Non-Surgical Treatments of Lower Back Pain

What is meant by lower back pain?

Lower back pain is caused by muscle strain or sprain of the ligament, the spine, or joints. It can be triggered by daily activities at home or vigorous exercise at the gym.

The spine is composed of bones that stack on top of each other, called vertebrae. The vertebrae in the lower back are known as lumbar vertebrae and are five in number.  These vertebrae have discs with a fibrous coating surrounding the spongy area inside, between them acting as shock absorbers while providing flexibility when they are in a healthy state.

Any injury to the vertebrae, the discs, the spinal cord housing between these bones, ligaments attaching the whole apparatus and the lamina can trigger lower back pain.

What are the causes of lower back pain?

Some of the very common causes of lower back pain are:

• Traumatic injury
• Aging
• Spine trauma
• Strain or sprain due to daily activities
• Lumbar spine disease
• Fracture
• Osteoarthritis

Some of the more complicated reasons for lower back pain are:

• Herniated discs

Wear and tear on the outer layer of the disc causes it to rupture, resulting in herniated disc that can put pressure on nerve roots and cause pain, numbness, and weakness.

• Bone spurs

These are bony malformations caused by wear and tear to the vertebrae.  These can put pressure on discs, inflaming the nerves which as a result cause pain. Bone spurs are also responsible for narrowing the spinal column.

• Instability

Spondylolisthesis or spinal instability can also cause extreme discomfort and pain. This happens when vertebrae slip from their position in the spine causing problems and leading to pain.

How is lower back pain diagnosed?

Lower back pain is usually recognized by its signs and symptoms. It manifests as pain in the lower back that extends to your legs and might cause numbness or weakness in an individual. The pain can be dull, aching, burning, or sharp with constant lingering or episodic, activity-related occurrences.

Further, cause of lower back pain can be diagnosed through:

• CT scan
• MRI scan
• Discography
• X-rays
• The selective nerve root block

Is surgical intervention necessary for lower back pain?

Surgery is not the first choice when it comes to the management of lower back pain. Many conservative treatments and therapies have shown to be beneficial in this regard. Exercises and other non-surgical treatments have shown great promise in this regard and have worked wonders.

Non-surgical treatment options for lower back pain

Non-surgical treatment options usually include physical therapy, back exercises, steroid injections, weight control, anti-inflammatory medications, rehabilitation, acupuncture, and limiting physical activity. All of these treatments aim to relieve inflammation in the lower back and nerve irritation. Physicians recommend three to five weeks of conservational therapy before considering surgical options.

Physical therapy

Physical therapy can be very beneficial to some patients. Patients are taught exercises and ways to improve posture which helps reduce stress on their back. Patients may be taught home exercises that can help reduce stress on the spine and improve pain. Physical therapy helps to strengthen the muscles in your back which helps improve your symptoms.

Some exercises to help lower back pain are:

Here are a few helpful exercises that may help you and speed up the recovery process. You should always go to your physical therapist so they can suggest exercises depending on your needs. Done wrong, these exercises can have a harmful effect rather than the benefits they claim.

• Wall Sit: Place your feet at shoulder length, a foot in front of you. Leaning against the wall, slide down into a sitting position.
• Hamstring: Pull your leg towards you and then straighten it, gently.
• Half Sit-Up: Tighten your abdominal muscles and raise your torso high enough so that your shoulder blades are not touching the floor.
• Lumbar Arc: Tighten your abdomen and buttock muscles while lying down. Tilt your hips upward until your spine is completely in contact with the floor.
• Hip Flex: Lean forward while tightening your abdominal muscles, feeling a stretch in your groin and hip.
• Back Flex: Keep your hips touching the floor while pushing your upper body off the floor.

Medication

Medications are often used to reduce inflammation, relax muscles, and control pain. These non-steroidal anti-inflammatory medications can be used to manage and calm the symptoms of lower back pain. They help fight the inflammation and provide an analgesic effect to the pain in the lumbar region of the spine.

Posture correction

Poor posture can be a root cause of back problems, so learning to improve your posture is a step in the right direction to improving your symptoms. Bad posture such as slouching forward or arched back can have a very debilitating effect on your lower back. Correcting the posture can improve the state of your lower back pain immensely.

Lumbar Epidural Steroid Injections (ESIs)

ESIs are a very common treatment option in cases of lower back pain. These have shown promising results in regards to managing the pain and restoring health in individuals suffering from backache. These are an integral part of the non-surgical approach for lower back pain. These are a set of 2-3 injections into the lumbar spine that can help reduce pain and strengthen the lower back. The entire procedure only takes about a minute to perform by a professional.

The steroid and local anesthetic is injected right in the epidural space surrounding the nerve endings and spinal cord. After two injections, the patient can feel the recognizable difference in the state of pain and stress on the lower back.

These injections are administered by trained professionals and specialists to minimize any risks and make sure that no adverse effects are experienced. Choose the best professionals for yourself to get these injections done effectively and safely.

If you are someone who suffers from lower back pain and considering options to get this condition treated, we highly recommend you to contact us and let us help you in this regard. You can get guidance regarding the lifestyle changes you need to make and other possible approaches that can manage your condition effectively. We are available to guide you about the options you have in the conservative treatment approaches and help you select a method that is beneficial and suitable for your betterment.

References:

1. Patel K, Upadhyayula S. Epidural Steroid Injections. [Updated 2019 May 2]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470189/
2. https://pubmed.ncbi.nlm.nih.gov/6458028/
3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2805825/
4. https://www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Low-Back-Pain