- 28 June 2019
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Lower Back Pain – Diagnosis, Treatment & Prevention
Back pain, the most common and annoying problem facing by many people these days. Back pain is of different types and differentiated based on the location it effects. Among them, lower back pain is a common painful condition which is affecting the lower portion of the spine.
Lower back pain is a result of injuries to a muscle (strain) or ligament (sprain). The most common causes are an improper lifting of weights, poor posture, lack of physical fitness, fractures, ruptured discs or arthritis etc. Pain that varies according to severity is the most common symptom lower back pain.
Most probably low back pain cures on its own days or weeks. Physiotherapy and some pain killers can help. But, in some cases, surgery may also require.
Diagnosing Lower Back Pain
An overall medical history and a complete physical exam of a person can usually recognise any serious health conditions that may cause pain. The doctor may ask about the area and severity of the pain, duration of symptoms and other conditions which are related to the pain. The particular cause of chronic lower back pain is quite difficult to find even after a thorough examination.
Basic Imaging tests are not guaranteed in some of the cases. However, in some cases, imaging is done to rule out specific causes of pain like tumours and spinal stenosis.
X-ray: It is often the first and foremost imaging technique which is used to look for broken bones or an injured vertebra.
Computerized tomography – CT Scan: It is used to observe spinal structures that are not visible on conventional x-rays, such as ruptured discs, spinal stenosis that lead to pain.
Myelograms: It enhances the diagnostic imaging of CT scans and x-rays.
Discography: It is used to identify the cause of pain when the other diagnostic procedures fail. In this procedure, an injection of a contrast dye is injected into a spinal disc that believed to be causing low back pain.
Electrodiagnostics: These are the procedures primarily used to confirm if a person has lumbar radiculopathy in the setting of low back pain. Procedures like EMG – electromyography, NCS – nerve conduction studies and EP – evoked potential studies also involved in this process.
Bone Scans: They are used to identify and monitor any infections, bone fractures, or any other disorders in the bone.
MRI – Magnetic Resonance Imaging: MRI scans can produce images of soft tissues like muscles, ligaments and blood vessels, where an x-ray can show only bony structures. An MRI is taken to find problems such as tumours, inflammation, disc herniation etc., that causes back pain.
Ultrasound Imaging: It is also termed ultrasound scanning or sonography. Ultrasound imaging can detect tears in muscles, ligaments, tendons and other soft tissues of the back.
Blood tests: Usually, they are not used to diagnose the cause of back pain. However, in some cases, they are done to detect any symptoms of inflammation, infection or the presence of arthritis etc.
Treatment For Lower Back Pain
Usually, Back pain resolves by taking rest for some time and following home remedies, but in some situations medical treatment is necessary. Generally, treatment depends on the type of pain, whether it is acute or chronic. In general, surgery is recommended only if the condition worsening nerve damage and indicating structural changes.
Applying a hot compress or an ice pack in the painful area can also reduce pain.
Exercises: Exercises can improve your posture and gives strength to your back and abdominal muscles. It can be considered as one of the best treatment options for back pain
Salt Baths: A hot bath can do miracles for aching muscles. But, when you’re soaking, mix Epsom salt in the water so that your body can absorb some minerals from the salt water and they can help you to ease aching muscles.
Yoga: some specific yoga poses and breathing exercises. can help in strengthening the back muscles and improves posture.
Medication: A wide range of medications are available to treat acute and chronic low back pain. When over the counter (OTC) does not respond well, some physician’s may prescribe certain drugs like NSAIDs, codeine, oxycodone, hydrocodone and morphine etc.
Physical Therapy: Guided physical therapy with some exercises like stretching, strengthening therapies, applying heat, ice, ultrasound and other electrical stimulation may help to alleviate back pain.
Cortisone Injections: Cortisone is an anti-inflammatory drug injected into the epidural space around the spinal cord. It helps to decrease inflammation growing around the nerve roots.
Botox: Botox (botulism toxin) injections are believed to reduce the pain by paralyzing damaged muscles in spasm.
Traction: This is used to move herniated disk back into position. It can also help in relieving pain only when traction is applied.
Along with the conventional therapies, some other complementary therapies like Chiropractic, osteopathy, shiatsu and acupuncture can also help in relieving back pain.
When other solutions failed, surgery is considered the last option to get relieved pain which is caused by serious musculoskeletal injuries or nerve compression. All surgical procedures might not be successful always, and of course, there is very little evidence that the procedures are worked for their particular indications.
Vertebroplasty: It is a minimally invasive treatment procedure that helps to repair compression fractures of the vertebrae due to osteoporosis.
Spinal Laminectomy: It is also known as spinal decompression and is performed when spinal stenosis narrowing the spinal canal which leads to intense pain, numbness, or weakness.
Discectomy or microdiscectomy: The procedure involves removing a disc when it is herniated and pressurising a nerve root or the spinal cord, which might cause severe and enduring pain.
Nucleoplasty: It also termed as Plasma Disc Decompression (PDD), a type of laser surgery used to treat people with low back pain due to mildly herniated discs.
IDET – Intradiscal electrothermal therapy: The procedure involves treating cracked or bulged discs that occur as a result of degenerative disc disease.
Foraminotomy: Discs or joints are thickened with increasing age and narrow the space where the spinal nerve exits and pressurise the nerve resulting in pain, numbness and weakness. Foraminotomy procedure enlarges the bony hole and reduces the narrowness where a nerve root exits in the spinal canal.
Spinal Fusion: Spinal fusion gives strength to the spine and helps to prevent pain in people with degenerative disc disease or spondylolisthesis. The procedure involves removing the spinal disc between two or more vertebrae and “fused” with adjacent vertebrae by bone grafts or some other metal devices secured by screws.
Artificial Disc Replacement: It is said to be alternative to spinal fusion for the people with severely damaged discs. The procedure involves removing the disc and replacing it by a synthetic disc that helps in the movement between the vertebrae.
Prevention Of Lower Back Pain
If you follow some tips, you can easily prevent low back pain. Some important remedies you need to look at to not to fall a victim of lower back pain are;
- Guided and regular exercise can build strength to back muscles and controls body weight.
- Use of lumbar like wide elastic bands might provide support to the lower back and abdominal muscles that prevent low back pain
- Take a healthy diet which includes sufficient calcium and vitamin D, as they are needed for good bone health.
- You need to quit smoking
- Maintain proper body weight
- Wear flat shoes because high-heeled shoes are more likely to damage your back
- Maintain proper posture while sitting standing
- Take proper back support while driving
- While lifting heavy objects try to bear weight on your legs rather than your back.
- Arrange bed and pillows properly while sleeping
We, Sunshine Hospitals have the best spine doctors in Hyderabad. Our doctors are well experienced and can address any kind of spine-related problems. If you’re facing such problems, book an appointment, consult our doctors, get the best and permanent treatment for back pain or if having any other spine problems.
About Sunshine Hospitals:
A Multi Super Speciality Institution, 500 bedded Sunshine Hospitals (Paradise Circle, Secunderabad) is promoted by globally reputed Joint Replacement Surgeon Dr AV Gurava Reddy (Orthopedic Doctor) and like-minded associates who share the objective of making world-standard healthcare available, affordable and accessible to the common man. Sunshine has now become one of the best hospitals for many treatments including Orthopedic, Gastroenterology, Cardiology, Trauma and Neurology.