Back Pain TreatmentsAdmin2019-12-13T12:07:05-05:00
There are a variety of back pain treatments to meet the many conditions that can result in back pain, which will affect most people some time during their lives. So to help, we review various types of back pain treatments ranging from home treatments, to OTC and prescription medications, to minimally invasive back pain treatments.
The initial home treatment for back pain usually involves rest, along with heat and ice treatments. Over-the-counter (OTC) pain relief medication, typically nonsteroidal anti-inflammatory drugs (NSAID) such as ibuprofen, can also help ease discomfort.
Rest. Depending on the severity of the symptoms, resting the back can help ease the pain. Rest may simply mean reducing the level of activity for a couple of days. However, remaining moderately active and moving will help ease stiffness, reduce pain, and prevent muscles from weakening.
When lying on your back, place a pillow under your knees to help keep the back in a neutral position. Some patients find relief by lying on their back on the floor with their knees bent at a 90-degree angle and placing their feet and calves on a chair.
Doctors no longer recommend bed rest for treating back pain, except for short periods, since long periods of inactivity can cause muscles to weaken and increase back pain. Additionally, extended bed rest can lead to secondary complications such as depression and blood clots in the legs.
Heat and ice. Applying a hot compress or an ice pack to the painful area may also reduce pain. According to NINDS, there is evidence that the use of hot and cold packs can help increase mobility while helping to reduce pain and inflammation.
Begin with cold to reduce the inflammation. Wrap an ice pack, bag of ice, or frozen vegetables in a towel to protect your skin from frostbite. Then apply the cold to the injured area several times a day for 20 minutes at a time.
Switch to heat after 24 to 72 hours, after the initial swelling and inflammation subsides, to help loosen the tight muscles that are causing your pain. Heat can be in the form of a heating pad or a warm bath.
Topical pain relievers. There are many topical creams, sprays, and ointments that can dull and soothe back pain. These are applied to the skin and stimulate localized nerves to provide feelings of warmth or cold to dull the sensation of pain. Topical analgesics can reduce inflammation and increase blood flow.
OTC pain relievers. Over-the-counter (OTC) pain relievers such as naproxen, ibuprofen, and acetaminophen are most effective in reducing pain and swelling associated with muscle-related back pain.
Prescription Medication for Back Pain
Back pain that does not respond well to OTC medications may require a prescription NSAID. Depending on the type of back pain, your doctor might recommend the following:
COX-2 inhibitors (e.g. Celebrex). This type of NSAID helps limit inflammation but has different risk factors than other NSAIDs.
Muscle relaxants. A group of drugs that provide an overall sedating, relaxing effect on the body, allowing the muscles to relax.
Anti-depressants. Low doses of certain types of antidepressants, particularly tricyclic antidepressants like amitriptyline, have been shown to relieve some types of chronic back pain independent of their effect on depression.
Injections for back pain relief. Epidural steroid injections of cortisone work by reducing inflammation around the nerve root to relieve pain. Injections are intended for short-term use and should not be utilized for an extended period, since they may worsen pain in the long run.
Each type of medication has strengths, limitations, and risks. A patient’s particular back pain condition and overall health will determine which pain reliever, if any, is indicated.
Exercise as a Back Pain Treatment
Although it may be the last thing on your mind when your back hurts, exercise and physical activity are effective ways to help you recover more quickly from back pain. Exercise is the foundation of chronic back pain treatment.
Doctors recommend core exercises that strengthen the muscles in your abdomen and back that support the spine. The stronger these muscles become, the less likely you are to be affected by back pain.
Swimming and walking are also great ways to keep your back healthy, in addition to maintaining a healthy weight. Excess weight plays a role in lower back pain because it puts more pressure on your joints.
Physical Therapy for Back Pain
As the pain improves, a physical therapist can help by introducing flexibility and strength exercises for the back and abdominal muscles. Techniques for improving posture may also help. The patient is encouraged to practice the techniques regularly, even after the pain is gone, to prevent back pain recurrence.
