Back Pain Treatment
Back Pain Causes
One of the most common locations for acute or chronic pain is the back. Common back pain causes and conditions include injuries like sprains, strains, and fractures, as well as conditions such as arthritis, degenerative disc disease, ankylosing spondylitis, or a herniated disc. Back pain can lead to discomfort in the muscles, in or along the spine, or even in the hips, legs, or buttocks, depending on the cause. Whether dull, sharp, or stabbing, back pain can make walking, standing and sitting difficult, and can also worsen after lying down. Back pain can limit the ability to work or be active, and bending or twisting can feel difficult or impossible.
Disc Problems and Related Conditions
The five lumbar vertebrae in the lower back are cushioned by discs that function as shock absorbers in our body, allowing the spine to twist and bend smoothly. Slipped, herniated, or bulging discs can occur when the soft tissue inside the disc pushes out through the disc wall due to compression or simple wear and tear over time. This situation can cause pain due to pressure on the nerves that run along the spine. Disc problems can also cause weakness, tingling, or numbness in the limbs.
Sciatica can develop when a herniated disc compresses the sciatic nerve, which branches downward from the lower spine. This condition can lead to pain in the lower back, hip, buttock or back of the leg that can range from mild or achy to sharp, jolting or even excruciating.
Along with herniated discs, degenerative disc disease can arise as a result of the natural aging process, or because of an injury to the spine. This condition occurs when the discs cushioning the vertebrae are weakened due to small, painful tears in the disc wall. These tears create scar tissue when they heal; since the scar tissue isn’t as strong as the original disc wall, the new tissue weakens over time, resulting in lower back pain.
Muscle, Tendon, or Ligament Strains and Sprains
Back muscle, tendon or ligament strains typically occur after lifting something improperly. Lack of regular exercise, poor posture and being overweight are also risk factors in developing back pain due to a strain or sprain, as is lifting and twisting at the same time. Improper form during weight training and other types of physical exercise can also lead to a painful back strain or sprain.
Arthritis, Ankylosing Spondylitis, and Other Inflammation Conditions
Arthritis is common among older people, and more common among women than men. Osteoarthritis occurs with age as the cartilage protecting the ends of the bones wears down over time, causing grating and pain when the bones rub against each other. Bone spurs due to osteoarthritis can develop along the spine, causing even sharper pain. In rheumatoid arthritis, the joints become inflamed; this can occur in the small joints of the spine, causing stiffness and pain. In serious cases, the spinal cord and nerves may become compressed, producing pain that can be quite severe.
Spinal stenosis can develop as a result of osteoarthritis when the open spaces within the spine become narrower, putting pressure on the spinal cord and nearby nerves. This condition can cause pain, numbness, tingling, or muscle weakness, and can even compromise the normal functioning of the bladder or bowels.
Ankylosing spondylitis is an inflammatory disease which can develop when the vertebrae in the spine fuse together over time. Typically affecting more men than women and often starting in early adulthood, this condition causes the back to become progressively less flexible. The fused vertebrae can cause pain and stiffness in the hips and lower back, and sometimes in the neck.
Coccydynia is an inflammation of the tip of the tailbone (or coccyx) that causes pain in the area between the buttocks. It can develop after childbirth, sitting too long or as a result of a fall.
Other Conditions Causing Back Pain
Osteoporosis is a condition that can develop with age and is most common among white and Asian women. This condition causes the bones to become progressively weaker and more brittle, to the point that a fall or even something as simple as coughing or bending over can cause a fracture. Spinal fractures due to osteoporosis are also referred to as compression fractures of the spine. These fractures can be quite painful, as can the collapse of vertebrae in the spine due to overall bone degeneration.
Scoliosis, an abnormal curvature of the spine, normally develops in early childhood. It usually isn’t painful, but in some cases, when the spine twists, an affected individual can experience back pain.
Metastatic cancer of the spine develops and spreads within or near the vertebrae. If a tumor develops in the spine, the side effects can be serious, including paralysis or the inability to urinate.
Failed back syndrome after surgery occurs when a surgery on the back or spine results in continued pain post-surgery. This typically happens when the operation failed to correct the original cause of pain.
Kidney stones can cause flank pain—that is, pain in the side of the body between the ribs and the hip.
Even simple day-to-day activities can trigger back pain, such as lack of exercise, wearing high heels, slouching and other forms of poor posture.
How is Back Pain Treated?
