9 Best Treatment Options for Low Back Pain

There is no single or sure shot cure for low back pain for most people. In fact, it usually takes a whole process of trial and error to determine the best options. The best treatment for low back pain depends on varied factors such as medical history of patient, type of pain and severity of pain. Most types of lower back pain cases get better within a period of 6 weeks without surgery.

Listed below are the best treatment options for Low Back Pain:

1. Trust Endorphins

These feel 'happy' hormones are made naturally in the human body. Unfortunately, most people are unaware of the power of endorphins. These are as strong as any pain medication available on the market! Release of endorphins in the body help with blocking all pain signals from registering with a  brain. The miracle hormones are also helpful in alleviating stress, anxiety, and depression. All of these emotions are mainly associated with chronic back pain. These tend to make the pain worse.

2. Yoga is Helpful

Studies have revealed that taking 12 weeks of classes offers significant improvements in function for adults suffering from chronic low back pain.

3. Pain Medications

Medicines are known to reduce low back pain and reduce muscle spasms. However, medicines alone aren't effective for low back pain. It is always suggested to use medicines along with other treatments, heat therapy, cold therapy, exercises, etc. Here are some of the medication choices usually recommended by doctors, depending on the duration of pain, symptoms you have, and patient's medical history:

Muscle Relaxants – The medicines are helpful for fighting bad muscle spasms off. These are also effective for low back pain.

Acetaminophen (Tylenol) and Nonsteroidal Anti-inflammatory Drugs – Doctors may prescribe ibuprofen and naproxen. These can also be bought without a prescription (milder does).

Opiate Pain Relievers - These are strong medicines prescribed to ease sudden, severe back pain that cannot be controlled by other medications. It takes around 1 to 2 weeks to see effects.

Antidepressants – These include amitriptyline and duloxetine. The medicines treat depression and may also help with chronic pain.

Other medicines used for low back pain less frequently include the following:

Botox Injection – The shot into the back muscles is known to offer relief for patients. However, it is not well tested for chronic low back pain.

Injections  (Anesthetic or Steroid) - These are prescribed for chronic low back pain. However, these have not been researched enough to reveal the effectiveness for back pain. They may offer short-term relief from leg pain resulting from persistent back problems.

Anticonvulsants - These are used to treat low back pain only in some cases.

Since each person is different from other, medicines that work for some may not work for others. So let your doctor know how the medicine fares for you.

4. Massage

Chronic low back pain sufferers benefit from massages. It is revealed from research that patients who got weekly massages reported less pain. The result was seen after a period of 10 weeks. Massage is found helpful for muscle related pain resulting from tight hamstrings.

5. Surgery

The decision for surgery depends on the mutual decision of doctor and patient. A qualified spine surgeon will explain a patient the pros and cons of varied procedure ideal for the condition. Surgery has proved helpful for laminectomy, sciatica, and microdiscectomy. It can reduce pain symptoms significantly by relieving the pressure on compressed nerve roots. Another option is fusion surgery,  which can be used for stopping motion at a motion segment. This is known to be a more extensive version of the surgery. It can be very effective for relieving pain.

6. Restorative Sleep

Inadequate sleep can make back pain worse. Hence, it is important to focus on some restorative sleep. Address sleep problems and get enough of it. Remove all distractions from your bedroom and create a soothing environment to lull yourself to sleep.

7. Cold and/or Hot Therapy

Although traditional and outdated (for modern age individuals), it is not wise to underestimate the pain reduction possibility via applying cold packs and/or hot packs. These are very effective for reducing lower back pain and boosts healing process. Cold application minimizes inflammation, which is usually a major contributor of back pain. Hot therapy acts as a local anesthetic via slowing down nerve impulses to prevent nerves from spasming and causing pain.

8. Hamstrings Stretch

Stretching hamstrings twice daily will work! Tight hamstrings are one of the major contributor to lower back pain. These can stress, lower back and sacroiliac joints resulting in pain. Be careful while stretching hamstrings. Your doctor will suggest you a variety of gentle stretching exercises that should not hurt.

