Pain In The Right Lower Back/Acute Back Pain or short-term Back pain lasts a few days to a few weeks. Most low back pain is acute. It tends to resolve on its own within a few days with self-care and there is no residual loss of function. In some cases, a few months are required for the symptoms to disappear. Exercising, bed rest, and surgery are typically not recommended for acute back pain.

Acute Back Pain refers to pain that you feel in your lower back. You may also have back stiffness, decreased movement of the lower back, and difficulty standing straight. Acute back pain can last for a few days to a few weeks. Most back pain is what’s known as “non-specific” (there’s no obvious cause) or “mechanical” (the pain originates from the joints, bones, or soft tissues in and around the spine).

Causes of Pain In The Right Lower Back

Most people have at least one backache in their life. Although this pain or discomfort can happen anywhere in your back, the most common area affected is your lower back. This is because the lower back supports most of your body’s weight. Low back pain is the number two reason that Americans see their health care provider. It is second only to colds and flu.

You will usually first feel back pain just after you lift a heavy object, move suddenly, sit in one position for a long time, or have an injury or accident. Acute low back pain is most often caused by a sudden injury to the muscles and ligaments supporting the back. The pain may be caused by muscle spasms or a strain or tear in the muscles and ligaments.

Causes of sudden low back pain include:

  • Compression fractures to the spine from osteoporosis
  • Cancer involving the spine
  • Fracture of the spinal cord
  • Muscle spasm (very tense muscles)
  • A ruptured or herniated disk
  • Sciatica
  • Spinal stenosis (narrowing of the spinal canal)
  • Spine curvatures (like scoliosis or kyphosis), which may be inherited and seen in children or teens
  • Strain or tears to the muscles or ligaments supporting the back
  • An abdominal aortic aneurysm that is leaking.
  • Arthritis conditions, such as osteoarthritis, psoriatic arthritis, and rheumatoid arthritis.
  • Infection of the spine (osteomyelitis, diskitis, abscess).
  • Kidney infection or kidney stones.
  • Problems are related to pregnancy.
  • Problems with your gall bladder or pancreas may cause back pain.
  • Medical conditions that affect the female reproductive organs, including endometriosis, ovarian cysts, ovarian cancer, or uterine fibroids.
  •  Pain around the back of your pelvis, or sacroiliac (SI) joint.

Back pain can also be triggered by everyday activities at home or work, and by poor posture. For example, back pain may be triggered by:

  • bending awkwardly,
  • lifting, carrying, pushing or pulling incorrectly,
  • slouching in chairs,
  • standing or bending down for long periods,
  • twisting,
  • coughing,
  • sneezing,
  • muscle tension,
  • over-stretching,
  • driving in hunched positions, or
  • driving for long periods without taking a break.

Sometimes, you may wake up with back pain and have no idea what has caused it.

The Symptom of Pain In The Right Lower Back

The main symptom of back pain is, as the name suggests, an ache or pain anywhere on

  • Pain in the back, and sometimes all the way down to the buttocks and legs. Some back issues can cause pain in other parts of the body, depending on the nerves affected.
  • In most cases, signs, and symptoms clear up on their own within a short period. If any of the following signs or symptoms accompany back pain, people should see their doctor:
  • Pain. It may be continuous, or only occur when you are in a certain position. The pain may be aggravated by coughing or sneezing, bending or twisting.
  • Patients who have been taking steroids for a few months
  • Drug abusers
  • Patients with cancer
  • Patients who have had cancer
  • Patients with depressed immune systems
  • Stiffness.

or

  • inflammation or swelling on the back,
  • constant back pain that doesn’t ease after lying down or resting,
  • pain that travels to the chest or pain high up in your back,
  • pain down the legs and below the knees,
  • recent trauma or injury to your back,
  • loss of bladder control,
  • inability to pass urine,
  • loss of bowel control, or
  • numbness around the genitals, buttocks or anus.