As pain improves, the therapist can teach you exercises that will help increase flexibility, strengthen the back and abdominal muscles, and improve posture. Regular use of these techniques can help keep pain from returning. Some of the physical therapy treatments for chronic back pain include:
Biofeedback. The process of biofeedback helps a patient become aware of normally involuntary processes inside the body (such as blood pressure, temperature, and heart rate control). Biofeedback helps you gain conscious control of these processes which can influence and improve your level of pain. This awareness of the body helps the patient to relax, which can help relieve the pain.
Traction is a system of specially designed pulleys and weights that stretch and help align the spine.
Ultrasound involves massaging the soft tissues around your back injury with sound waves that warm the muscles, causing them to relax and heal more quickly.
Transcutaneous electrical nerve stimulation (TENS) involves the placement of electrodes on the skin to stimulate the nerves with electric pulses. The electricity blocks pain signals that travel through the nerve paths.
Minimally Invasive Back Pain Treatments
Minimally Invasive treatments for back pain will depend on the patient’s history, in addition to the type and severity of pain. Some of the minimally invasive back pain treatments include:
Prolotherapy. A technique of injecting irritating substances into painful ligaments and tendons of the back. This procedure initiates the body’s healing of a damaged ligament or tendon.
Peripheral nerve blocks and ablation. Nerves leading away from the spinal cord (peripheral nerves) can often be a source of pain. This pain is blocked with administering a local anesthetic and then destroying the nerves (ablation).
Peripheral nerve stimulation. Tiny electrodes placed close to the affected nerves release a small electrical current that inhibits pain transmission, providing pain relief.
Trigger point injections.This procedure involves injecting a local anesthetic and steroid into a “trigger point.” These are usually effective for treating muscle spasms.
Disc denervation. Electrical stimulation is delivered along the vertebral bodies (the thick oval segment of bone forming the front of the vertebra also called the centrum) near the discs. The appropriate nerves are anesthetized and destroyed using electricity.
Spinal cord stimulation (SCS). An implanted electrical device decreases the perception of pain by confusing the pain processing centers. A small electrical lead is placed in the epidural space next to the spinal cord, and electrical signals replace the pain signals.
Lysis of adhesions (“Racz Procedure”). This procedure is effective in removing excessive scar tissue in the epidural space when conservative treatment for lower back pain has failed. A 2005 study found that “spinal adhesiolysis with targeted delivery of local anesthetic and steroid is an effective treatment for a significant number of patients with chronic low back and lower extremity pain without major adverse effects.” This procedure is used when there are vertebral body compression fractures, post-laminectomy syndrome, radiculopathy, or disc disease.
Infusion techniques. This procedure involves inserting a small catheter into the epidural space or directly next to affected spinal nerves. The catheter delivers a local anesthetic, and other medicines, for extended time periods. When the nerves are blocked continuously with an infusion, pain relief can be dramatic and long-lasting.
Kyphoplasty and vertebroplasty. Two minimally invasive procedures for treating osteoporotic fractures. Both stabilize crushed vertebrae with an injection of acrylic cement into the vertebra. Pain is relieved from the added support and stability to the spine.
Intrathecal pump implants. An intrathecal pump works to relieve chronic pain by inserting small amounts of medicine directly into the area surrounding the spinal cord (intrathecal space) to prevent pain signals from reaching the brain.
Percutaneous discectomy. In this procedure, a needle is inserted through the skin into the affected disc to suction out disc material from the bulging disc to relieve pressure within the disc.
Cryotherapy. Electrical stimulation from a probe helps identify the affected nerves. Once identified, freezing cycles are initiated of the painful nerves.
Stem cell and platelet-rich plasma (PRP) therapy. These regenerative therapies can help patients suffering from lower back or neck pain, leg pain, or numbness and tingling in the arms, hands, legs, or feet that is the result of bulging discs and the problems related to a herniated disc.
Alternative and Complementary Back Pain Treatments
A number of alternative and complementary therapies may be used alongside conventional therapies or on their own to help relieve back pain, as well as encouraging the patient to feel more relaxed.
Acupuncture. A practitioner of acupuncture inserts very fine, sterilized stainless steel needles into the skin at specific points on the body. The procedure can help the body release endorphins, the body’s natural painkillers, as well as stimulate nerve and muscle tissue.
