How to treat back pain in easy steps
Back pain is one of the most common reasons people go to the doctor or miss work, and it is a leading cause of disability worldwide. Most people have back pain at least once. Because the causes of back pain are often complex and multi-factorial, it is often more difficult to get an accurate diagnosis for back pain than for other medical conditions. While some spinal diagnoses are relatively straightforward (such as tumors, infections, or fractures), for many conditions there is little agreement among spine specialists about a diagnosis.
Fortunately, you can take measures to prevent or relieve most back pain episodes. If prevention fails, simple home treatment and proper body mechanics often will heal your back within a few weeks and keep it functional. Surgery is rarely needed to treat back pain.
Symptoms of back pain
Signs and symptoms of back pain can include:
Shooting or stabbing pain
Pain that radiates down your leg
Pain that worsens with bending, lifting, standing or walking
Pain that improves with reclining
When to see a doctor for your back pain
Most back pain gradually improves with home treatment and self-care, usually within a few weeks. If yours doesn’t improve in that time, see your doctor.
In rare cases, back pain can signal a serious medical problem. Seek immediate care if your back pain:
- Causes new bowel or bladder problems
- Is accompanied by fever
- Follows a fall, blow to your back or other injuries
- Contact a doctor if your back pain:
- Is severe and doesn’t improve with rest
- Spreads down one or both legs, especially if the pain extends below the knee
- Causes weakness, numbness or tingling in one or both legs
- Is accompanied by unexplained weight loss
Also, see your doctor if you start having back pain for the first time after age 50, or if you have a history of cancer, osteoporosis, steroid use, or excessive drug or alcohol use. Back pain that comes on suddenly and lasts no more than six weeks (acute) can be caused by a fall or heavy lifting. Back pain that lasts more than three months (chronic) is less common than acute pain. However, getting an accurate diagnosis of the cause of back pain is critical, because different diagnoses will require very different treatment approaches. And the sooner an accurate diagnosis is made, the sooner the patient can find an appropriate treatment for pain relief and improve his or her ability to enjoy everyday activities.
The medical diagnosis, also called a clinical diagnosis, serves to identify the underlying cause of the patient’s back pain. Medical professionals determine the cause of the patient’s pain through a combination of the following two to three steps:
A Physical Examination
The doctors will conduct a thorough physical exam of the patient, such as testing nerve function and muscle strength in certain parts of the leg or arm, testing for pain in certain positions, and more. Usually, this series of physical tests will give the spine professional a good idea of the type of back problem the patient has.
A Review of the Patient’s Medical history
The doctor will spend time asking the patient a series of questions, such as a description of when the low back pain, sciatica, or other symptoms occur, a description of how the pain feels, what activities, positions, or treatments make the pain feel better and more.
Diagnostic Testing (if needed)
After the doctor has a good idea of the source of the patient’s pain, a diagnostic test, such as a CT scan or an MRI scan, may be recommended in order to confirm the presence of the suspected cause of the patient’s pain. For example, if a disc problem is suspected, an imaging test can provide a detailed image showing the location and size of the herniated disc and affected nerve roots.
Back pain often develops without a cause that your doctor can identify with a test or an imaging study. Conditions commonly linked to back pain include:
Muscle or ligament strain. Repeated heavy lifting or a sudden awkward movement can strain back muscles and spinal ligaments. If you’re in poor physical condition, constant strain on your back can cause painful muscle spasms.
Bulging or ruptured disks. Disks act as cushions between the bones (vertebrae) in your spine. The soft material inside a disk can bulge or rupture and press on a nerve. However, you can have a bulging or ruptured disk without back pain. Disk disease is often found incidentally when you have spine X-rays for some other reason.
Arthritis. Osteoarthritis can affect the lower back. In some cases, arthritis in the spine can lead to a narrowing of the space around the spinal cord, a condition called spinal stenosis.
Skeletal irregularities. A condition in which your spine curves to the side (scoliosis) also can lead to back pain, but generally not until middle age.