Diagnosis of Pain In The Right Lower Back

Diagnosis of back pain is following

  • The physical exam – is also performed similarly between the age groups as long as the patient is old enough to communicate and participate in the review. The physical exam should include inspection, palpation, the range of motion, strength testing, provocative maneuvers, and neurologic (limb strength, sensation, and deep tendon reflex) assessments. Several provocative exercises help demonstrate or decrease suspicion of different processes.
  • A straight leg raise (SLR) – can be complete by raising the patient’s leg to 30 to 70 degrees. Ipsilateral leg pain at less than 60 degrees is a positive test for lumbar disk herniation. The likelihood ratio (LR) of a straight leg raise is 2, with ave likelihood ratio (NLR) of 0.5. If the pain reproduction occurs contralaterally, it is a positive test for a lumbar disk herniation with LR of 3.5 and NLR of 0.72.
  • One leg hyperextension test/stork test – Have the patient stand on one leg and (while being supported by the provider) have them hyper-extend their back. Repeat this maneuver on both sides. Pain with hyperextension is positive for a pars interarticularis defect.
  • Adam test –  Have the patient bend over with feet together and arms extended with palms together. The practitioner should observe from the front. If a thoracic lump is present on one side or the other, it is an indication of scoliosis.
  • A straight leg raising – can be painful in lumbosacral radiculopathy. The mechanism of pain during a straight leg raise is increased dural tension placed upon the lumbosacral spine during the test. Patients are supine during the test. The physician will flex the patient’s quadriceps with the leg in extension as well as dorsiflex the patient’s foot on the symptomatic side. Pain or reproduction of paresthesias is considered a positive test (Lasegue sign). Separately, a Bowstring sign is a relief of this underlying radicular pain with flexion of the patient’s knee on the affected side. The straight leg raising test is most helpful in the diagnosis of L4 and S1 radiculopathies.
  • An internal hamstring reflex – for L5 radiculopathy has also been shown to be a useful test. Tapping either the semimembranosus or the semitendinosus tendons proximal to the popliteal fossa elicits the reflex. When there is an asymmetry of the reflex between legs, this can be significant for radiculopathy.
  • A contralateral straight leg raising test – is the passive flexion of the quadriceps with the leg in extension and foot in dorsiflexion of the unaffected leg by the physician. This test is positive when the unaffected leg reproduces radicular symptoms in the patient’s affected limb. However, the straight leg raising test is more sensitive but less specific than the contralateral straight leg raising test.
  • The prone instability test – The patient starts by standing on one end of the examination couch. While continuing to stand on the foot end of the couch, the patient lowers his / her torso onto the couch.  The patient can hold onto the couch’s sides for support. The examiner then palpates the lower lumbar spine to elicit tenderness. The patient then holds onto the couch and lifts his / her feet off the ground tensing the paraspinal muscles. Less pain and tenderness on repeat palpation of the lower lumbar spine, while the feet are off the floor, is considered positive.
  • Prone Plank/Bridge – The patient is prone and elevates his / her entire body off the couch/mat on the forearms and tips of toes. The body should be parallel to the couch/mat. With adequate muscle strength, men should maintain this position for 124 +/- 72s and Women for 83 +/- 63s.
  • Supine Bridge – The patient is supine and flexes the hip and knee to keep the feet flat on the couch/mat. The arms are flexed to position the hands beside the ears. The lower part of the torso and pelvis is lifted off the couch/mat, to maintain the trunk and the thigh in a straight line. With adequate muscle strength, men should maintain this position for 188 +/- 45s and Women for 152 +/- the 30s.

Lab Test

  • Blood tests – CBC ,ESR,Hb, RBS,CRP, Serum Creatinine, Serum Electrolyte,
  • Bone scan – It is a bone scan that may be used for detecting bone tumors or compression of nerve root fractures caused by brittle bones and osteoporosis. The patient may receive an injection of a tracer (a radioactive substance) into a vein at the same time. The tracer collects or examiner in the bones and helps the doctor detect bone problems with the aid of a special camera.
  • Electromyography (EMG) – It one kind of test that helps assess the electrical activity in a muscle and nerve impulse velocity or nerve root compression and can detect if muscle weakness results from a problem with the nerves that control the muscles. Very fine needles are inserted in muscles to measure electrical activity transmitted from the brain or spinal cord to a particular area of the body that are causing pain.
  • Evoked potential studies – It may involve two sets of electrodes are placed one set to stimulate a sensory nerve, and the other placed on the scalp to record the speed of nerve signal that is transmitted to the brain.
  • Nerve conduction studies (NCS) – It also uses two sets of electrodes to stimulate the nerve that runs to a particular muscle and record the nerve’s electrical signals to detect any nerve damage for lower right and left side back pain.
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Imaging

