin and acetaminophen (Tylenol) from the NSAIDs. The most popular of these is aspirin as it can reduce both the inflammation and relieves the associated pain. It is easily available under a variety of brand names. It should however be checked for safety in cases of allergy, stomach ulcers or when used in children due to risks of aspirin use in such cases. Acetaminophen is a safe drug in this aspect. However it is associated with risks for patients suffering from liver disorders where it can harm the liver as well as the kidneys.
Other important nonsteroidal anti-inflammatory drugs (NSAIDs) that relieve pain as well as inflammation, which are more commonly used include; Diclofenac (Cataflam, Voltaren), Flurbiprofen (Ansaid), Ibuprofen (Advil, Motrin), Indomethacin (Indocin), Ketoprofen (Actron), Naproxen (Aleve, Anaprox, Naprelan, Naprosyn), Piroxicam (Feldene), The less common NSAIDs for this purpose include Diflunisal (Dolobid), Etodolac (Lodine), Meclofenamate (Meclomen), Nabumetone (Relafen), Orudis, Oruvail, Oxaprozin (Daypro), Phenylbutazone, Salsalate (Disalcid), Sulindac (Clinoril) and Tolmetin (Tolectin).
Muscle relaxants
These are centrally acting drugs that are usually prescribed for back ache relief when the muscle spasm is contributing to the pain.
These are available as prescription only medicines in the USA but some are available in Canada without a prescription. Most are available in tablet forms and are prescribed usually along with rest, exercise, physical therapy, or other treatments. Only methocarbamol (Robaxin) is available in both tablet and injectable forms. It is important to note that these muscle relaxing drugs should never be considered as a substitute for the other more important forms of treatment. Carisoprodol (Soma), Chlorzoxazone (Parafon Forte DSC), Cyclobenzaprine (Flexeril), Methocarbamol (Robaxin)
Steroids
In some severe cases the steroids are given as epidural injections to ease the pain. These cases include Herniated disc, sciatic nerve compression or spinal stenosis which involve the nerve compressions where steroids are effective. The effects are temporary but are beneficial to patients of acute episodes of back or leg pain. This also helps in the rehabilitation of the patient by relieving pain.
Physical therapy
Physical therapy may be prescribed by your doctor, which is very effective in healing the pain. This therapy includes;For 20 minutes, 3 or 4 times a day during the first few days of a muscle sprain or spasm the effected person should use ice packs on his back. A hot bath or heating pad can help reduce pain and stiffness of the back muscles as well. Maintain good posture to keep your body's weight aligned and reduce stress on the back muscles thus causing pain relief. For the prevention of future problems weight loss is important. Avoid lifting heavy objects and repeated bending and twisting. Change positions often during the day and use a chair with good lower back support. It should also be noted that if the back pain is not relieved in 3 days by any of the treatments it is better to consult the health care provider.
Surgery
Fewer than 1 in 100 people ever require surgery for back pain.
Generally it is considered after months of an ineffective treatment by the physician but rarely used for this purpose. Surgery is an option in the case of a proven herniated disc that is causing the pain. Treating a herniated disc involves decompressing the nerve in the back that is causing the pain. If herniated disc is causing the pain surgery is an option in that case only which involves decompressing the nerve in the back. Tr aumatic conditions such as fractures of the spine, dislocations, painful spondylolisthesis where one vertebra slips forward on the one beneath it, neurological deficits caused by nerve compression or instability are the rare cases that requires surgery
PREVENTIVE MEASURES
Some tips to maintain a healthy back and avoid causes of low back pain are given below:
Lift an object only by bending your knees and squatting to pick up the object. Always keeping the back straight and holding the object close to the body. By avoiding twists on the body while lifting anything the pain can be prevented. Rather than pulling when moving heavy objects it is always better to push them to avoid any strain on the back muscles.
By stopping or taking intervals while driving a car or truck for long hours. By sitting at a desk the pain is avoided by sitting on a chair that has a good support for the spine. By wearing flat shoes or shoes with low heels (1 inch or lower) to provide a straight stature to the body. An inactive lifestyle contributes to low back pain thus exercising regularly is important. Maintenance of weight is also very important, by putting down the weight the stress on the lower back is reduced.
When the back hurts, the best position for relief is to lie on the back on the floor with pillows under knees, with hips and knees bent and feet on a chair or just with hips and knees bent. This takes the pressure and weight off the back muscles and vertebrae. Resting for 1 to 2 days on the bed can relieve the back pain. Muscles may weaken if rest is more than that and recovery is slowed down so for avoiding this a few minutes walk is recommended.
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