Osteoporosis. Your spine’s vertebrae can develop compression fractures if your bones become porous and brittle.
Risk factors associated with back pain
Anyone can develop back pain, even children and teens. These factors might put you at greater risk of developing back pain:
Age. Back pain is more common as you get older, starting around age 30 or 40.
Lack of exercise. Weak, unused muscles in your back and abdomen might lead to back pain.
Excess weight. Excess body weight puts extra stress on your back.
Diseases. Some types of arthritis and cancer can contribute to back pain.
Improper lifting. Using your back instead of your legs can lead to back pain.
Psychological conditions. People prone to depression and anxiety appear to have a greater risk of back pain.
Smoking. This reduces blood flow to the lower spine, which can keep your body from delivering enough nutrients to the disks in your back. Smoking also slows healing.
Prevention of back pain
You might avoid back pain or prevent its recurrence by improving your physical condition and learning and practicing proper body mechanics.
To keep your back healthy and strong:
Exercise. Regular low-impact aerobic activities — those that don’t strain or jolt your back — can increase strength and endurance in your back and allow your muscles to function better. Walking and swimming are good choices. Talk with your doctor about which activities you might try.
Build muscle strength and flexibility. Abdominal and back muscle
exercises, which strengthen your core, help condition these muscles so that they work together like a natural corset for your back. Flexibility in your hips and upper legs aligns your pelvic bones to improve how your back feels.
Your doctor or physical therapist can tell you which exercises are right for
Maintain a healthy weight. Being overweight strains back muscles. If you’re overweight, trimming down can
prevent back pain.
Quit smoking. Talk to your doctor about ways to quit.
movements that twist or strain your back. Use your body properly:
Stand smart. Don’t slouch. Maintain a neutral pelvic position. If you must stand for long periods, place one foot on a low footstool to take some of the load off your lower back. Alternate feet. Good posture can reduce the stress on back muscles.
Sit smart. Choose a seat with good lower back support, armrests and a swivel base. Placing a pillow or rolled towel in the small of your back can maintain its normal curve. Keep your knees and hips level. Change your position frequently, at least every half-hour.
Lift smart. Avoid heavy lifting, if possible, but if you must lift something heavy, let your legs do the work. Keep your back straight — no twisting — and bend only at the knees. Hold the load close to your body. Find a lifting partner if the object is heavy or awkward.
Ice Massage Therapy
One of the best ways to get temporary relief is the Ice Massage Therapy
To do ice massage therapy, a regular ice cube may be used, but it’s better to use a larger piece of ice. One easy way to do this is to freeze water in a paper or Styrofoam cup, then peel the top inch or two of the cup to expose the ice surface. Someone else can give the ice massage, with the patient lying on his or her stomach in a comfortable position. Placing a pillow or towel under the hips will help keep stress off the low back. Patients can also give themselves ice massages by lying on their side and reaching around to apply ice to the low back.
For optimal results, ice
massage therapy should be gently applied to the lower back as follows:
Apply the ice gently and massage in a circular motion
Focus the ice massage therapy on the six-inch area of the back where the pain is felt
Avoid applying the ice massage directly on the bony portion of the spine (the bones that protrude along he spinal column)
Limit the ice massage therapy to about 5 minutes at a time (to avoid an ice burn)
Repeat the ice massage two to five times a day.
In general, one should never apply ice directly to the skin to avoid burning the skin. However, with ice massage therapy it is acceptable to apply the ice to the skin because the ice doesn’t stay in one place for long.
The key to ice massage therapy is to achieve numbness in the area of injury without burning the skin. Once this ‘numbness’ has been achieved, gentle, minimal stress movements can be made. When the numbness has worn off, the ice massage can be applied again for another cycle.
Ice massage and ice application are generally most helpful during the first 48 hours following an injury that strains the back muscles. After this initial period, heat therapy is probably more beneficial to the healing process. For some people, alternating heat therapy with cold application/icing provides the most pain relief.