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Lumbar Pain
Acute or chronic low back pain is a common symptom that will affect over 80 percent of all adults at some time in their lives. Pain in the low back or lumbar region may be caused by a variety of diseases and disorders. In fact, low back pain is the second most common reason for visits to a primary care physician’s office.
The vertebrae of the lumbar region are responsible for supporting the body’s weight and consequently these vertebrae are bigger than those of the cervical and thoracic area. Large, strong lumbar muscles are attached to the spine at this location.
Common causes of low back pain including injuries to the muscles, ligaments, or discs, degeneration of the discs or facet joints or compression of nerves. To reduce the risk of low back problems, it is important to participate in a daily physical fitness program, maintain good flexibility, maintain good posture and body mechanics, eliminate the use of tobacco and maintain good overall health.
Treatment
Treatment of low back pain usually begins with a few basic steps. Before beginning any back pain treatment program, be sure you know your diagnosis and discuss the treatment plan with your doctor. There are some conditions that cause back pain and require immediate treatment. For most cases of back pain, the first treatments are as follows:
*Rest. A short period of rest (24-48 hours) is appropriate when an acute back strain has occurred. This will allow inflammation to be reduced and strained muscles to heal. Prolonged bed rest has been shown to be counter productive. Once the acute back pain eases, activities can be slowly instituted, avoiding excessive lifting, twisting or poor body mechanics.
*Anti-Inflammatory Medications. Anti-inflammatory medications, or NSAIDs, are helpful in treatment of both back pain and the associated inflammation. There are both over-the-counter and prescription NSAIDs that may be appropriate for low back problems. However, remember that the side-effects of NSAIDs include problems with gastrointestinal bleeding, and these medications should be avoided in patients with stomach ulcers. Your doctor can determine if these medications are appropriate for your back problem.
*Heat Application. Application of moist heat can help to ease discomfort associated with muscle spasm in some patients with lower back pain. Patients may find that the use a heating pad, hot water bottles, or even a hot bath can help ease the muscle discomfort.
*Exercise. Strengthening of back muscles is probably the most important step in treatment of most causes of back pain. By increasing strength and flexibility of back muscles, weight is better distributed, and less force is placed on the spine.
These simple measures often lead to the resolution of the symptoms of lower back pain. If not, you should certainly be under the direct care of a physician to aid in the diagnosis and treatment of your condition. There are further steps in the treatment of lower back pain that can be considered:
*Narcotic Pain Medication. Narcotic pain medications do assist in relieving pain acutely, but can be dangerous and addictive if used for prolonged periods. These medications should only be used under close supervision of a physician and only for a limited period of time.
*Muscle Relaxers. Muscle relaxing medications can be very helpful in the treatment of some types of acute back pain with significant associated muscle spasm. Like narcotics, these medications often make you drowsy and have the risk of addiction if used for longer periods of time.
*Physical Therapy. Back exercises, as listed above, are the focus of physical therapy. However, there are other modalities that may be used by a physical therapist include aquatherapy, ultrasound, electrical stimulation, and manual therapy.
*Epidural Steroid Injections. Epidural steroid injections are used to decrease inflammation around the spinal nerves. An epidural steroid injection is performed using an x-ray to guide the medication to the area adjacent to the inflamed spinal nerve. They are best used when the back pain is combined with pain radiating into the buttock or legs caused by nerve root compression. |