  • X-rays – These are very accessible at most clinics and outpatient offices. This imaging technique can be used to assess for any structural instability. If x-rays show an acute fracture, it needs to be further investigated using a computed tomogram (CT) scan or magnetic resonance imaging (MRI).
  • CT Scan – It is the preferred study to visualize bony structures in the spine. It can also show calcified herniated discs. It is a less accessible inpatient in office settings compared to x-rays. But it is more convenient and reliable than MRI. In the patients with lower right and left-back pain, that have non-MRI comparable implanted devices, CT myelography can be performed to visualize herniated disc.
  • CT myelography -It is a special kind when the patient has either a contraindication to having an MRI such as heart problem, open-heart surgery, or having a pacemaker device or defibrillator or be used when a standard CT or MRI is negative or equivocal. Myelography is a CT scan or an MRI with intrathecal administration of contrast for lower back pain. CT myelography visualizes a patient’s spinal nerve roots in their passage through the neuroforamina area. CT myelography can be used to assess the underlying root sleeve and nerve root compression. A CT is a poor test for the visualization of nerve roots, making it challenging to diagnose radicular disease.
  • Electromyography (EMG) – It is complete after three weeks of symptoms, not before the lower right and left back pain. Diagnostic tests such as EMG or nerve conduction studies are accurate only after three weeks of persistent symptoms of right or left lower back pain. The primary reason or why using an EMG or nerve conduction study is to identify the delayed three weeks or more time following the development of pain is because of fibrillation potentials after an acute injury in the brain and spinal cord lead to an axonal motor loss. These do not develop until two to three weeks following injury for the lower right and left back pain.
  • Cerebrospinal fluid analysis – It is a useful test for investigating the right and left lower back pain if there is an involvement of neoplasm or infectious cause or radiculopathy symptoms and radiating pain syndrome. The recommendation for lower right and left back pain in lumbar puncture is in the case of a patient with negative or nondiagnostic neuroimaging, without knowing primary cancer and its related condition, who has progressive neurological symptoms and has failed back syndrome to improve it properly.
  • MRI – It is the preferred and most sensitive study to visualize herniated disc, bulging disc, or sequestered disc. MRI findings will help to find the soft tissues, ligament, tendon, cartilage even spinal cord clearly to surgeons and other providers plan procedural for lower right and left side back pain care if it is indicated.
  • Bone scintigraphy – It is a special type of test that is done when some or above mention test failed to identify the causes of right and left lower back pain with single-photon emission computed tomography (SPECT) is more sensitive in detecting facet joint lesions and bony lesion, none spurs and allows more accurate anatomical localization of lower back pain. A recent study suggested that SPECT could help to identify patients with lower back pain who would benefit from facet joint intraarticular injections []. Facet joint block (FJB)injection is an indispensable diagnostic instrument in order to identify painful or painless back pain from painless facet joints and to plan the intervention strategy.
  • Foraminal nerve root entrapment test – It is best visualized on T1-weighted MRI where are used to identify the high contrast fat tissue and the nerve root sheath that is of great help for lower and right or left ba. In here usually, a combination of hypertrophic degenerative facets with osteophytes spurs posteriorly, and vertebral osteophytes and/or disc herniation anteriorly diminishes the anteroposterior diameter of the foramen and it associate condition. Foraminal height is erased by degenerative disc disease and subsequent disc height loss or not. In this case, the normal rounded (oval) appearance of the nerve root sheath is lost in combination with loss of the surrounding fat tissue, nerve root compression should be considered to identifying the lower right and left side back pain.


