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Mid Coast Center for Community Health & Wellness Newsletter
April 2019
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Risks, Diagnosis and Treatment Options for Low Back Pain

Teen Brain Health

Back pain is a common condition, and most people will experience it at some point in their lives. For most, back pain is usually triggered by incorrect lifting, awkward bending, or bad posture. It will generally resolve over a few weeks or months.

For others, back pain can be long-term or chronic which is typically caused by an injury or disease including herniated disc, sciatica, or ankylosing spondylitis.

Diagnosis

Diagnosing back pain initially focuses on the symptoms you are having. The exam will include testing of your range of motion, reflexes, nerve function, and identification of specific body points. In general, physicians do not use imaging tests unless the pain persists beyond a few weeks.

Diagnostic tests include:

  • X-ray - Used to identify broken bones or spine issues
  • MRI or CT Scan - Identifies soft tissue damage, such as a herniated disc
  • EMG - Evaluates nerve and muscle damage

Unfortunately, the results of these tests do not always have a direct link to the pain you are having, which may lead to frustration at times.

Treatment

Back pain is a very individualized condition. However, research has identified some positive outcomes with the following treatments:

  • Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) - Evidence strongly suggests that NSAIDs relieve back pain better than placebo medications.
  • Physical Activity - Evidence suggests that bedrest is not an effective treatment for acute back pain. Instead, staying active helps speed up recovery and reduces chronic symptoms. Check with your physician or physical therapist, and if approved, start with easy activity including walking or simple water exercises.
  • Physical Therapy - Physical therapy is an individual-specific exercise program that often includes massage and ultrasound. Click to watch an Ounce of Prevention program about Treating Pain Without Drugs.
  • Medications - If your back pain is making it difficult for you to get through your day, your provider may prescribe muscle relaxants or pain medications. Many of the pain medications have opioids in them which have the potential for dependency. Because of this, narcotics may not be the first choice in medications. Other drugs, such as antidepressants or steroids, may be used instead.
  • Chiropractic/Osteopathic Treatments - Spinal manipulation is generally considered a safe and effective treatment for acute back pain. Chiropractic and osteopathic doctors are trained to perform this treatment. It is often combined with physical therapy and exercise.
  • Acupuncture - Acupuncture involves placing small, dry needles into the skin in specific locations in order to release endorphins to treat pain. It may also alter brain chemistry to improve your pain tolerance.

As always, discuss your treatment options with your primary care provider. Your provider will help manage the uniqueness of your situation.

Acute versus Chronic Pain

Acute pain starts suddenly and generally lasts days to weeks. When acute pain is identified and treated early, it is less likely to become chronic pain. Conversely, the longer that acute pain persists, the more likely people are to develop chronic pain.

The transition from acute pain to chronic pain is complicated. Recent studies found that depression, anxiety, distress, and somatization are associated with and increased potential for developing chronic pain. There are additional factors that can increase the risk of chronic pain listed at right.

Chronic pain can last months to years, and it can be challenging to manage. For many, chronic pain itself becomes a disease.

Most pain is managed by primary care providers. If you are having problems, please consult your provider. Don’t lose hope; there are many options available to you.

Risk Factors for Low Back Pain
  • Individual: Age, physical fitness, weakness of the back/abdominal muscles, and smoking. Chronic in the obese, those with low educational levels, and those with high levels of pain or disability.
  • Psychosocial: Stress, anxiety, negative mood/emotions, poor cognitive function, and pain behaviors. Chronic in those with distress or depressive mood.
  • Occupational: Manual material handling, bending/twisting, whole body vibration, job dissatisfaction, monotonous tasks, and poor work relationships/social support. Chronic in those with job dissatisfaction, unavailability of light-duty work, and jobs requiring lifting for three quarters of the day.
Risk Factors for Low Back Pain
  • Individual: Age, physical fitness, weakness of the back/abdominal muscles, and smoking. Chronic in the obese, those with low educational levels, and those with high levels of pain or disability.
  • Psychosocial: Stress, anxiety, negative mood/emotions, poor cognitive function, and pain behaviors. Chronic in those with distress or depressive mood.
  • Occupational: Manual material handling, bending/twisting, whole body vibration, job dissatisfaction, monotonous tasks, and poor work relationships/social support. Chronic in those with job dissatisfaction, unavailability of light-duty work, and jobs requiring lifting for three quarters of the day.
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