It can happen in an instant. One minute the world is full of color and you are living your best life. Then your world comes to a crashing halt. You can’t stand up fully. Your back isn’t cooperating. The pain is intense. Your lower back hurts so bad. Is it serious? Do you need to go to the ER? What is happening to your body?
Firstly, don’t panic. Statistics show that around 80% of us will experience low back pain at some point in our lives and that most cases of low back pain are not serious and will clear up on their own. Lumbago is a term that is used to describe pain in the lower back. Lower back pain usually results from issues with parts of the back like your ligaments, muscles, nerves, and your vertebrae (spine bones).
Is My Back Pain Serious?
One of the most interesting things about low back pain is how the severity of the pain is not normally linked to the seriousness of the condition. In other words, despite the fact that most cases of low back pain are not serious and do not need medical attention, many people who suffer from low back pain find the condition quite debilitating. Words like “excruciating”, “agony”, “off the charts pain” are often used when people talk about their chronic low back pain.
It comes as little surprise then that lower back pain is one of the most common causes for visits to the doctor and an estimated 2.6–2.7 million ER visits each year. Most cases of low back pain result from muscle strains and sprains that occur when people lift heavy objects or engage in strenuous repetitive movements.
There are certain red flags to watch out for that can indicate something more serious (see our blog on Low Back Pain Red Flags). If you suspect that you have any of these red flags you should make an appointment with your healthcare provider to rule out any more serious conditions.
Serious Conditions Associated With Low Back Pain:
Spinal cord cancer
spinal epidural abscess
Who Gets Low Back Pain?
While it is easy to think that only “old” people get low back pain, this condition is actually more common in people in their 30s, 40s and 50s. As we get older there is certainly more wear and tear on our spine and joints as well as a reduction in the fluid content between the spinal vertebrae. After 50 years of age, most cases of low back pain are commonly caused by osteoarthritis and spinal degeneration.
How To Handle Low Back Pain
So, you are in pain and you think it is your lower back and you don’t have any red flags. What do you do now?
Many people think that they should rest and spend a few days in bed, or on the couch. Research has now shown that this is NOT the right way to manage low back pain. It is vital that you stay as mobile and as active as possible to maintain flexibility and mobility. Prolonged rest can cause your muscles to become stiff, making movement much more difficult.
If you have any concerns regarding your condition then it is a good idea to go and get checked out by your primary care doctor. They can run through your medical history and do a thorough examination to see where the pain is coming from. They will also check to see how much your range of motion is being affected.
Checking your reflexes and responses to certain stimuli will let your doctor know if the pain is affecting your nerves in any way. If all of these are normal your doctor will probably recommend just monitoring your condition for a few weeks and may give you some tips on how to speed up your recovery and manage your pain at home.
Back Pain Products - Help Or Hinder?
There are tons of products on the market all promising miraculous cures for low back pain. Unfortunately the market for many of these products is largely unregulated and there is little oversight of some of the claims that are made. Other products may provide short term pain relief but lose their effectiveness over time.
When it comes to the management of chronic low back pain there are international guidelines that have been created by some of the top doctors around the globe who have examined the science behind certain treatments and who have put together their recommendations.
Evidence-Based Recommended Treatments For Lower Back Pain
Maintaining gentle activity is a key way to manage low back pain. Evidence has shown that resting can actually do more harm than good. Engaging in low impact exercises such as swimming, yoga, pilates, walking, and tai chi, can help ensure that your back muscles stay supple and flexible and that they don't stiffen up and lose their range of motion. Stiff muscles are more prone to further injury as well.
Non-Steroidal Anti Inflammatory Drugs (NSAIDS)
Inflammation is a contributing factor in most cases of lower back pain so reducing that inflammation is key to helping prevent pain. Taking a low dose, over-the-counter anti-inflammatory medication, such as ibuprofen, can help reduce the inflammation in your muscles.
While anti-inflammatories have long been the go-to for low back pain, there is a growing body of research that suggests that NSAIDs may actually delay healing due to their effect on inflammation. It is for this reason that it might be better to use heat and ice packs, as well as some of the other treatment options until we know more about their impact on healing.
Multi Disciplinary Rehabilitation
Chronic low back pain results from multiple causes, both physiological and psychosocial. In a study published in the New England Journal Of Medicine in 2015, researchers examined data from 41 randomized controlled trials to assess the effects of multidisciplinary rehabilitation versus other treatments.
They looked at 6900 patients with chronic low back pain who had been suffering from it on average, for more than one year. Multidisciplinary rehabilitation consisted of 'physical treatment (e.g., heat, electrotherapeutic modalities, stretching, strengthening, manual therapy) plus a psychological component, a social or work-related component, or both'.
The researchers found strong evidence to show that 'intensive multidisciplinary biopsychosocial rehabilitation with functional restoration improves function when compared with inpatient or outpatient non-multidisciplinary treatments'. Basically, when people suffering from low back pain are offered a mix of treatments that looks at both the physical and the psychological aspects of low back pain, they did much better than people who only received treatment for one of those things.
Cognitive Behavioral Therapy
Cognitive Behavioral Therapy (CBT) is another treatment that looks at the psychological component of lower back pain. CBT is a form of psychotherapy that trains people to change specific thoughts and behaviors - especially around pain perception. There is extensive research to show that it is an effective treatment for alleviating back pain in a variety of age groups.
Just like maintaining an active lifestyle, exercise therapy is a guideline-based, universally recommended treatment for preventing and managing low back pain.
It doesn't really matter too much what type of exercise you prefer, as long as it is not too intensive. Some exercise programs look at strengthening and stretching out the core muscles that support your back. Programs like the McKenzie exercise approach, yoga, and Pilates, all focus on helping to strengthen the muscles that support your spine.
Another wonderful benefit to exercise is the endorphins that your body makes when you engage in these types of programs. Endorphins are your body's "feel good" hormones, so they can help reduce feelings of pain, and increase your feelings of well-being. They can also help reduce the feelings of depression that sometimes accompany low back pain, and can help to relieve stress.
If you have been suffering from low back pain for some time now, it can probably feel extremely frustrating and you might feel like you are never going to feel better. You may already have tried some of these treatments and felt like they just did not work for you.
Low back pain is very challenging to treat, and everyone's pain experience is different. Hopefully reading about some of these tried and trusted methods might inspire you to try one more thing - one more time. These treatments have been tested on people just like you, with many of them finding some type of relief.
It is also important to keep the biopsychosocial model in mind. Research is pointing to the fact that tackling low back pain from many angles, at the same time, seems to have the best success rates both for reducing pain and for helping prevent future flare ups. Don't give up!