Treatment of Pain In The Right Lower Back

Most cases of acute back pain can be treated using self-help techniques. These are discussed below.

  • Physiotherapy – Physiotherapy aims to improve human function and movement and maximizing potential: it uses physical approaches to promote, maintain and restore physical, psychological, and social well-being, through the use of manual therapy, electrotherapy, and exercise.
  • Manual therapies – including manipulation, massage, mobilization.
  • Heat and/or ice – may help ease pain, reduce inflammation, and improve mobility for some people
  • Gentle stretching – (not vigorous exercise) upon advice by your healthcare professional
  • Other non-pharmacological interventions – Including, laser, transcutaneous electrical nerve stimulation, traction, ultrasound, IRR, wax therapy.
  • Percutaneous electrical nerve stimulation (PENS)- including acupuncture, electro-acupuncture, nerve blocks, neuro reflexotherapy, percutaneous electrical nerve stimulation (PENS), injection of a therapeutic substance into the spine.
  • Hydrotherapy – An exercise treatment conducted within a specially designed pool so that water supports the patient’s body weight
  • Interferential therapy – An electrical treatment that uses two medium frequency currents, simultaneously, so that their paths cross. Where they cross a beat frequency is generated which mimics a low-frequency stimulation
  • Intra-Discal Electrothermal Therapy (IDET) – Use of a heating wire passed through a hollow needle into the lumbar disc intended to seal any ruptures in the disc.
  • Manipulation – Small amplitude high-velocity movement at the limit of joint range taking the joint beyond the available range of movement.
  • Transcutaneous electrical nerve stimulation (TENS) – Electrodes are placed on the skin and different electrical pulse rates and intensities are used to stimulate the area. Low-frequency TENS (also referred to as acupuncture-like TENS) usually consists of pulses delivered at 1 to 4 Hz at high intensity, so they evoke visible muscle fiber contractions. High-frequency TENS (conventional TENS) usually consists of pulses delivered at 50 to 120 Hz at a low intensity, so there are no muscle contractions.
  • McKenzie – A system of assessment and management for all musculoskeletal problems that uses classification into non-specific mechanical syndromes. Assessment involves the monitoring of symptomatic and mechanical responses during the use of repeated movements and sustained postures
  • Neuroreflexotherapy – Temporary implantations of epidermal devices into trigger points at the site of each subject’s clinically involved dermatomes on the back and into referred tender points in the ear.
  • Traction – Traction performed by utilizing the patient’s own body weight (for example by suspension via the lower limb) or through movement.
  • Intra-Discal Electrothermal Therapy (IDET) – Use of a heating wire passed through a hollow needle into the lumbar disc intended to seal any ruptures in the disc.
  • Topical pain relief – such as creams, gels, patches, or sprays applied to the skin stimulates the nerves in the skin to provide feelings of warmth or cold in order to dull the sensation of pain. Common topical medications include capsaicin and lidocaine.
  • Acupuncture – This Chinese practice uses thin needles to relieve pain and restore health. Acupuncture may be effective when used as a part of a comprehensive treatment plan for low back pain. But it has a side effects and controversy of pain management.
  • Acupressure – A therapist applies pressure to certain places in the body to relieve pain. Acupressure has not been well studied for right and left back pain. Move your body properly while you do daily activities, especially those involving heavy lifting, pushing, or pulling. Back pain is generally treated with non-pharmacological therapy first, as it typically resolves without the use of medication. Superficial heat and massage, acupuncture, and spinal manipulation therapy may be recommended.
  • Heat therapy –  It is useful for back muscle spasms or weakness or other conditions. A review concluded that heat therapy can reduce symptoms of acute and sub-acute low-back pain.
  • Regular activity and gentle stretching exercises – It is encouraged in uncomplicated lower back pain and is associated with better long-term treatment outcomes. Physical therapy to strengthen the muscles in the abdomen and around the spine may also be recommended that are work surprisingly.
  • Outdoor exercises  – It is associated with better patient satisfaction, although it has not been shown to provide functional improvement in satisfaction level. However, one scientific study found that exercise is effective for chronic back pain, but not for acute pain. If used, they should be performed under the supervision of a licensed health professional.
  • Massage therapy – may give short-term pain relief, but not a functional improvement for lower back, for those with acute lower back pain. It may also give short-term pain relief and functional improvement for those with long-term (chronic) and sub-acute lower pack pain, but this benefit does not appear to be an effective result after 6 months of treatment. There has not appeared to be any serious side effects associated with massage.
  • Spinal manipulation – Spinal manipulation for lower back pain is a widely-used method of treating back pain, although there is no evidence of long-term benefits.
  • Back school – It is an intervention that consists of both education and physical exercises. A 2016 Cochrane scientific review found the evidence concerning back school to be very high-quality effectiveness and was not able to make generalizations as to whether back school is how much effective.
  • Heat Or Ice Therapy – Applying heat pads, ice packs, or using both alternatively sometimes can help to relieve stiffness, inflammation, and muscle spasms related to right and left side of lower back pain. Cold compresses can be used to reduce swelling in the back muscle.
  • Braces – For patients with chronic lower back pain or a deformity in the spine due to trauma, the doctor may recommend wearing a brace to provide support to the spine. Back braces can help to maintain the right proper posture, limit strenuous movement, or unusual movement and the spine to provide relief from lower back pain.
  • Physical Therapy – The physical therapist may apply heat, ice, electrical stimulation, and other mechanisms to release muscle weakness and stiffness from the back muscles. He may also help the patient learn posture correction techniques to prevent the pain from recurring lower back pain.
  • Exercise – Your doctor may advise you to perform light stretching exercises to increase the flexibility of the muscles in the back. He may also recommend certainly or exercises to strengthen the core and improve the overall well-being of the patient.
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Medication

