When you’re experiencing lower back pain for more than six weeks, it is considered chronic pain and it’s time to seek professional help. No home remedy is going to alleviate the pain. I’m not talking surgery here, surgery is always a last resort and the subject of a future post. The first step should always be some form of non-surgical treatment for back pain. There are some traditional treatments and some non-traditional treatments. All of which could help to eliminate the pain.
For this post. I’m going to concentrate on traditional non-surgical treatments. Depending on the intensity and cause of the pain, your medical professional may use one or a combination of the treatments discussed below.
While not typically used to treat chronic lower back pain, it can be prescribed if much of the pain is resulting from muscle spasms. This uncontrollable twitching or cramping can happen for various reason, but is often very painful. Muscle relaxers may also be prescribed if the patient is unable to take acetaminophen or ibuprofen for pain.
There are times a patient may have back pain sever enough to interfere with sleep. Proper sleep is important for the healing process so your doctor may recommend muscle relaxers since they cause drowsiness.
Like many prescription drugs, muscle relaxers have side effects that you need to be aware of other than the drowsiness, Because of this, you should never drive or operate any machinery while taking muscle relaxers. They can also cause fatigue, weakness, decreased blood pressure, depression, and dizziness. You can suffer from dry mouth, but you should never drink alcohol to alleviate it. I know a cold beer may taste really good on a hot summer afternoon, but Impaired judgment and function, caused by the muscle relaxers will only get worse with alcohol.
Muscle relaxers can become addictive. After prolonged use, your body can get to the point where it needs the drug to function normally. When you get to that point, and try to quit taking it, you may suffer withdrawal symptom like a heightened anxiety, vomiting or even insomnia. Withdrawal can be serious or even dangerous. Your doctor should be notified if you begin to experience these symptoms so you can be weaned off the muscle relaxers slowly.
Narcotic Based Pain Medication
Narcotic based pain medication is often referred to as opioids. I’m sure you’ve heard a lot about them in the news lately. These medications work by interfering with the pain signals that are sent to the brain. The most common one used for lower back pain is hydrocodone/acetaminophen, commonly called Vicodin. It is used primarily for short term severe pain relief.
Opioids should only be used for short periods of time, and only under a doctors care. The body can quickly develop a tolerance for the opioid and it’s pain killing effect is reduced. Because of this, it takes more and more of the medication to get the same amount of pain relief. If long term use is required, it must be closely monitored by a doctor.
Common side effects from opiod use include, inability to get a good nights sleep, dry mouth, upset stomach, constipation, and possible respiratory problems. On top of that there is also the risk of opioid dependence from the need for higher doses as well as the increased risk of and accidental overdose. Something as simple as taking opioid tablets with grapefruit juice can put too much of the medication in your system at once causing an accidental overdose. My advice is to follow your doctor’s and/or pharmacist’s directions closely and only take the pills with plain water.
Back Braces (Some Say Yes, Some say no)
Back braces have been used for back injuries for years and years. The big question is, “Do they actually work?” Nowhere was I able to find a definitive answer. Some believe in them, some think they’re a waste of money and can do more harm than good, and some say yes with limitations. I’ll weed through all these discussions and at least give you enough information to decide for yourself whether you should use a back brace.
Let’s first look at the elastic flexible type that you can pick up for a few dollars at your local pharmacy or sports store. Some people swear by them claiming they get the additional support they needed during some strenuous activities. This may be true but do they offer sufficient support to help someone who is already experiencing lower back pain. According to the Mayo Clinic, there’s not enough evidence to prove that they are more or less effective at helping to relieve back pain.
The recommended back brace to help alleviate lower back pain is one that is not flexible. The more rigid braces offer better support and promotes healing when used in conjunction with physical therapy. One thing everybody agrees on is the back brace is not meant as a permanent support for lower back pain. Excessive use can actually do more harm than good. Prolonged use will actually allow the core muscles that support the entire upper body to atrophy, leading to re injury or worse a more severe injury than you started with.
In my particular case, I have spinal stenosis due to osteoarthritis. I wore an adjustable rigid brace for only about four or five weeks. After my core muscles got strong enough, from therapy and exercise, to better support my upper body, I quit wearing it. I no longer needed the extra support. I will say this though, while I wore it, I became very aware of my posture. Proper posture is needed to help reduce back issues. It’s hard to slouch with a stiff brace on.
So, back brace, yes or no. My recommendation is to speak with your doctor or medical professional, you should decide together. If you do need one, only use it as long as you have to.
One of the most common treatments for many lower back issues is physical therapy. Since the spine, core muscles and related tissues support the entire upper body, it’s easy to understand why so many of us have back issues. As we age, these muscles become weaker causing the entire support structure to become vulnerable to pain and injury.
Physical therapy, often used in conjunction with other treatments, is prescribed to both alleviate the pain and strengthen the core muscles. There are actually two forms of physical therapy, Passive and Active. Many therapy sessions involve both.
Passive physical therapy, also known as Modalities, are treatments that are used while the patient is at rest. These treatments can include:
- Heat and cold therapy – most commonly available and used to reduce inflammation and muscle spasms.
- Intophoresis – steroid creams are applied to the skin to target specific areas, then an electrical current is used to force the steroid into the skin to receive acute pain.
- Ultrasound – deep heating sound waves are used to penetrate into targeted soft tissues to receive and accelerate the healing process.
- Transcutaneous electrical nerve stimulation (TENS) – electrical pulses are introduced to the painful area to actually override the pain signals that are being sent to the brain.
Active physical therapy is a series of targeted stretches and strength building exercises. These are designed to strengthen the core muscles in order to help the spine support the upper body. Specific exercised can be used to strengthen specific muscles or muscle groups.
Epidural Steroid Injections
The spinal cord actually ends at the top of the lumbar region in the lower back. From that point on, nerve roots, that resemble a horses tail, travel down and out of the spine. Spinal stenosis occurs when a nerve root is compressed and causes pain running down through the extremities. Sciatica is similar, only it’s caused by twisting or bending or even an issue with the discs that are between the vertebra.
The dural sac surrounds the spinal cord and the nerve roots. A specialist will use live x-ray, called fluoroscopy, to guide the needle to a precise location inside the dural sac. The injected steroid solution is meant to receive inflammation and reduce acute pain. Sometimes the injection alone is enough to receive the pain, but often it brings enough relief for the patient to get additional benefits from physical therapy.
I underwent this treatment soon after I was diagnosed with spinal stenosis due to osteoarthritis. I had two injections in my lower lumbar region. It didn’t give me total relief, but it did ease the pain enough to give me better mobility and to manage physical therapy, which did help get me back to work.
These are all considered traditional non-surgical.treatments. Each one can be an effective treatment by itself, but normally a combination of these are prescribed by your doctor to receive lower back issues. As for me, the only thing that wasn’t done this last time around was muscle relaxers. It took a battery of all the other treatments to get me back on my feet.
The next installment will be on non-traditional treatments.
If you have any comments or questions, or want information on some other procedure or product, please leave it in the comment section below. Thanks for stopping by.