Treatments
Exercises for the back are discussed in the exercise section of this website and are important for strengthening and stabilizing the back and core muscles. Stretching and flexibility exercises also help to relieve pain and improve movement.
Physiotherapy, acupuncture, chiropractic care, and massage therapy may assist in rehabilitation. Different patients respond differently to each of these therapies. Some patient's will have temporary relief, others it may last longer. If there is no benefit after a few sessions, more treatments will unlikely change the outcome.
MEDICATIONS FOR BACK PAIN
Acetaminophen: This medication can help relieve mild pain. If taken too often, it may cause problems with the liver.
Nonsteroidal anti-inflammatory drugs (NSAIDs): Advil, Aleve, and other NSAIDs can help manage pain. They do carry risks of gastrointestinal problems such as ulcers.
Muscle relaxants: While these may have some benefit with acute back pain, they should not be taken for chronic pain. They can also cause dizziness and drowsiness.
Topical pain relievers: These have limited benefit for most patients. These products deliver pain-relieving medications through the skin.
Narcotics: Opioids, such as oxycodone or hydrocodone, are not shown to be of benefit for chronic back pain.
Antidepressants: Some antidepressants such duloxetine (Cymbalta) and amitriptyline have a role in relieving symptoms of chronic back pain.
Neuromodulators: Pregabalin or Gabapentin help to reduce neuropathic pain caused by sciatica or nerve irritation.
INTERVENTIONAL PROCEDURES
Nerve blocks: These are injections near specific nerves to deliberately block the pain signal. This treatment offers temporary relief of pain and creates a therapeutic window to allow for restoration of function so to enable one to sleep better, have better mood, and to increase activities that may help with rehabilitation and long-term improvement.
Epidural Steroid Injection: This treatment involves the delivery of medication into the epidural area which is the space around the spinal cord. If there are sciatic symptoms owing to the narrowing of space in the nerve passages, this treatment helps reduce inflammation and irritation.
Radiofrequency Ablation: This treatment uses heat from radio waves to destroy an area of a problematic nerve, stopping the nerve from sending further pain signals to your brain. It can offer longer pain relief.
Surgery: While there various factors to take into account before considering surgery, every patient should be aware of the following red flags that would prompt immediate surgical attention.
1. New onset bowel/bladder issues. The most common symptom is urinary retention where the bladder is full but one doesn't feel an urge to urinate. Other bowel/bladder issues can include bowel/bladder incontinence.
2. Sensory disturbance in the anus, genitals and buttocks region. This is known as "saddle anesthesia".
3. Weakness or paralyses in the limbs.
4. Gait or balance problems.
Mindfulness and Meditation
While back pain may have started as the primary problem, once the condition has been present for some time, psychological factors can add a different dimension to one's condition.
The chronicity of pain can be emotionally exhausting. Relaxation strategies including tai chi and yoga, as well as meditation exercises, can help alleviate the frustration, irritability, and mood disorders that often accompany chronic pain.