If non-pharmacological measures are not effective, medications may be tried.

  • Analgesics – It is with or without paracetamol may improve pain and function compared with treatment for lower right and left back pain. It is taken by mouth or applied to the skin. Examples include acetaminophen and aspirin. Your doctor may suggest steroid or numbing shots lessen your pain reliever to erase the lower back pain. However, long-term use of NSAIDs or opioids may be associated with well-recognized adverse effects.
  • Non-steroidal anti-inflammatory drugs – (NSAIDs) may be more effective than placebo at improving pain intensity in lower back pain and people with chronic low back pain. Pain medicines and anti-inflammatory drugs help to relieve pain and stiffness, allowing for increased mobility and exercise. There are many common over-the-counter medicines called non-steroidal anti-inflammatory drugs (NSAIDs). They include mainly or first choice etodolac, then tramadol, aceclofenac, etoricoxib, ibuprofen, and naproxen. Nonsteroidal anti-inflammatory drugs were again the first-line pharmacologic agents recommended followed by tramadol in first-line and duloxetine as the second-line treatments.
  • Antidepressants  – It is used to decrease chronic low back pain or improve function compared with placebo in people with or without depression. The antidepressants such as tricyclic antidepressants and SNRI’s, muscle relaxers, N-methyl-d-aspartate (NMDA) receptor antagonists, and alpha 2 adrenergic agonists are also the most effective pharmacological therapies for the treatment of lower back pain.
  • Muscle Relaxant – Benzodiazepines may improve pain, but studies of non-benzodiazepine muscle relaxants have given conflicting results. Muscle relaxants, such as baclofen, tolperisone, eperisone, methocarbamol, carisoprodol, and cyclobenzaprine, may be prescribed to control muscle spasms and their associate low back pain.
  • Gabapentin – The initial stage of treatment for lower back pain, neuropathic pain, and chronic back pain are often treated with gabapentin or pregabalin.  It is Considere’s most effective treatments are in general recommended in chronic low back pain. They have also indicated for postherpetic neuralgia, diabetic neuropathy, and mixed neuropathy.
  • Tricyclic antidepressant (TCA) – It is a type of drug that can be used to treat back pain this use is different from its mode of action in treating depression, which usually requires a much higher dose. Examples include amitriptyline and imipramine that are used to treat the right and left side lower back pain.
  • Epidural corticosteroid injections – It is a type of injection or local injections with corticosteroids and a local anesthetic that are pushed in the joint space to reduce the nerve entrapment related to lower back pain to improve chronic low back pain treatment in people without sciatica. Facet-joint corticosteroid injections may be more effective than placebo at reducing pain.
  • Epidural glucocorticoid injections – are beneficial for up to three months in duration in patients with acute lumbar radiculopathy and lower back pain. This injection benefit is modest yet clinically significant in the short-term. If a patient has not improved after six weeks of conservative management, they would be eligible for an epidural glucocorticoid injection to treat the right and left side lower back pain.
  • Oral steroids tablets – These a very simple and are often prescribed for acute low back pain, and chronic low back pain although there is limited evidence to support their use. It is basically used to remove nerve-related inflammation, edema, hematoma. There is evidence that a single dose of steroids, such as dexamethasone, may provide lower back pain relief.
