LivaFortis’ Ultimate Guide To Low Back Pain

Do you have questions about low back pain? Want to know what causes it? How to fix it? How long will it last? We looked at some of the most popular questions that people have about low back pain and put together a list of FAQs and answers for everything you need to know about managing this often debilitating condition.



How long does low back pain typically last?

1. How Long Does Low Back Pain Last?


Most cases of LBP go away on their own after a few days or weeks. In some instances the pain can last more than 12 weeks, when it is then classified as chronic low back pain. 80% of cases should resolve on their own within a few weeks.



NSAIDs are recommended for managing low back pain.



2. Should I Take Medication For My Low Back Pain?


Guidelines recommend the use of over the counter pain relievers such as acetaminophen or NSAIDs for managing low back pain. While opioids are still often prescribed for LBP, these medications are only effective in about 30% of non-cancerous pain.



It is a is a good idea to talk to your primary care doctor about any history or concerns that you might have.


3. Who Should I See If I Have Low Back Pain?


Making an appointment with your primary care provider is a good idea to talk about any history or concerns that you might have. They can also do a full medical history and identify if there are any red flags present that might indicate something more serious that could warrant further investigation.






4. How Common Is Low Back Pain?


80% of the population will suffer from LBP at some point in their lives.

Nearly 65 million Americans report a recent episode of back pain. Some 16 million adults — 8 percent of all adults — experience persistent or chronic back pain, and as a result are limited in certain everyday activities.



Low back pain can be expensive to treat for a variety of different reasons.



5. How Much Does It Cost To Treat Low Back Pain?


Americans in 2016 spent an estimated $380 billion on low back and neck pain, as well as on joint and limb pain, and other musculoskeletal disorders. In total, $3.1 trillion – or $9,655 per person, about 17.9% of the US GDP – was spent on health care by a combination of individuals and public and private insurance


Chiropractic sessions can range from $34 to $106 per session depending on where you live, how many regions of the spine a chiropractor services and whether exams are required. Average fees are highest in the South, around $70 per session, and lowest in the Midwest, at $60.


Physical therapy sessions can range from a $20 co pay to $180 per session with the average patient requiring around 12 sessions. Surgery and diagnostic imaging can push these costs even higher.





6. What Is The Best Treatment For Low Back Pain?


Current international guidelines recommend physical therapy and exercise as the best treatment for low back pain.


When it comes to treating low back pain, the experts all agree that nonpharmacologic treatment is the way to go. Nonpharmacologic treatment refers to treatments that don’t include medication. For acute low back pain that includes things like superficial heat therapy, massages, spinal manipulation or acupuncture.


When looking at chronic lower back pain, experts often recommend multidisciplinary treatments like yoga, tai chi, exercise, biofeedback, cognitive behavioral therapy (CBT), and mindfulness-based stress reduction (MBSR). These treatments are generally cost effective and safe for most individuals, plus they have clinical studies to support their effectiveness in helping to reduce low back pain.



Guidelines recommend the use of exercise for managing low back pain.


7. When Will My Low Back Pain Go Away?


80% of low back pain cases will resolve on their own within a few weeks but a small percentage can go on to become chronic low back pain which is pain that typically lasts for longer than 12 weeks.



Yoga and Tai Chi are great exercises for managing low back pain.


8. What Can I Do To Fix My Low Back Pain?


Keep moving. One of the worst things that you can do for low back pain is resting. Movement will keep your muscles flexible and will continue to ensure that blood and nutrients reach the injured muscles helping them to heal faster. Gentle exercise like walking, swimming, stretching and yoga can go a long way to helping your low back pain heal faster.



Research actually advises against getting an x-ray for your low back pain.


9. Should I Get An X-ray Or An MRI For My Low Back Pain?


Unless you have certain red flags that are present, the research actually advises against getting an x-ray for your low back pain, or doing any other type of diagnostic imaging. This type of testing can increase the cost of treatment unnecessarily, and can sometimes do more damage than good.


Imaging should be reserved for patients with red flags for cauda equina syndrome, recent trauma, risk of infection, or when warranted before treatment (e.g., surgical, interventional). As many as 1 in 5 people with low back pain will receive an MRI for their back pain, despite the fact that there is little evidence to support the use of diagnostic imaging for this condition in the majority of cases.


Both the American College Of Physicians (ACP) and the American Pain Society (APS) recommend that imaging is only used for patients with severe or progressive neurologic deficits, or other red flags that could indicate a serious underlying condition.


Due to the nature of the condition diagnostic imaging often does not detect the cause of the pain and can actually detect other conditions that may have no impact on low back pain at all.


Typically low back pain patients don't require an ER visit.

