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Back pain

What is it?

Back pain or a low back strain is your back's way of responding to injury or illness. Back pain is pain in the back that usually happens by hurting muscles or ligaments in your back. Everybody reacts to back pain in different ways. What you think is painful may not be painful to someone else. But, pain is whatever you say it is!

Causes:

Back pain may happen when you hurt your back by lifting something or straining hard. You may have hurt your back falling down. Other back problems, like a ruptured (burst) disk or pinched nerve, may be the cause of your back pain. An infection in the spine could be causing you to have back pain. Other causes of back pain are osteoporosis ("brittle bone" disease), tumors, or childbirth. Sometimes it is not known what has caused the problem.

Signs and Symptoms:

Back pain may start suddenly or slowly. It may be felt at the time you hurt your back or it may start hurting hours later. You may have constant pain or pain that comes and goes. Your back may feel stiff. You may have trouble bending over or getting out of bed in the morning. You may have pain in your legs or buttocks (rear end). Backaches tend to come and go. Or, you may have long-term backaches.

Wellness Recommendations:

  • Stay active. Walking, yoga, and stretching help back pain.
  • Do not sit for long periods of time. If you must, always sit in a straight-backed chair with your feet flat on the floor.
  • Never reach, pull, or push while sitting.
  • Change your position often when standing for long periods of time. Try resting one foot on a small box or stool and then switch to the other foot often.
  • Follow these rules when lifting or picking up things no matter how light the object.
  • Bend your knees and keep your back straight when you reach for the object. Never just bend over at the waist.
  • Use bent knees and your leg muscles, not your back, as you lift the load.
  • While lifting the object, keep it close to your chest.
  • Try not to twist or lift anything above your waist. Do not reach above your waist for long periods of time.

Medical Care:

Caregivers will plan your treatment based on what is causing your back pain. So, your care may change if your back pain gets worse with time. Any or all of the following may be used to treat your back pain.

  • Medicines may be used to treat some symptoms like pain and inflammation (in-fluh-ma-shun) or swelling. Epidural steroid medicine is a shot given in your spine for pain relief and to lessen swelling. Other medicines are used to help your muscles relax. Some of the medicines used to treat back pain have side effects. Ask caregivers about these possible side effects.
  • Electrical stimulation through TENS (transcutaneous electrical nerve stimulation) or PENS (percutaneous electrical nerve stimulation) can help back pain.
  • Gentle stretching and exercise of your back.
  • Heat or cold.
  • Physical therapy.
  • Sleeping on a firm mattress or on the floor.
  • Short-term bed rest.
  • Surgery may be needed to remove a bad disc in your spine. This is done to decrease the pressure on the nerve. Sometimes, special medicines are used during surgery which help the hurt disc soften and shrink (get smaller).
  • Wearing a back brace to help you remember to lift things correctly.
  • Weight loss.

Tests: You may need one or more of the following tests to look at your back. These tests can help caregivers find out if other problems are causing your back pain, such as broken bones or cancer. Usually these tests are not done until other treatments have been tried and have not helped your back pain. Ask your caregiver if you want more information about these tests.

  • Bone Scan.
  • CT Scan.
  • MRI.
  • Myelogram.
  • X-rays.

Dietary Measures:

  • Lose weight if you are overweight.

Herbs and Supplements:

Before taking any herbs or supplements, ask your caregiver if it is OK. Talk to your caregiver about how much you should take. If you are using this medicine without instructions from your caregiver, follow the directions on the label. Do not take more medicine or take it more often than the directions tell you to. The herbs and supplements listed may or may not help treat your condition.

Herbs:

    Supplements:

      Complementary Therapies:

      • Acupuncture may help back pain. For more information, read the ACUPUNCTURE document .
      • The Alexander technique or other "movement re-education" methods may be helpful for back pain. For more information, read the ALEXANDER TECHNIQUE document .
      • Biofeedback may help back pain. For more information, read the BIOFEEDBACK document .
      • Hypnosis may be helpful for back pain. For more information, read the HYPNOSIS document .
      • Massage helps back pain. For more information, read the MASSAGE THERAPY document .
      • Spinal manipulation (both chiropractic and osteopathic) can help back pain. For more information, read the CHIROPRACTIC and OSTEOPATHY document s.
      • Yoga is a form of combined exercise and stretching that may help back pain. For more information, read the YOGA document .

      Other ways of treating your symptoms : Other ways to treat your symptoms are available to you.

      Talk to your caregiver if:

      • You would like medicine to treat back pain.
      • Your symptoms have not gone away or improved by these self-help measures.
      • You have shooting pains into your buttocks, groin, or legs.
      • You have questions about what you have read in this document.

      SEEK CARE IMMEDIATELY IF:

      • You have numbness or weakness in your legs or feet.
      • You have trouble urinating or lose control of your BMs or urine.
      • You cannot get an erection.

      Care Agreement:

      You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

      References:

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      3. Elkayam O, Ben Itzhak S, Avrahami E et al: Multidisciplinary approach to chronic back pain: prognostic elements of the outcome. Clin Exp Rheumatol 1996; 14(3):281-288.

      4. Ernst E & White AR: Acupuncture for back pain: a meta-analysis of randomized controlled trials. Arch Intern Med 1998; 158(20):2235-2241.

      5. Ernst E: Massage therapy for low back pain: a systematic review. J Pain Symptom Manage 1999; 17(1):65-69.

      6. Ferrell BA, Josephson KR, Pollan AM et al: A randomized trial of walking versus physical methods for chronic pain management. Aging (Milano) 1997; 9(1-2):99-105.

      7. Flor H & Birbaumer N: Comparison of the efficacy of electromyographic biofeedback, cognitive-behavioral therapy, and conservative medical interventions in the treatment of chronic musculoskeletal pain. J Consult Clin Psychol 1993; 61(4):653-658.

      8. Giles LG & Muller R: Chronic spinal pain syndromes: a clinical pilot trial comparing acupuncture, a nonsteroidal anti-inflammatory drug, and spinal manipulation. J Manipulative Physiol Ther 1999; 22(6):376-381.

      9. Grant DJ, Bishop-Miller J, Winchester DM et al: A randomized comparative trial of acupuncture versus transcutaneous electrical nerve stimulation for chronic back pain in the elderly. Pain 1999; 82(1):9-13.

      10. Hambly MF & Mooney V: Effect of smoking and pulsed electromagnetic fields on intradiscal pH in rabbits. Spine 1992; 17(6 suppl):S83-85.

      11. McCauley JD, Thelen MH, Frank RG et al: Hypnosis compared to relaxation in the outpatient management of chronic low back pain. Arch Phys Med Rehabil 1983; 64(11):548-552.

      12. Nespor K: Psychosomatics of back pain and the use of yoga. Int J Psychosom 1989; 36(1-4):72-78.

      13. Rosomoff HL & Rosomoff RS: Comprehensive multidisciplinary pain center approach to the treatment of low back pain. Neurosurg Clin N Am 1991; 2(4):877-890.

      14. Zhang WY & Li Wan Po A: The effectiveness of topically applied capsaicin. Eur J Clin Pharmacol 1994; 46(6):517-522.


      Last Updated: 4/4/2014

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