9. Acupuncture

This is yet another excellent option for patients with low back pain. According to various studies, patients with lower back pain who had undergone needle treatment shown more improvement in condition than those receiving conventional care.

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Spondylolisthesis – Causes, Diagnosis, and Treatment

Spondylolisthesis can be defined as a condition that results in sliding off one of the back bones (vertebra) forward over the bone under it. The condition mainly occurs in the lower spine (lumbosacral). In certain cases, the condition may squeeze spinal cord or nerve roots resulting in back pain and numbness or weakness in one or both legs.

In some rare cases, spondylolisthesis will result in loss of control over bladder or bowels. Under such conditions, it is crucial to get in touch with a doctor without delay. Patients may not experience any symptoms when vertebra slips out of place. But years later, they may feel some discomfort or pain in the low back or buttock.

Causes

The spinal bones may come together at various smaller joints that keep the bones lined up and allowing them to move. Spondylolisthesis is usually caused by an issue with one or more of these small joints, allowing a bone to move out of line.

Here are some of the common problems in small back joints that leads to Spondylolisthesis:

• Any congenital (since birth) defective joint.
• Any joint damaged in an accident or other kind of trauma.
• A vertebra with a stress fracture caused due to joint overuse.
• A joint damaged due to an infection or arthritis.

Spondylolisthesis may affect both children and teens involved in sports. There are some sports that tend to overuse backbones such as weight lifting, gymnastics, etc. These  causing stress fractures in vertebrae leading to spondylolisthesis.

Older adults may develop spondylolisthesis. This is due to wear and tear of back leading to stressful fractures. It may also occur when there are no stress fractures, but the disc and joints get worn down and slip out of their original place.

Symptoms

The major symptoms of spondylolisthesis may include the following listed below:

• Back pain and discomfort
• Buttock pain
• Pain running from the lower back down one / both legs
• Numbness in one / both legs
• Difficulty walking
• Pain in leg, back, or buttock which which gets worse as and when you bend over or twist
• Weakness in one or both legs
• Loss of bladder control (rare case)
• Loss of bowel control (rare case)

Unfortunately, sometimes spondylolisthesis may show no symptoms at all.

Diagnosis

Your doctor will look at X-rays of your back if he or she suspects you have spondylolisthesis. X-rays will show if any of the vertebrae in your back have fractures or cracks and have slipped out of place. You could also have a CT scan or an MRI to pinpoint the damage and help guide treatment.

Treatment Options

No Activities - Treatment for spondylolisthesis starts with  patient stopping any or all physical activities that the specialist may suspect have caused damage to the vertebrae.

Drugs - Pain relief is brought by prescribing nonsteroidal anti-inflammatory drugs to patients.

Physical Therapy – Most doctors will recommend physical therapy so as to build up stomach and back muscles. This facilitates core strengthening activity. Weight loss is recommended in overweight (obese) individuals.

Surgery – It is recommended when patients complain of extreme pain. Under cases, where bones don't stop moving, or damage to nerve root or spinal cord is detected, doctors suggest surgery. Surgery is usually done so as to remove bone or other tissues to remove pressure from the spinal cord or nerves (decompression).

Sometimes, surgery may be done so as to fuse the bones in position.

Rehabilitation Therapy – This is given to patients post surgery in order to make muscles stronger and facilitate movement.

Complications

Spondylolisthesis is usually followed by persistent pain. Patients may experience reduced mobility and inactivity. Remaining inactive for a long time leads to weight gain, bone density loss, and loss of muscle strength, and reduced flexibility in other parts of the body.

Is Prevention Possible?

Spondylolisthesis is not completely preventable. However, there are certain steps you can take in order to reduce risk:

• Maintain back and abdominal muscle strength. This will help you provide ample support to the back.

• Staying active is important. However, you must choose activities and sports that do not risk your lower back. Some of the best options are swimming and biking.