10. Do I Need To Go To The ER For My Low Back Pain?


There are two main types of pain associated with low back problems - acute pain and chronic pain. Acute low back pain is the most common type of low back pain and it generally lasts between a few days to a few weeks. Chronic low back pain is classified as low back pain that has lasted for longer than 3 months.


If your back pain is acute then there is a good chance that it will resolve on its own within a few days and you will be back to your usual activities in no time. Acute pain is generally related to an accident or injury and there is a specific incident that can generally be recognized as the cause of the pain. Some cases of acute pain do last longer than a few days which is why pain is only labeled as chronic after it has been present for a few months.


Guidelines recommend that doctors reassure patients that 90% of back pain patients get better within 6 weeks. Unless there are red flags present, treatment is generally conservative and patients are advised to keep moving and take over the counter pain relievers if necessary.




11. What Medication Is Best For Low Back Pain?


Pain is very subjective and it is very personal. No two people have the exact same response to injuries or to treatments. For this reason, the guidelines recommend that chronic low back pain sufferers who do not respond to the above treatments try medications like NSAIDs (nonsteroidal anti-inflammatory drugs) or muscle relaxants.


The data around the effectiveness of spinal surgery is somewhat inconsistent.

12. Do I Need Surgery For My Low Back Pain?


Spinal surgery is a controversial topic and rates of surgeries differ vastly among different counties. Norway has seen a dramatic increase in spinal surgery rates while other countries in Europe are trying their best to discourage the number of spinal surgeries performed. Typically, most cases of low back pain will resolve on their own within a few weeks, or months, but not everyone wants to wait and see what happens.


Unfortunately, the data around the effectiveness of spinal surgery is somewhat inconsistent. Most studies put the efficacy rates at around 50% but some studies have shown more promising results, while still others have shown less promising outcomes. Most success rates depend on a wide range of factors such as current health conditions, age, gender, and even levels of anxiety.


A report from Johns Hopkins Medicine actually suggests that fewer than 5 percent of people with back pain are actually good candidates for surgery.



It is important to track your rehabilitation progress so you can know if you are getting better.


13. How Can I Tell If My Low Back Pain Is Getting Better?


No one knows your pain better than you do, which is why it is good to have some kind of measurement that will help you to track any type of program you participate in to improve your condition. When change happens gradually, it can be difficult to remember where you were or how far you have come with your treatment. With so many different low back pain products and programs on the market, it is important that you are able to track results with the work that you are putting into your rehabilitation.


The Oswestry Disability Index, also known as the Oswestry Low Back Pain Disability Questionnaire, was first initiated by John O’Brien in 1976. It is an extremely important tool that researchers and disability evaluators use to measure a patient’s permanent functional disability. The test is considered to be the ‘gold standard’ of low back functional outcome tools.


A herniated disk can irritate the spinal nerves causing pain, weakness, or numbness.

14. What Is A Herniated Disk?

The term ‘herniated disk’ refers to a problem with one of the rubbery cushions (disks) that are between the vertebrae (bones) that make up your spine. A herniated disk can happen anywhere along the spine, but typically they occur in the lower back or neck - rarely do they occur in the middle of the back.


Our spines consist of 24 bones (vertebrae) that have little shock absorbers between them called disks which allow us to move and bend. These disks are made up of a soft, jelly-like middle, called a nucleus which is covered by a tougher outside, called the annulus. A herniated disk (often referred to as a ‘slipped disk’) happens when the annulus gets torn and some of that jelly nucleus starts to squeeze out. While most people don’t experience any symptoms, the herniated disk can irritate the spinal nerves causing pain, weakness, or numbness.


There is no concrete evidence to support the use of steroid injections for low back pain.

15. Do Epidural Or Steroid Injections Work For Low Back Pain?


The North American Spine Society evaluated all of the available clinical research on these topics and found that there was insufficient evidence to make recommendations either for, or against, these treatments.


Epidural means "around the spinal cord." These shots include a steroid medicine, also called corticosteroid, and usually an anesthetic medicine, too. How effective they are isn’t clear yet. Their effects seem to only last a short time and offer modest pain relief. So these might not be something you’d get for long-term back pain. And if your back pain started suddenly, there are other treatments your doctor would probably consider first.


Considerations


When it comes to steroid injections, there can be some side effects that go with them. Headache, nausea, vomiting and soreness can all happen. Since the effectiveness of this treatment has yet to be confirmed, more research is needed to establish just how helpful they are when used for low back pain.



Conclusions


There are so many questions you might have if low back pain happens to strike. Knowing how to handle it - what to do and what not to do - can help speed up the recovery process.


While we are still learning more and more about this condition there are things we can do to help that were not options in the past. Debunking myths such as the need for rest can help sufferers to feel more in control of their low back pain and help them return to regular activities much faster.