Treatments for back pain depend on the specific condition causing the pain, such as nerve damage, an injury, or an inflammatory condition. At Balcones Pain Consultants, we combine our expert knowledge of back pain with compassionate care to develop an individualized treatment plan to minimize your discomfort.
Treatments for back pain might include more conservative therapies like massage, acupuncture, chiropractic treatments, support braces, or physical therapy. Topical or oral medications might also be used to reduce back pain. More aggressive treatment options include superficial muscle injections, steroid injections, nerve blocks, radio frequency thermocoagulation, spinal cord stimulation and surgery.
Simple Techniques for Treating Back Pain
Simple techniques such as cold and heat therapy—applying ice or heating packs to the affected area—can help relieve back pain by reducing stiffness and inflammation. This simple technique is usually effective in treating back pain due to arthritis, muscle strains, and more.
NSAIDs (non-steroidal anti-inflammatory drugs) are also helpful in reducing both pain and inflammation. Physical therapy involving massage, specific exercise programs and other techniques can go a long way in the treatment of back pain.
Core strengthening exercises can be an essential part of long-term recovery plan after a back injury, as building up the core muscles in the back and abdomen can help prevent future injuries and pain from occurring. All these techniques, especially used in combination, can be helpful in treating back pain due to muscle, tendon, or ligament strains or sprains, as well as pain due to arthritis, degenerative disc disease, and ankylosing spondylitis.
Acupuncture to Treat Back Pain
Acupuncture is an ancient healing technique of Traditional Chinese Medicine that can be a highly effective treatment for back pain. This noninvasive technique involves stimulating specific points on the body with extremely fine, sterile needles to promote the natural healing process. Acupuncture can be a beneficial component of treatment for back pain linked to arthritis and post-surgery pain.
Medications for the Treatment of Back Pain
Medications other than pain reducers can also help in the treatment of back pain. Muscle relaxants, for example, might be prescribed for back pain due to muscle spasms, while antidepressants can sometimes alleviate back pain related to nerve damage or arthritis.
Injections and Other Methods for Treating Back Pain
Back pain from conditions like chronic lower back pain and sciatica can be treated with epidural steroid injections. This type of intervention is especially effective when used to treat sudden, acute pain episodes, since its effects are likely to be short-term. For this reason, steroid injections are best used in combination with other, longer-term treatments, such as physical therapy.
Transcutaneous electrical nerve stimulation is another method for treating chronic back pain. This treatment involves using electrical current to block pain signals from reaching the brain. Spinal cord stimulation is one type of electrical nerve stimulation, in which a pulse generator relieves back pain by sending electrical pulses to the spinal cord.
Back pain due to nerve damage, arthritis, or injury can also be treated with radiofrequency thermocoagulation. Also called radiofrequency neurotomy, this is a method of interrupting pain signals by heating a small area of nerve tissue with radiofrequency current.
Surgery and Post-Surgical Pain Treatment
Sometimes, surgery is necessary for treating back pain due to herniated discs, bone spurs and other conditions. Many, but not all, back surgery procedures will be successful in reducing pain. Some people experience failed back syndrome after surgery, when surgery intended to correct a painful back condition does not diminish the pain, or results in further chronic pain.
In this case, treatment of the residual pain might involve physical therapy, medications, and pain management techniques. Exercises to reduce the formation of scar tissue can be particularly helpful, as they keep the back limber and flexible. This activity, in turn, prevents scar tissue from pressing on nerves in the back and causing further discomfort.
Advanced Treatments for Back Pain Management
Severe or chronic back pain which does not respond to other treatments, or which significantly impacts your life or activity level, may be treated with more advanced methods. It’s important to let your healthcare provider at Balcones Pain Consultants know about all your symptoms, so that we can help you to return to living life as smoothly and quickly as possible. We will be happy to answer any questions you have about the many treatment options available, including:
- Caudal Steroid Injection
- Costovertebral Block
- Dekompressor Discectomy
- Facet Joint Injections
- Intrathecal Pump Implant
- Lumbar Epidural Steroid Injection
- Lumbar Radiofrequency Neurotomy
- Lumbar Sympathetic Block
- Lumbar Transforaminal Epidural Steroid Injection
- Medial Branch Block
- Prolotherapy Treatment for Low Back Pain
- PRP for Chronic Back Pain
- Sacroiliac Joint Steroid Injection
- Spinal Cord Stimulator Implant (Includes Trial Procedure)
- Thoracic Epidural Steroid Injection
- Thoracic Facet Radiofrequency Neurotomy
- Thoracic Transforaminal Epidural Steroid Injection
- Trigger Point Injections