Pain in the lower part of the back is what is known as low back pain. Approximately 8 in 10 adults will experience lower back pain in their lifetime. This is a high percentage of individuals and it is no surprise that lower back pain is the leading cause of disability in the U.S.
Low back pain usually occurs after an injury to the lower back. The pain may vary in severity and characteristics, depending on the type of injury involved. Common causes of low back pain include a ruptured or herniated disc, spine infections, poor posture, heavy lifting, sciatica, kidney and spine infections, arthritis, and cancer of the spinal cord.
Back pain can be either acute or chronic. Acute back pain lasts for a few days to a few weeks while chronic back pain may persist for weeks. Low back pain usually affects those who are between 30 to 50 years. At this stage, the aging process has started and the amount of fluid that is found between your vertebrae has begun to decrease. This makes it easy to have an injury in your lower back as the range of mobility has diminished. This article explains the different treatment modalities that are available for the management of lower back pain.
Lower Back Pain: Diagnosis
This condition is characterized by pain in the lower back that may be mild, moderate, or severe. Once you report pain in your lower back the doctor will take a complete medical history and also conduct a physical exam. The doctor will want to check your range of motion and assess how much the pain is interfering with your day to day activities. The doctor may also be interested in assessing your reflexes to discover underlying causes of the pain.
Certain symptoms may accompany the pain in the lower back. When they occur, the doctor may request further tests. They include:
- Fever and chills (lookout for spinal infection)
- Acute loss of bowel or bladder control
- Weakness in the lower part of the body or unsteady gait
- Weight loss (lookout for spinal tumor)
In such a case the doctor may order for X-rays, CT scans, MRIs, or Electromyography (EMG). If the low back pain is causing debilitating symptoms it is best to have it treated as an emergency. Otherwise the doctor may opt not to take an aggressive approach and instead use non-medical treatment.
Common causes of lower back pain include the following:
- Osteoarthritis
- Muscle strain
- Disc disease
- Nerve impingement
- Spinal stenosis
How To Treat Low Back Pain
The treatment for low back pain will vary based on the severity of the pain and accompanying symptoms. There are several things that can be done to manage the pain at home within the first seventy two hours. However, you should not attempt to manage lower back pain if it is accompanied by any of the four danger signs mentioned above.
Managing Lower Back Pain at Home
Once you experience lower back pain, you should reduce the amount of physical strain that you are exerting on your lower back. The first thing is to avoid aggravating the situation; so go slow on physical activities. Below are 12 non-medical remedies that can be carried out at home to relieve back pain:
- The RICE protocol where Rice stands for rest, ice packs, compression, and elevation. This is usually effective within the first 48 hours after the pain starts.
- Practice light stretches especially early in the morning, but don’t overdo it. Yoga or Pilates can help. However, this can only be done after you have ruled out any spinal cord involvement
- Maintain a good posture
- Taking a warm bath
- Eat a healthy diet that is rich in minerals such as calcium and phosphorus and vitamin D
- Hydrate frequently
- Use medicated creams such as camphor or menthol on the affected area
- Use a back brace to support your back
- Ensure that you get adequate sleep
- Massage the affected area
- Engage a physiotherapist
- Engage a psychotherapist to help you deal with the psychological components of the pain
Medical Management for Lower Back Pain
Mild lower back pain can be managed with over-the-counter pain medications. This includes the use of acetaminophen (tylenol) or NSAIDs (Advil). Severe back pain can be managed using a combination of drugs as listed below:
- Opioids such as morphine or codeine
- Muscle relaxants such as diazepam (valium)
- Steroids to reduce inflammation
- Antidepressants such as amitriptyline (Elavil)
Lower back pain is usually present with different characteristics. For example, burning pain may signify inflammation. In this case adding a steroid to the pain meds can be of help. Where the pain has a psychological component, antidepressants will help. Pain that presents with spasms will benefit from the addition of anticonvulsants.
Can Surgery Treat Lower Back Pain?
Surgery is usually a last resort in the management of lower back pain; when all else has failed. However it may be the primary treatment modality when there is a risk of spinal cord compression. In this case the surgery will be an emergency.
Different kinds of surgeries can be conducted to treat lower back pain. For example a discectomy is conducted to relieve pressure from a compressed nerve root. On the other hand, spinal fusion involves removing discs between vertebrae and then fusing the vertebrae. This makes the spine stronger and reduces painful motion.
Alternative Therapies for Lower Back Pain
Apart from medication and surgery, alternative techniques can be used to manage lower back pain. Acupuncture involves inserting needles in “acuzones” to numb the area and prevent the transmission of pain. Chiropractic treatment is a common non-surgical technique used to manage lower back pain. It involves the use of spinal manipulations to relieve tension in the spinal cord. Reiki healing is a newish treatment modality for lower back pain. It involves initiating a process of self-healing through what is referred to as “energy-based” techniques. Biofeedback techniques can be used to make the patient relax and in the process reduces pain sensation.
Can Medical Marijuana Help With Low Back Pain?
One of the many medical marijuana health benefits is relief from pain. Phytocannabinoids that are found in cannabis offer pain relief through different mechanisms, mostly involving the endocannabinoid system (ECS).
Recent research has shown that cannabidiol (CBD) can be used in the management of lower back pain. CBD has anti-inflammatory effects which can be harnessed in the treatment of lower back pain. CBD also has strong antispasmodic effects which can be used to relieve painful muscle spasms in the lower back. Lastly, CBD has relaxing and antidepressant effects which can address the psychological aspects of chronic lower back pain. However, further research is needed to elucidate the pain relieving properties of CBD.
If you are considering CBD for pain management it is crucial to first seek advice from your primary care doctor. In case you get the go ahead from your doctor, CBD gummies for pain offer an exciting option. Juts ensure that you source your CBD from a reputable vendor; not all CBD is created equal!
