Usual care provided by general practitioners for low back pain does not match the care endorsed in international evidence-based guidelines and may not provide the best outcomes for patients. This situation has not improved over time.
How long back pain lasts depends on its cause. For example, if your pain is caused by strain from overexertion, symptoms usually subside over days or weeks and you may be able to return gradually to your normal activities. However, you should avoid heavy lifting, prolonged sitting or sudden bending or twisting until your back gets better.
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This restriction of movement is not an uncomfortable one, but rather one that enforces good back positioning with no effort on your part. The shape of a lumbar support is what allows it to reduce bending of the spine. It’s curvatures falls in line with the natural curve of your lumbar to prevent it from bending unnaturally, which can lead to incrementally more serious back problems over time.
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Other NIH-funded studies are investigating physical therapy and chiropractic approaches. For example, researchers are studying whether therapy programs that emphasize certain types of exercises, such as core stabilization exercises, provide benefit to people who experience recurrent low back pain.
Indicators of autoimmune disease include a family history of autoimmune disease, gradual but progressive increase in symptoms before the age of 40, marked morning stiffness, pain in other joints as well as the low back, rashes, difficult digestion, irritated eyes, and discharge from the urethra.
2015 — Science update: Added discussion of a popular acupuncture-for-back-pain paper, Cherkin 2009. Which is not fit to a birdcage, in my opinion. [Section: The fascinating case of acupuncture, formerly a contender in low back pain therapy, but which has now miserably failed well-designed scientific tests.]
The management goals when treating back pain are to achieve maximal reduction in pain intensity as rapidly as possible, to restore the individual’s ability to function in everyday activities, to help the patient cope with residual pain, to assess for side-effects of therapy, and to facilitate the patient’s passage through the legal and socioeconomic impediments to recovery. For many, the goal is to keep the pain to a manageable level to progress with rehabilitation, which then can lead to long-term pain relief. Also, for some people the goal is to use non-surgical therapies to manage the pain and avoid major surgery, while for others surgery may be the quickest way to feel better.
Facet joint dysfunction. There are two facet joints behind each disc at each motion segment in the lumbar spine. These joints have cartilage between the bones and are surrounded by a capsular ligament, which is richly innervated by nerves. These joints can be painful by themselves, or in conjunction with disc pain.
Acupuncture is moderately effective for chronic low back pain. It involves the insertion of thin needles into precise points throughout the body. Some practitioners believe this process helps clear away blockages in the body’s life force known as Qi (pronounced chee). Others who may not believe in the concept of Qi theorize that when the needles are inserted and then stimulated (by twisting or passing a low-voltage electrical current through them) naturally occurring painkilling chemicals such as endorphins, serotonin, and acetylcholine are released. Evidence of acupuncture’s benefit for acute low back pain is conflicting and clinical studies continue to investigate its benefits.
Infrared K-Laser therapy works by stimulating the cytochrome oxidase enzyme in your cells’ mitochondria. It enhances microcirculation and stimulates the red blood cell flow in the area being treated. K-Laser therapy helps reduce pain and inflammation and enhances tissue healing in hard and soft tissues, including your muscles, bones, and ligaments. It also returns venous and lymphatic function, as your tissues become oxygenated.
And a few thanks to some health professionals who have been particularly inspiring to me: Dr. Rob Tarzwell, Dr. Steven Novella, Dr. David Gorski, Sam Homola, DC, Dr. Harriet Hall, Simon Singh, and Dr. Stephen Barrett.
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Radicular pain. This type of pain can occur if a spinal nerve root becomes impinged or inflamed. Radicular pain may follow a nerve root pattern or dermatome down into the buttock and/or leg. Its specific sensation is sharp, electric, burning-type pain and can be associated with numbness or weakness (sciatica). It is typically felt on only one side of the body.
Difficulty urinating, incontinence, numbness around the groin, foot drop (a toe that drags), and significant weakness in the legs are all potentially serious signs of a neurological problem. These symptoms can develop over time, so it’s important to keep considering them.
Bulging or ruptured disks. Disks act as cushions between the bones (vertebrae) in your spine. The soft material inside a disk can bulge or rupture and press on a nerve. However, you can have a bulging or ruptured disk without back pain. Disk disease is often found incidentally when you undergo spine X-rays for some other reason.
So, how is low back pain treated? As described above, the treatment very much depends on the precise cause of the low back pain. Moreover, each patient must be individually evaluated and managed in the context of the underlying background health status and activity level.