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^ Abdel Shaheed, C; Maher, CG; Williams, KA; Day, R; McLachlan, AJ (1 July 2016). Efficacy, Tolerability, and Dose-Dependent Effects of Opioid Analgesics for Low Back Pain: A Systematic Review and Meta-analysis. JAMA Internal Medicine. 176 (7): 958–68. doi:10.1001/jamainternmed.2016.1251. PMID 27213267.
Consider this: Back pain is most commonly blamed on things like herniated (slipped) lumbar discs, poor postural alignment, lack of core strength, tight hamstrings or hip flexors, and being overweight. And it’s these factors that many popular treatment and prevention strategies claim to improve (or cure).
Remember, though, that just because you exercise regularly doesn’t mean that you can justify your long hours spent sitting. In fact, even if you’re fairly physically active, you may still succumb to back pain and other health problems if you spend most of your day behind a desk or on the couch. This phenomenon is called the active couch potato effect. In order to avoid this, you must make it a habit to break the pattern of sitting as frequently as possible. Dr. Goodman says:
Initial management with non–medication based treatments is recommended. NSAIDs are recommended if these are not sufficiently effective. Normal activity should be continued as much as the pain allows. Medications are recommended for the duration that they are helpful. A number of other options are available for those who do not improve with usual treatment. Opioids may be useful if simple pain medications are not enough, but they are not generally recommended due to side effects. Surgery may be beneficial for those with disc-related chronic pain and disability or spinal stenosis. No clear benefit has been found for other cases of non-specific low back pain. Low back pain often affects mood, which may be improved by counseling or antidepressants. Additionally, there are many alternative medicine therapies, including the Alexander technique and herbal remedies, but there is not enough evidence to recommend them confidently. The evidence for chiropractic care and spinal manipulation is mixed.
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Electromyogram or EMG is defined as a test that records the electrical activity of muscles. Normal muscles produce a typical pattern of electrical current that is usually proportional to the level of muscle activity. Diseases of muscle and/or nerves can produce abnormal electormyogram patterns.
Cauda equina syndrome is a medical emergency whereby the spinal cord is directly compressed. Disc material expands into the spinal canal, which compresses the nerves. A person would experience pain, possible loss of sensation, and bowel or bladder dysfunction. This could include inability to control urination causing incontinence or the inability to begin urination.
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It is important to stay away from poor quality lumbar supports. A bad lumbar cushion can actually do far more damage than good, even if you don’t suffer from pre-existing back problems. If your lumbar support is poorly shaped or made with low quality materials, it will not offer the support you need, and also won’t last long.
Patrick Roth, M.D., is an award-winning neurosurgeon practicing in New Jersey. He is the chairman of the Department of Neurosurgery at Hackensack University Medical Center and the director of the residency training program. He is the author of “The End of Back Pain.” His interest is in improving the treatment of back pain with or without surgery.
^ a b c Stockwell, Serena (2017-05-01). New Clinical Guideline for Low Back Pain Says Try Nondrug Therapies First. AJN, American Journal of Nursing. 117 (5). doi:10.1097/01.naj.0000516263.01592.38. ISSN 0002-936X.
There are a number of ways to classify low back pain with no consensus that any one method is best. There are three general types of low back pain by cause: mechanical back pain (including nonspecific musculoskeletal strains, herniated discs, compressed nerve roots, degenerative discs or joint disease, and broken vertebra), non-mechanical back pain (tumors, inflammatory conditions such as spondyloarthritis, and infections), and referred pain from internal organs (gallbladder disease, kidney stones, kidney infections, and aortic aneurysm, among others). Mechanical or musculoskeletal problems underlie most cases (around 90% or more), and of those, most (around 75%) do not have a specific cause identified, but are thought to be due to muscle strain or injury to ligaments. Rarely, complaints of low back pain result from systemic or psychological problems, such as fibromyalgia and somatoform disorders.
Thoracic pain is the term used to describe upper back or middle back pain. Some of the most common accompanying middle back pain symptoms are soreness to the touch, difficulty in performing simple activities, stiffness, and restriction in body movements.
Cauda equina syndrome is a serious but rare complication of a ruptured disc. It occurs when disc material is pushed into the spinal canal and compresses the bundle of lumbar and sacral nerve roots, causing loss of bladder and bowel control. Permanent neurological damage may result if this syndrome is left untreated.
Driving – it is important to have proper support for your back. Make sure the wing mirrors are properly positioned so you do not need to twist. The pedals should be squarely in front of your feet. If you are on a long journey, have plenty of breaks – get out of the car and walk around.
^ Carragee EJ, Alamin TF, Miller JL, Carragee JM (2005). Discographic, MRI and psychosocial determinants of low back pain disability and remission: a prospective study in subjects with benign persistent back pain. The Spine Journal. 5 (1): 24–35. doi:10.1016/j.spinee.2004.05.250. PMID 15653082.
Crooked weaves together her compelling personal story and those of compatriots in back pain of all ages. It also follows the money, revealing the hidden motivations of many industry players: workers compensation insurance companies, pain management specialists, the drug companies that make narcotic painkillers, personal injury lawyers, spinal device makers, and spinal surgeons, especially the ones who advertise late at night, often touting their laser surgery. All appear to make a living by exploiting the “fix me” pleadings from people in pain.
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The presence of any acute nerve dysfunction should also prompt an immediate visit. These would include the inability to walk or inability to raise or lower your foot at the ankle. Also included would be the inability to raise the big toe upward or walk on your heels or stand on your toes. These might indicate an acute nerve injury or compression. Under certain circumstances, this may be an acute neurosurgical emergency.
The lumbar cushion has a curved shape to follow the contours of the spine. This ensures that your back is always in contact with the cushion. Without support, the muscles in your lower back remain taut to keep you supported, leading to the tell-tale build-up of lower back pain.
Back pain is generally treated with non-pharmacological therapy first, as it typically resolves without the use of medication. Superficial heat and massage, acupuncture, and spinal manipulation therapy may be recommended.
Of course, not all incidences of back pain are injury or trauma-related. Many back problems are congenital (found at birth), degenerative, age-related, disease-related, and may be linked to poor posture, obesity or an unhealthy lifestyle such as smoking. Sometimes the back pain is worse than the severity of the injury or disorder. That statement raises the question, “When should I seek medical attention for back pain?”
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A CT scan is an X-ray procedure that combines many X-ray images with the aid of a computer to generate cross-sectional and three-dimensional images of internal organs and structures of the body. A CT scan is a low-risk procedure. Contrast material may be injected into a vein or the spinal to enhance the scan.
^ a b c d e f g Menezes Costa Lda, C; Maher, CG; Hancock, MJ; McAuley, JH; Herbert, RD; Costa, LO (7 August 2012). The prognosis of acute and persistent low-back pain: a meta-analysis. CMAJ : Canadian Medical Association Journal. 184 (11): E613–24. doi:10.1503/cmaj.111271. PMC 3414626 . PMID 22586331.
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.