|
 Lower back pain (LBP) is one of the most common health problems
a person is likely to experience in their lifetime. In fact,
over 90% of the population will experience an acute episode
of LBP sometime during their adult years. Back pain ranks
as the second most common reason for visiting a doctor, and
after the common cold, is the leading cause of missing work.
The most common cause of acute LBP is musculoskeletal. By
musculoskeletal, we are referring to the many muscles, ligaments,
and joints that stabilize the lower back. The majority of
musculoskeletal lower back pain is relatively mild and self-limited.
Symptoms typically consist of aching lower back pain with
stiffness and reduced range of motion sometimes punctuated
by acute muscle spasm. In general, about 80% of acute LBP
resolves within 6 weeks. Rarely, the cause of lower back pain
can be more serious and be due to a bulging or ruptured disc,
bone fracture, infection or tumor. Symptoms can be more sever
in these cases and include neurologic symptoms in the form
of leg pain, numbness, weakness or urinary problems.
In my opinion, the best “treatment” for LBP
is to prevent it from occurring. The best preventive measures
utilized for LBP can be achieved by adhering to a healthy
lifestyle. Exercise remains the cornerstone of maintaining
a healthy lower back. Regular low impact aerobic exercise
combined with a regimen of core strengthening exercises and
gentle stretching will prevent the majority of LBP from developing.
Maintaining a healthy balanced diet and reasonable weight
will reduce the stress of the lower back and foster strong
bones and muscles. Strongly avoid smoking, as there is a direct
effect on the health of your lower back discs and joints with
a significant increase in degeneration of these structures
in smokers.
If, however, you do develop acute LBP, below are some of
the most common questions and answers concerning your treatment.
Should I restrict myself to bed rest
with acute LBP?
No. Numerous studies have illustrated a quicker recover
and shorter duration of LBP when bed rest is avoided and the
patient maintains a low level of tolerated aerobic activity.
No vigorous activity, but regular walking and your daily routine
activities can continue.
Should I use Tylenol or Advil/Motrin?
Both medications can be useful in reducing pain and can be
considered as initial medications for the treatment of acute
LBP. Advil or Motrin may be more successful in reducing symptoms
over several days if used consistently since they act as anti-inflammatory
medications and can treat the pain at its source. Consult
your doctor to discuss any long-term use of these medications.
Should I use Heat or Ice?
As in the above question, both can be utilized in treating
LBP but generally ice has a bigger role in treating the acute
pain. Ice directly helps reduce inflammation in your lower
back and thereby reduces pain. Ice should be used consistently
in the initial 48 to 72 hours of the onset of acute LBP with
you applying ice to the affected area for 15-20 minutes up
to every 2-3 hours during the day.
How should I sleep when I have acute
LBP?
Sleeping on your back with a pillow under your knees or
on either side with a pillow between your knees can help reduce
stress on your lower back. Avoid sleeping on your stomach
as it puts more strain on the lower back.
Consult your doctor if you back pain persists despite these
conservative treatments. Immediately call your doctor if your
pain is not just limited to your back but also includes leg
pain, leg numbness, leg weakness, problems going to the bathroom,
or uncontrolled pain.
|