• Maintaining a healthy body weight is important. Excess weight tends to put more stress on your lower back making it vulnerable to slips.

• Always consume a well-balanced diet. This will provide your bones ample nourishment and strength.

Lumbar Disc Herniation – Causes, Diagnosis, Treatment

Lumbar disc herniation is a condition that results in lower back and leg pain. Some of the major symptoms of this condition include dull or sharp pain, sciatica, spasm in muscle, cramping, and leg weakness or loss of leg function. Most patients can experience increased pain during activities such as sneezing, coughing, or bending. In some rare cases, patients may even suffer from bowel or bladder control.

Sciatica is one of the most common symptoms associated with a lumbar herniated disc. This occurs when there is pressure on one or several nerves leading to pain, burning sensation, numbness or tingling in the back that extends from the buttock into the leg. In some cases, these sensations may even be felt in the foot. The condition usually affects one side of the body (right or left).

Risk Factors

A number of risk factors are associated with disc herniation. These include:

• Wrong lifestyle choices such as use of tobacco, lack of activity or regular exercise, and inadequate nutrition. These conditions contribute to poor disc health.
• With age, the body undergoes some natural biochemical changes leading to drying out of discs gradually. This may affect the overall strength of disc strength and resiliency.
• The natural process of ageing decreases the ability of intervertebral discs to absorb shock from body movements.
• Poor posture is another major risk factor of lumbar disc herniation. When combined with incorrect body mechanics. it stresses the lumbar spine and affects its normal ability to carry body weight.

Combining the above listed factors with regular affects from daily wear and tear, trauma, injury, incorrect lifting, or twisting, a disc may herniate leading to pain and discomfort. For instance, lifting something in an incorrect way may result in increased disc pressure (many hundred pounds per square inch)!

Causes

A herniation may develop all of a sudden or gradually over several weeks or months. There are four stages to a herniated disc. These include

Stage 1 - Disc Degeneration:

It is a result of chemical changes related to ageing. The process leads to weakening of discs sans a herniation.

Stage 2: Prolapse:

In this stage, the placement or form of the disc changes. This happens with slight spinal canal or nerve impingement. This stage is also referred to as a protruding disc or a bulging disc.

Stage 3: Extrusion:

In this stage, nucleus pulposus, the gel-like structure breaks through annulus fibrosis (tire-like wool). It does not move out of the disc.

Stage 4: Sequestered Disc / Sequestration:

In this stage, the nucleus pulposus breaks through the annulus fibrosus. Here, it may move outside the intervertebral disc.

Symptoms of Lumbar Disc Herniation

Some of the general symptoms of this condition include any one or a combination of the following listed below:

• Leg pain (sciatica) that may occur with or without lower back pain. Usually, the leg pain gets worse and more problematic than the lower back pain.
• Numbness, weakness and/or tingling in the leg
• Lower back pain
• Pain in the buttock
• Under rare cases, the patient may experience loss of bladder or bowel control. This is an indication of a serious medical condition referred to as 'cauda equina syndrome'.

Most patients can start feeling better (with pain subiding) within six weeks.

Treatment Options

A number of non-surgical treatments can help alleviate the pain. These are also very helpful in long term healing. Some of the most common nonsurgical treatments prescribed for herniated disc patients include:

• Physical therapy
• An epidural (cortisone) injection
• Osteopathic/chiropractic manipulation (manual manipulation)
• Oral steroids (e.g. prednisone or methyprednisolone)
• Heat and/or ice therapy
• Non-steroidal anti-inflammatory drugs (NSAIDs)

In the event pain, discomfort and other symptoms continue after six weeks, the doctor will suggest surgery after a detailed inspection. In case, the pain experienced is severe, the doctor may consider microdiscectomy surgery as an option.

