Choosing the right back pain management strategy

3-minute read

Back pain is the second most common reason Americans visit their healthcare providers, preceded only by the cold and flu. Whether acute or chronic, back pain limits what you're able to do. It might interfere with work, family responsibilities, and daily activities you enjoy. Beyond the physical symptoms, back pain can also cause mental and emotional stress. Back pain management can get you on the path to feeling better.

What causes back pain?

Most people experience low back pain at some point in their lives. Acute back pain typically lasts a few days or weeks and gets better on its own. Low back pain becomes chronic when it lingers for 12 weeks or longer. You might develop chronic low back pain if the treatment you received for acute pain doesn't provide relief.

Back pain can develop when an injury or inflammation affects one or more of the back's components — the bones, spine, joints, nerves, intervertebral discs, or connective tissues. Common causes of back pain include:

• Arthritis
• Bone spurs, small bumps that grow on bones, often as a result of arthritis
• Broken bones and stress fractures
• Congenital diseases, such as spina bifida and scoliosis
• Degenerative disc disease, wear and tear on the cartilage in the spine that often develops as a result of arthritis
• Ligament sprains
• Muscle spasms or strains
• Myofascial pain syndrome and fibromyalgia, two forms of chronic pain
• Spinal cord problems, including herniated discs, spinal nerve compression, spinal stenosis, sacroiliitis, spondylosis, and spondylolisthesis
• Tendinitis
• Traumatic injuries from, for example, athletic activities, car accidents, or falls
• Tumors

You might also feel back pain as a complication or side effect of conditions unrelated to your back, such as kidney stones and endometriosis.

Diagnosing back pain

If your primary care provider suspects you need specialized care, they might refer you to a neurologist or orthopedic specialist. These clinicians will perform a physical examination and review your medical history and symptoms to diagnose what's causing your pain. They might also use diagnostic tools, such as a musculoskeletal ultrasound or electromyography if they need additional information.

Acute back pain management

With the numerous causes of acute and chronic back pain, treatment requires a holistic approach.

Initially, providers often take a conservative approach to back pain management. That usually involves:

• Over-the-counter and prescription pain medications, including nonsteroidal anti-inflammatory drugs
• Muscle relaxants
• Physical therapy
• Topical pain relief in the form of creams, sprays, and gels
• Use of hot or cold packs on the affected area

People with acute back pain typically don't need surgery, and bed rest might not help either. Lying in bed or being sedentary can cause your muscles to tighten and get weaker, which can increase your pain. Although you should avoid intense exercises for acute back pain, gentle stretching can strengthen muscles and improve flexibility. Work with a physical therapist, who can teach you proper stretching techniques.

Back pain management for chronic pain

Since chronic back pain is more complex, treatment often follows a progressive approach. Your clinician will also recommend options specific to your diagnosis, such as:

• Lifestyle changes: Your clinician might recommend changing your diet, limiting alcohol intake, or quitting smoking.
• Medications: In addition to prescription and over-the-counter pain medications, your clinician might also prescribe antidepressants or neuropathic agents. These medications have shown promise in treating some forms of chronic pain, and they address depression, which has been linked to some forms of chronic pain.
• Physical therapy: Just as it can help with acute back pain, physical therapy for chronic back pain can help you stretch and strengthen weak muscles that contribute to pain. A physical therapist can also help you change your activities and environment to make regular movements less painful. You might also benefit from talk therapy, which provides an outlet for sharing the emotional and mental side effects of living with chronic back pain.
• Injections: Spinal injections can treat back pain at its source and provide weeks to months of pain relief. Some spinal injections, such as epidural steroid injections, are delivered directly to the spine. Another form of injections — nerve blocks — are delivered to the nerves responsible for causing pain.

When back pain won't budge: Additional options for care

For complex cases of chronic back pain, clinicians might recommend more advanced solutions, such as surgery. For instance, a spinal laminectomy can correct pain caused by a narrowing of the spinal canal. Other approaches to treating back pain could involve:

• Transcutaneous electrical nerve stimulation (TENS): Using electrodes placed over the affected area, TENS devices produce electric currents that numb painful sensations.
• Spinal manipulation and mobilization: This treatment might include chiropractic care to stimulate the spine and nearby tissues.

Back pain has many causes, so finding a pain management plan tailored to your specific diagnosis and needs is important to finding relief.

Reid Health Pain Management works closely with Reid Orthopedics and our spine specialists to help people manage acute and chronic low back pain. Request an appointment with one of our spine specialists, or call (765) 935-8866 to speak with our pain management team.