Basics of low back pain
Low back pain (LBP) is one of the most common complaints among people. It is estimated that about 70 to 85 percent of all people have at least one experience of suffering from LBP at some time in their lives.
There are many causes but they are typically classified as specific and nonspecific. Most people have nonspecific LBP, which is not caused by a specific disease or abnormality in the spine but by strains or sprains to muscles or ligaments.
LBP is rarely caused by a potentially serious spinal condition, such as a fracture, cancer, infection or a disorder called caudaequina syndrome, which causes weakness and bowel or bladder dysfunction as well as pain. LBP that is associated with leg pain can be due to a herniated disc or spinal stenosis.
So, do not assume the worst even if you do experience LBP. Almost everyone gets this at some point in their lives. It can be scary but most cases are not serious and it usually goes away within four to six weeks. The cases that require surgery or urgent care are rare.
If people experience symptoms such as numbness or weakness in the legs, or problems with bowel or bladder control are present, they should consider seeing a doctor. If the back pain does not improve by taking a rest or changing position, and is so severe that they cannot perform tasks and the pain does not go way within 4 to 6 weeks, the should see a doctor.
Low back pain treatment
Unless LBP is caused by a serious medical condition, a rapid recovery is expected without surgery, even if there is a bulging disc. Only few people need surgery to treat back pain. Most people recover with several simple treatments.
Remaining active: Continue doing regular activities and light exercises, such as walking; but avoid high-impact activities. Many people are afraid that they will hurt their back further by remaining active. But when you remain active, LBP can recover faster because exercising relieves muscle spasm and prevents the loss of muscle strength.
If the back pain is severe, bed-rest may be necessary for a short period of time, usually one day. Prolonged bed-rest is not recommended. When in bed, lie on the back with a pillow behind the knees and the head and shoulders elevated, or lie on the side with the upper knee bent and a pillow between the knees.
Pain medicines and muscle relaxants: Take pain-relief medication such as aspirin, acetaminophen, ibuprofen or naproxen. Take a dose on a regular basis for three to five days, rather than using the medication only when the pain becomes unbearable.
You can get these medications without a prescription. If these do not work, doctors can prescribe stronger pain medicines such as narcotics. Medicines to relax the muscles may be helpful before bedtime when used for a short time, but can cause drowsiness.
Therefore people who need to be alert, such as those driving or operating machinery, should not use muscle relaxants. These medications are available by prescription only.
Hot packs: Using a heating pad can help relieve LBP during the first few weeks.
Physical therapy: Formal exercise programs may involve stretching, flexion and extension exercises, strengthening, aerobic activity, and general fitness.
Spinal manipulation, Acupuncture and Massage: Safe and as effective as conventional treatment such as pain medication, relaxation and exercise.
The author is an Assistant Professor at Seoul National University Hospital International Healthcare Center (SNUH-IHC).