Lower Back Pain | How is it Treated?

Lower back pain affects around 80% of adults at some point. With today’s many treatment options, most people can find relief from persistent back discomfort. This article explores medical, alternative, rehabilitative, and surgical therapies to ease lower back problems.

Common Causes

Frequent sources of lower back pain include:

• Muscle strains and ligament sprains from improper lifting, sports, accidents, or lack of flexibility
• Herniated discs pressing on spinal nerves
• Spinal arthritis wearing down joints over decades
• Structural issues like spinal stenosis (narrowing) or scoliosis (curvature)

Self-Care Remedies

Basic at-home care often helps alleviate back pain flare-ups. Options to try include:

Rest

Avoiding straining activities early allows inflamed tissues to start healing. Resume normal activity carefully after a few days of rest. Prolonged inactivity can weaken back muscles.

Hot/Cold Therapy

Both heat and ice therapy can relieve back pain symptoms. Heat relaxes tight muscles, while cold reduces swelling around irritated nerves. Target pain areas for 15-20 minutes at a time, using wrapped hot/cold packs.

Over-the-Counter Medication

Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen or aspirin decrease pain and inflammation. Acetaminophen blocks pain signals in the brain but does not lower swelling.

Targeted Exercise

Low-impact aerobic activity aids healing by increasing blood flow. Specific back exercises improve flexibility, strengthen core muscles, and support the spine. However, stop any movements worsening pain.

Conservative Medical Treatments

If self-care provides insufficient relief after a week or two, medical treatments potentially helpful for stubborn back pain include:

Medications

• Muscle relaxants – Relax tense back muscles causing painful spasms
• Steroids – Cortisone injections into the epidural space surrounding inflamed spinal nerves decrease swelling
• Narcotics – Prescription opioids alter pain signal perception but carry addiction risks

Supportive Devices

• Back braces – Rigid braces restrict movement of injured spinal tissues to promote healing
• TENS units – Small electrical nerve stimulators interrupt pain signal transmission
• Traction – Gentle stretching devices take pressure off compressed nerves

Injections

• Trigger point injections – Cortisone medication injected into knotted muscle areas
• Facet joint injections – Steroids delivered directly into inflamed spinal joints
• Nerve block injections – Numbing medication injected around affected nerves

Additional Therapies

• Ultrasound – Sound waves boost blood flow and facilitate tissue repair
• Interferential current – Alternating electric currents help nerve regeneration
• Diathermy – Deep heating tissues beneath the skin using shortwave radio frequencies

Alternative Medicine Approaches

Alternative therapies some find helpful for alleviating stubborn lower back pain include:

Spinal Manipulation

Spinal manipulation performed by chiropractors, osteopaths, or physical therapists involves using the hands or devices to apply controlled force to joints and muscles in the spine. The goals of spinal manipulation include:

• Restore normal range of motion
• Reduce muscle tension, spasm, and stiffness
• Mobilize stuck spinal joints
• Encourage centralized pain patterns
• Increase blood flow to affected tissues

Acupuncture

In acupuncture, practitioners stimulate specific body points along meridians using thin inserted needles to correct energy imbalances contributing to pain.

Massage Therapy

Various massage techniques help relax tense back tissues, increase blood flow, and release endorphins that dim the body’s pain perception.

Mind-Body Therapies

Meditation, yoga, tai chi, and other mind-body methods focus on deep breathing and mental tranquility to reduce stress and anxiety levels that can worsen pain.

Surgical Interventions

For severe back problems that do not improve with conservative treatment over 6-12 weeks, surgery may provide relief.

Decompression Surgery

Removing problematic disc fragments or bony overgrowths pressing on nerves can ease nerve compression issues causing neuropathy or sciatica. Two options include:

Microdiscectomy

• Minimally invasive procedure
• Small incision and little muscle disruption
• Quicker recovery than more extensive surgeries

Laminectomy

• Removes bone/tissue compressing nerves
• May utilize open or laparoscopic techniques
• Often outpatient surgery

Spinal Fusion

Fusion surgeries eliminate motion between unstable vertebrae by allowing bones to grow solidly together over several months. Various fusion approaches include:

Posterior Lumbar Interbody Fusion

• Accessing spine through the back
• Inserting bone graft or cage implant between vertebrae
• Adding rods/screws for stability

Anterior Lumbar Interbody Fusion

• Working through abdomen to access front of spine
• Fewer muscle disruptions than posterior
• Quicker recovery, less post-op pain

Lateral Lumbar Interbody Fusion

• Entering spine from patient’s side
• Smaller incisions but longer nerve recovery
• Avoids interfering with back muscles

Other Surgical Therapies

Newer options showing promise for select lower back conditions include artificial disc replacement, spinal spacer implants, and posterior dynamic stabilization utilizing flexible rods/cables.

Rehabilitation and Prevention

Certain lifestyle measures may facilitate recovery and help prevent recurrent or chronic back troubles.

Rehab and Recovery

Recovery timeframes and activity restrictions after back surgeries vary widely. Most patients need 6-12 weeks before returning to normal routines and participate in post-surgical physical therapy to rebuild strength and flexibility.

Prevention Strategies

Proactive steps to maintain a healthy spine include:

• Core/leg strengthening exercises
• Good posture during sitting and standing
• Managing a healthy body weight
• Safe lifting mechanics when moving heavy objects

Conclusion

Numerous conservative treatment options exist for most cases of lower back pain, including self-care remedies, medications, injections, supportive devices, and alternative therapies. Surgery may provide pain relief if nonsurgical approaches prove ineffective after 12 weeks. Maintaining spinal health through proper exercise, weight management, and lifting techniques can help prevent many back problems. Seek medical advice for unrelenting symptoms to obtain an accurate diagnosis and customized treatment plan.