Low back pain is a very common condition. Nearly everyone will experience some sort of low back pain in their lifetime. Pain here can be very serious and is one of the top causes of missed work. Usually, low back pain will improve as days go by. Unfortunately, some people will continue to have back pain beyond 4 weeks, and may even go on to develop chronic back pain which is usually back pain for more than 12 weeks. I am going to talk about some causes of back pain and its treatment options.
causes of back pain
Majority of cases (>85%) will have nonspecific low back pain, meaning there is no specific underlying condition that can be identified. Most of these people will improve in the intensity of back pain in a few weeks.
Spinal cord compression
Compression on the spinal cord can lead to low back pain. The commonest cause is the intervertebral disc herniation. Pain is the first symptom, followed by muscle weakness and numbness. It may progress up to urinary or bowel dysfunction.
Bone is a common site for cancer to spread to. If unfortunately, you have cancer that has metastasis in bones, you will have bone pain as the first symptom. Bone pain in patients with a history of cancer is alarming and should seek early medical attention.
Vertebral compression fracture
Around 4 % of patients with low back pain will have a vertebral compression fracture. This is basically a crack in the vertebral bone causing the pain. Some may recall previous trauma or injury, but a lot of people do not have preceding trauma.
It is always crucial to seek medical attention to exclude serious cause of low back pain.
Basic principles include staying active, in which daily exercises actually help with back pain. Applying heat pad can help with the first few weeks of low back pain.
Pain medications: over the counter painkillers like nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen should be better than paracetamol. Usually taking the painkillers at regular intervals for a few days work better than taking it when necessary.
Physical therapy can be beneficial to incorporate stretching, flexion and extension exercises. Usually, physical therapists will instruct on how to perform the exercises and you can go on to continue working on it at home.
There are specific treatment modalities for different etiologies. Such as steroid injections for people with persistent pain due to a herniated disc. The physician will inject a steroid to the epidural space which is a limited space outside your spinal cord.