Low Back Pain
Low back pain is a fairly common condition in general public. The lower back pain comes from multiple sources including the muscles and the soft tissues. The lower back pain can also come from the ligaments of the lower back and from the various joints and nerves supplying the lower back. The pain can come from the facet joints, which usually cause axial lower back pain. A person can also have lower back pain from sacroiliac joints, which is occasionally referred to by the patients as hip pain localized to the right or left lower back. A person can also have pain from a lumbar degenerative/ herniated disc. Other causes of back pain include various nerves such as the cluneal nerves or the superior gluteal nerves in the lower back. The lumbar facet joints are also implicated in causing mostly lower back pain in a significant number of patients. The other less common causes of lower back pain can be assessed and treated by the doctor as noted from the patient’s history & physical exam findings.
Primary Treatment of Lower Back Pain:
The primary treatment consists of relative resting to ease the lower back pain. Ice is usually beneficial in the acute phase to decrease the inflammation but based on the general experience of every patient, heat may be utilized if a person generally responds better to the above. Anti-inflammatory medications (if tolerated and not allergic to) can be tried such as ibuprofen or Aleve. These medications are generally taken at a higher dose to exert sufficient anti-inflammatory and pain relieving effects. Light massage may also be helpful. After a day or two of resting one can usually begin to mobilize more as tolerated and follow good postural mechanics to prevent the pain from increasing again. A belt can be used to help support the lower back area but while the support belts (the wide lumbar corsets) are useful in acute lower back pain by decreasing the range of motion of the back, long term use is not recommended because they tend to weaken up the back muscles and thus make the back more prone to re-injury. Muscle relaxants can also be utilized in the acute phase of treatment. If the back pain does not significantly improve with anti-inflammatory treatment or is just too severe, opiate medications and short-term steroids can be utilized. If the above treatments are not useful in that case further evaluation by a back specialist would be useful and an MRI test may be ordered to further evaluate the reason for the pain or sciatica based on the underlying suspect diagnosis.
The links provided may act as a guide and giving further information about the above conditions.