Chiropractic care. The manual manipulation of joints, muscles, and bones with a focus on the spine to ease back pain.
Osteopathic care. The manipulation of the muscles and bones to promote structural integrity and help restore or preserve health.
Cognitive-behavioral therapy (CBT): A procedure to help manage chronic back pain by encouraging new ways of thinking about pain. The therapy may include relaxation techniques and ways of maintaining a positive attitude. Studies have found that patients with CBT tend to become more active and exercise, resulting in a lower risk of back pain recurrence.
Massage. When back pain is the result of tense or overworked muscles, massage can be helpful.
Shiatsu (finger pressure therapy). A type of massage where pressure is applied along energy lines in the body. A shiatsu therapist applies pressure with the fingers, thumbs, and elbows.
Transcutaneous electrical nerve stimulation (TENS). A technique that employs a very mild electrical current to block pain signals from reaching the brain. The stimulator attaches to the skin with small sticky pads. TENS deals more with nerves than the spine.
Yoga. There are several types of yoga, a broad discipline that involves practicing specific postures or poses, breathing exercises, and relaxation techniques. Yoga can stretch and strengthen muscles and improve posture.
Lifestyle Changes to Avoid Back Pain
The following lifestyle changes may help reduce the risk of developing back pain.
Diet. Some diets are highly inflammatory, especially those high in trans fats, refined sugars, and processed foods. A doctor can help determine if your diet is contributing to chronic back pain, and how you can change it.
Footwear. Some back trouble starts from the ground up, so ensuring that you have supportive shoes that benefit your health is important. Wearing high heels can be especially tough on the feet and back, so wear flats as much as possible, especially when commuting to and from work and events.
Standing posture. Make sure you have a neutral pelvic position when standing. Stand upright, head facing forward, back straight, and balance your weight evenly on both feet. Keep your legs straight and your head in line with your spine.
Sitting posture. Your chair should have good back support, armrests, and a swivel base. When sitting, try to keep your knees and hips level and keep your feet flat on the floor, or use a footstool. If you are using a keyboard, make sure your elbows are at right-angles and that your forearms are horizontal.
Lifting. When lifting things, use your legs rather than your back. Keep your back as straight as you can, keeping your feet apart with one leg slightly forward so you can maintain balance. Bend only at the knees, hold the weight close to your body, and straighten the legs while changing the position of your back as little as possible.
Smoking. An important lifestyle change is to give up smoking. Nicotine is scientifically known to accentuate pain and delay healing.
Weight. Maintaining a healthy weight can help lessen back pain by reducing the pressure on your spine.
Mattress. The average life span of a mattress is less than ten years. If your mattress is sagging significantly or is more than six to eight years old, consider getting a new one. Several studies over the years suggest that people with lower back pain who sleep on medium-firm mattresses do better than those with a firm mattress.
Back pain can be incredibly frustrating. Some people may think surgery is the quickest, easiest fix to bring about relief. But the truth is, few people need surgery for back pain.
Typically, surgery is reserved for pain related to structural problems, such as narrowing of the spine (spinal stenosis) or a herniated disc that hasn’t responded to other therapy. However, if back pain results from a musculoskeletal condition, you will not require surgery.
Exercises to Help Prevent Back Pain
Flexion and extension exercises are commonly used to prevent low back pain. Before beginning any exercise program, be sure to talk with your doctor.
Ankle pumps: Lie on your back and move your ankles up and down.
Heel slides: Lie on your back and bend, then straighten the knees one at a time.
Wall squats: With your back flat against a wall, sit as you would in a chair with your knees lined up over your ankles. Gently press against the wall, keeping your abdominal muscles tight. Hold for five seconds.
Single knee to chest stretches: Lying down with a flat back, pull one knee toward your chest.
Novus Spine & Pain Center
Novus Spine & Pain Center is in Lakeland, Florida, and treats patients with back pain using various back pain treatments. By using a comprehensive approach and cutting edge therapies, we work together with patients to restore function and regain an active lifestyle, while minimizing the need for opiates.