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Compression Fractures – Understanding the Condition and Treatment Options

Compression fractures are a type of fracture in the spine. These are mainly caused by osteoporosis. Compression fractures may occur in vertebrae anywhere in the spine. However, the lower vertebrae of the thoracic spine (upper back) such as T10, T11, and T12 are more prone to the fracture. Upper lumbar segments (L1) may also experience compression fracture

Types of Compression Fracture

Wedge Fracture 

It usually occurs in the front portion of the vertebra collapsing the bone. The back portion of the same bone remains unchanged, causing the vertebra to take the shape of a 'wedge'. This kind of fracture is also termed as a mechanically stable fracture pattern. Wedge fracture is the most common type of compression fracture.

Crush Fracture 

The entire bone breaks instead of the front portion.

Burst Fracture 

The fracture results in height loss in front and back walls of the vertebral body. Burst fractures are unstable and result in neurologic compromise or progressive deformity.

Symptoms

• Acute back pain
• Chronic pain
• Height loss
• Deformity (thoracic kyphosis or dowager's hump)
• Crowding of internal organs
• Muscle loss
• Lack of activity leads to aerobic conditioning

A combination of the above symptoms of vertebral fractures may result in some significant changes in the self image of the patient which can adversely affect self-esteem. The patient also faces difficulty in concentrating and ability to carry on daily life activities. Since most of the damage is restricted to the front portion of the vertebral column, the fracture is stable and rarely result in spinal cord or nerve damage.

Treatment for Compression Fracture

Non Surgical Care

Compression fractures can be treated with non-surgical care. Patients are advised to rest and take medication to get relief from pain. Heat or ice packs can also help with pain relief and mobility.

Surgery

Surgery is recommended when the patient does not respond to medication and other non-surgical therapies. Vertebroplasty and Kyphoplasty are the two most common types of surgery for compression fractures.

Vertebroplasty 

It is minimally invasive treatment designed to decrease the intensity of pain or eliminate it completely. The surgery is performed to heal fractured vertebra and stabilize the bone. The surgeon injects low viscosity cement into the collapsed vertebral body under high pressure. This cement adds stability to the fracture and relieves back pain.

Kyphoplasty 

This is also a minimally invasive procedure that aims to decrease or heal the pain caused by a spinal fracture. The procedure also adds stability to the bone. It also restores some or all of the lost vertebral body height as a result of compression fracture.

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All About Vertebral Compression Fracture

Understanding Vertebral Compression Fracture

A vertebral compression fracture (VCF) is a breakage in a part of the vertebra. These fractures mainly occur in the middle (thoracic) and lower (lumbar) regions of the spine. Patients may experience mild to severe fractures.

Causes of Vertebral Compression Fracture

One of the major causes of VCF is osteoporosis, a condition that results in weak and brittle bones. Weaker bones are more prone to fractures during activities such as sneezing, coughing, bending forward, standing suddenly from a seated position, etc. Sometimes spinal injuries can be caused by a vehicle accident, a fall, or even when playing sports. Spinal conditions such as an infection, cancer, or vascular necrosis weakens bones and leads to fractures.

Signs and Symptoms

• Back pain that occurs all of a sudden and is sharp and severe
• Back muscle spasms
• Back pain that gets worse when you stand or walk
• Trouble urinating
• Problems with bowel movements
• Sudden weakness in legs or arms

Diagnosis

The healthcare provider will assess the past history of injuries and diseases. He / she will also conduct a physical exam and examine the spine. The diagnosis process may include some tests such as X-rays, MRI, or CT scans.

The Treatment

For Mild Fractures – Doctors suggest bed rest for a short time period. Patients may also require wearing a back brace for around 8 to 12 weeks. It helps in reducing pain and facilitate vertebral healing. The following treatment measures may also be suggested for relief:

Medicines such as NSAIDs, are prescribed to decrease swelling, pain, and fever. Calcitonin and Bisphosphonates may be prescribed to strengthen bones.

Physical and occupational therapy is prescribed to enhance movement and strength of bones and reduce pain.

