Treatment for low back pain generally depends on whether the pain is acute or chronic. In general, surgery is recommended only if there is evidence of worsening nerve damage and when diagnostic tests indicate structural changes for which corrective surgical procedures have been developed.
It’s hard to choose one data point from Crooked that lays bare all the misrepresentation and snake oil in the back pain industrial complex, but a few key statistics that Ramin has collected stand out.
^ Kelly GA, Blake C, Power CK, O’keeffe D, Fullen BM (February 2011). The association between chronic low back pain and sleep: a systematic review. Clin J Pain. 27 (2): 169–81. doi:10.1097/AJP.0b013e3181f3bdd5. PMID 20842008.
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These “truths” are held as indisputable to the practitioners who promote them. They base their expertise on personal experience and anecdotal results. It’s human nature: If someone you know benefited from seeing a chiropractor, they will always (loudly) proclaim their chiropractor a genius. Same for your friends who got positive results from a doctor, physical therapist, acupuncturist, massage therapist, or personal trainer.
Low back pain (LBP) is a common disorder involving the muscles, nerves, and bones of the back. Pain can vary from a dull constant ache to a sudden sharp feeling. Low back pain may be classified by duration as acute (pain lasting less than 6 weeks), sub-chronic (6 to 12 weeks), or chronic (more than 12 weeks). The condition may be further classified by the underlying cause as either mechanical, non-mechanical, or referred pain. The symptoms of low back pain usually improve within a few weeks from the time they start, with 40-90% of people completely better by six weeks.
A complete medical history and physical exam can usually identify any serious conditions that may be causing the pain. the exam, a health care provider will ask about the onset, site, and severity of the pain; duration of symptoms and any limitations in movement; and history of previous episodes or any health conditions that might be related to the pain. Along with a thorough back examination, neurologic tests are conducted to determine the cause of pain and appropriate treatment. The cause of chronic lower back pain is often difficult to determine even after a thorough examination.
Traction involves the use of weights and pulleys to apply constant or intermittent force to gradually “pull” the skeletal structure into better alignment. Some people experience pain relief while in traction, but that relief is usually temporary. Once traction is released the back pain tends to return. There is no evidence that traction provides any longterm benefits for people with low back pain.
Subacute low back pain. Lasting between 6 weeks and 3 months, this type of pain is usually mechanical in nature (such as a muscle strain or joint pain) but is prolonged. At this point, a medical workup may be considered, and is advisable if the pain is severe and limits one’s ability to participate in activities of daily living, sleeping, and working.
If you experience back spasms, sprains, and degenerative conditions associated with lower back pain, the NMT Lower Back Brace may help. It fits waist sizes between 34 and 40 inches and is composed of 100 percent latex, chemical-free materials. The brace stimulates circulation of the blood for the promotion of healing while at the same time relieving pain.
The lower back where most back pain occurs includes the five vertebrae (referred to as L1-L5) in the lumbar region, which supports much of the weight of the upper body. The spaces between the vertebrae are maintained by round, rubbery pads called intervertebral discs that act like shock absorbers throughout the spinal column to cushion the bones as the body moves. Bands of tissue known as ligaments hold the vertebrae in place, and tendons attach the muscles to the spinal column. Thirty-one pairs of nerves are rooted to the spinal cord and they control body movements and transmit signals from the body to the brain.
The symptoms can also be classified by duration as acute, sub-chronic (also known as sub-acute), or chronic. The specific duration required to meet each of these is not universally agreed upon, but generally pain lasting less than six weeks is classified as acute, pain lasting six to twelve weeks is sub-chronic, and more than twelve weeks is chronic. Management and prognosis may change based on the duration of symptoms.
Surgery – surgery for back pain is very rare. If a patient has a herniated disk surgery may be an option, especially if there is persistent pain and nerve compression which can lead to muscle weakness. Examples of surgical procedures include:
As has been highlighted by research presented at the national meeting of the American College of Rheumatology, a very important aspect of the individual evaluation is the patient’s own understanding and perception of their particular situation. British researchers found that those who believed that their symptoms had serious consequences on their lives and that they had, or treatments had, little control over their symptoms were more likely to have a poor outcome. This research points out to physicians the importance of addressing the concerns and perceptions that patients have about their condition during the initial evaluations.
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The location and severity of back pain depends on several factors, such as the individuals age, medical condition, level of physical fitness as well as the underlying cause. Fortunately, in most cases, upper, middle or lower back pain does not stem from any serious condition and can be managed with the help of medication, simple remedies, exercises, and so on. Only a serious condition such as a slipped or ruptured disc requires surgery. Diagnosis is therefore one of the most important prerequisites to successful treatment. If you suffer from severe back pain on a regular basis you should consult a doctor for exercises, diet, and lifestyle changes that can help prevent recurrent back pain.
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