Chronic Back Pain

As always, we caution our readers to seek pain relief assistance primarily from their medical advisor(s). The suggestions in this article should be discussed with your doctor before deciding on treatment options for your particular condition .

Chronic Back Pain – Typical Symptoms

The type of pain experienced with this condition varies with the underlying cause. The indicators of a potential chronic problem with back pain include:

• Pain that persists beyond a few weeks and does not go away by itself;
• Back pain due to soft tissue injuries (e.g. strains)  is usually short term and tends to  disappear after a period of rest that heals the underlying injury. However, pain that does not improve after a period of rest can be a sign that something more serious than a sprain or strain is present;
• Your pain may spread (or “radiate”) down one or both legs. If so , this is a possible indicator of a chronic problem that may include a pinched nerve adjacent to the spinal column. If the pain actually extends below the knee, this should especially be viewed as a cause for concern;
• Weakness or a loss of sensation in one or both legs can also be an indicator of a chronic problem requiring professional attention; and
• Weight loss can also be indicative of a persistent underlying issue
• Changes in bowel and/or bladder function
• Alteration or lack of sensation in the groin area between the legs.

Possible Causes

We will now briefly discuss some of the more common causes of chronic back pain before discussing possible non surgical treatments.

It is important to understand the underlying cause(s) of the pain before determining a course of treatment. Your doctor can arrive at  a diagnosis through physical examination, imaging procedures such as CT scans and other techniques.

Bulging or Herniated Disks

The vertebrae of the spine are separated by small disks that act as cushions or shock absorbers. The disks contain a soft material that can cause them to bugle and press on nerves adjacent to the spine. When this happens, you can start to experience chronic back pain. It should be noted, however, that in some cases, you may have a herniated disk without pain.

Osteoporosis

Chronic back pain can be an indirect result of a generally increasing brittleness of your bones that make them more vulnerable to compression fractures. This condition is known as osteoporosis. Osteoporosis itself does not usually cause pain. It is only when it leads to a fracture that pain is experienced.

Spinal Arthritis

Deterioration of the cartilage that runs through the spinal canal can cause the bones of the spine to make direct contact with each other. This contact can contribute to back pain. This condition is a form of osteoarthritis, a condition that is discussed in detail here.

Spinal Stenosis

This is a result of narrowing of the spinal canal. For more information on this condition, please visit this page.

Typically, spinal stenosis causes pain in the back and one or both legs. This pain tends to improve on leaning forwards or sitting down.

Possible Non Surgical Treatments

Many of the conditions mentioned above (such as stenosis and disk herniation) can be treated or mitigated by surgical procedures. There are also a variety of invasive procedures that you can try short of surgery, such as steroid injections.

However, in many cases, there are also non invasive treatments that you can try to reduce pain.

In some cases, these may prevent back pain entirely. Although they may not address the underlying cause of the pain, they may at least make it more manageable and avoid some of the complications that can arise from back surgery.

Physical Therapy

Many causes of chronic back pain can be significantly mitigated by physical exercise. This should, therefore, be one of the first non-surgical options that you should consider.

It is important to realize, though, that your physical therapy exercise routine needs to be tailored to your specific condition. It is also important that the routine should be one you are capable of performing at home, without the supervision of a physical therapist.

Physical therapy exercises can be designed to achieve one or more of the following goals:

• Helping you to adapt your posture to reduce stress on your lower back;
• Improving the flexibility of your back muscles and ligaments;
• Strengthening the muscles of your back (and core region generally); and
• Testing and establishing the limits of your tolerance for pain.

To evaluate this treatment option, you should consult a physiotherapist. He or she will be able to design an exercise routine that you can follow at home to attain some or all of the goals listed above.

Modify Your Diet

Different types of foods can have varying impacts on bodily inflammation levels. For example, foods that are high in refined sugars or trans fats can increase inflammation levels and make your pain worse.

Consult with your doctor or a dietician to see whether changing your diet may contribute to reducing your chronic back pain.

Activity Modification

This can also have an important effect on the amount of back pain you experience. If you spend a lot of time in a seated position, consider switching to an ergonomically designed chair that will place less pressure on your lower back.

You may frequently participate in activities that can stress your back and are repetitive in nature. If so, this may be another contributing factor to your chronic back pain. Try changing your activity pattern by taking frequent brief rests during this activity.

Smoking can be another activity that may be contributing to your back pain (as well as causing many other serious health problems). This link between smoking and lower back pain has been established by many studies. It is thought to increase inflammation inside the body and make it more difficult for the body to heal itself. If you are a smoker, consider giving up this habit.

Pharmaceutical Treatments

There are many pharmaceutical products (topical or otherwise) that can be an important part of your pain treatment. Anti-inflammatory drugs and muscle relaxants are two important groups of medications that you should discuss with your doctor. Examples for anti-inflammatory drugs include ibuprofen (advil) and naproxen (aleve). These drugs are associated with a risk of damage to the lining of the stomach. Therefore, it is recommended that they should be taken only with food and never on an empty stomach. Often, these drugs need to be combined with paracetamol (tylenol) to achieve adequate pain relief.

If your pain is not too severe, consider topical pain relievers such as BioFreeze as a possible solution. These have the advantage of being non habit forming and generally free of side effects.

Extreme caution should be exercised when choosing pain relievers that may be opioid based. Many of these drugs are highly addictive and may have effects that are actually worse than the back pain you are currently experiencing. This may be compounded by the fact that they will not address the underlying cause of your pain. Examples for this class of drugs include codeine. Side effects include constipation and drowsiness. People who drive should avoid taking codeine too soon before driving if it makes them feel drowsy.

We would suggest considering these types of pain relievers only as the last option and after extensive discussions with your doctor.