For Severe Conditions – Doctors suggest surgery in cases where pain, weakness, or numbness does not go away with medications, rest, bracing, and physical exercises. Surgery provides more stability to  the spine and decreases pressure on spinal nerves caused due to fracture. The surgical options include:

Vertebroplasty – The procedure involves placing of bone cement into the fractured vertebrae.

Kyphoplasty - A balloon is used to allow space in the fractured vertebrae. The space is filled with bone cement.

Open Surgery – It helps bones to take the right place. Wires, plates, screws and pins are used to hold bones together.

Emergency Treatment – When to Rush to a Doctor

When you experience the following symptoms, it is time to rush to a doctor for immediate treatment:

• Coughing up blood
• Light-headedness, short of breath, and chest pain
• Problems urinating
• Arm or leg feels warm, tender, and painful
• Sudden numbness in legs
• Leg / arm appear red and swollen
• Troubles with bowel movements
• Severe back pain after sneezing, falling, coughing, or bending forward
• Sudden trouble moving legs / legs 

Speak to the Doctor

As a patient, you hold the complete right towards owning a care agreement. The authorities have a responsibility towards you. Ample care should be given to you in a timely manner. Also learn more about your health condition from an experienced doctor and understand various ways to treat it.

It is crucial to have a clear discussion about various treatment options available for your condition. As a patient, you always have the right to refuse treatment. Medical advice from experienced nurses, doctors or specialists prior to following a treatment is very important.

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Understanding Sciatic Nerve Pain and its Causes

What is Sciatic?

Sciatica is a condition that give rise to pain, tingling, or numbness due to an irritation of the nerve roots. This leads to sciatic nerve. The sciatic nerve is formed by nerve roots emerging out of the spinal cord towards lower back. These nerve roots travel down through the buttock. The branches extend down towards the back part of the leg and move to ankle and foot.

Causes of Sciatica

A ruptured or bulging disc (herniated disc) is the most common cause of sciatica. This spinal disc presses against the nerve roots leading to the sciatic nerve.

Sometimes sciatica can also be a symptom of other conditions affecting spine, such as bone spurs caused by arthritis, spinal canal narrowing, nerve root compression etc.

Sciatica may also be caused due to non-spinal conditions such as pregnancy or tumours. This occurs in rare cases.

Signs and Symptoms

The major symptom of sciatica is pain. It starts in the back or buttock and gradually travels down the leg. Sometimes, it may also move into foot. Other symptoms for the condition include weakness, numbness or tingling in the leg may also occur.

Patients may experience severe pain while sitting, standing for a long time. Movements leading to flexing of the spine can make symptoms worse. Light movements such as walking and lying down will relieve symptoms by extending the spine may relieve symptoms.

Diagnosis

Sciatica is usually diagnosed by a specialist through thorough assessment of medical history. A detailed physical exam is also done to understand the level of severity. Doctors will also suggest X-rays and a variety of other tests including magnetic resonance imaging (MRI) in order to discover the root cause of the sciatica.

The Treatment for Sciatic Nerve Pain

In most cases, sciatica improves and go away with time. Hence, initial treatment options mainly emphasises on medications and certain exercises to help relieve pain. It is possible to relieve pain by the following treatment methods:

• Avoiding sitting for a long time
• Alternating lying down with short walks
• Gradually increase walking distance
• Medications such as Acetaminophen (Tylenol)
• Nonsteroidal anti-inflammatory drugs (NSAIDs)
• Ibuprofen (Advil)
• Naproxen (Aleve)
• Use of a heating pad every 2-3 hours
• A warm shower
• Ice pack for 10 to 15 minutes every 2 to 3 hours

Other treatment options depends completely on the precise cause of  nerve irritation. In the event your symptoms do not improve with time and the above mentioned tips, speak to your doctor. The health expert will suggest you a combination of physical therapy, medications, injections etc. Depending on your condition, the doctor will also suggest steroids, muscles relaxants and opiates. Surgery may also come as the last option for severe cases.

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