  • The serotonin-norepinephrine reuptake inhibitor (SNRI) – duloxetine is useful in treating chronic pain, osteoarthritis, and the treatment of fibromyalgia and associate pain. Furthermore, the efficacy of duloxetine in the treatment of comorbid depression is comparable to other antidepressants. Venlafaxine is an effective treatment for neuropathic pain, as well as another neuropathic agent. A TCA can also be utilized, such as nortriptyline. TCA medications may require time six to eight weeks to achieve their desired effect.
  • Topical lidocaine and ointment – is a useful treatment for neuropathic pain and allodynia as in postherpetic neuralgia. Separately, topical capsaicin cream and ointment is an option for chronic neuropathic or musculoskeletal pain unresponsive to other treatments for conservative management failed.
  • Opioids – are considered a second-line option; however, they may be warranted for pain management for patients with severe persistent pain, chronic or neuropathic pain secondary to malignancy. Opioid therapy should only start with extreme caution for patients with chronic back pain and musculoskeletal pain. The drug has the major side effects of opioids are significant and frequent and may include opioid-induced hyperalgesia, constipation, dependence, and sedation or its associate problem.
  • Epidural corticosteroid injection – (ESI) is a procedure in which steroid medications are injected into the epidural space of the spinal cord. Steroid medications help to reduce inflammation and thus decrease pain and improve functional mobility. ESI has long been used to both diagnose and treat back pain, although recent studies have shown a lack of efficacy in treating lower back pain.

Treatments you can try yourself

Stay active

  • One of the most important things you can do is to keep moving and continue with your normal activities as much as possible.
  • It used to be thought that bed rest would help you recover from a bad back, but it’s now known that people who remain active are likely to recover quicker.
  • This may be difficult at first, but do not be discouraged – your pain should start to improve eventually. Consider taking painkillers if the pain is stopping you from carrying on as normal.
  • There’s no need to wait until you’re completely pain-free before returning to work. Going back to work will help you return to a normal pattern of activity and may distract you from the pain.

Back exercises and stretches

Simple back exercises and stretches can often help reduce back pain. These can be done at home as often as you need to. For information about exercises and stretches that can help, see:

  • back pain pilates workout video
  • Versus Arthritis: exercises to manage back pain

A GP may be able to provide information about back exercises if you’re unsure what to try, or you may want to consider seeing a physiotherapist for advice. Read about how to get access to physiotherapy. Doing regular exercise alongside these stretches can also help keep your back strong and healthy. Activities such as walking, swimming, yoga and pilates are popular choices.

Hot and cold packs

  • Some people find that heat (such as a hot bath or a hot water bottle placed on the affected area) helps to ease the pain when back pain first starts.
  • Cold (such as an ice pack or a bag of frozen vegetables) on the painful area can also help in the short erm. However, do not put ice directly on your skin, as it might cause a cold burn. Wrap an ice pack or bag of frozen vegetables in a cloth or towel first.
  • Another option is to alternate between hot and cold using ice packs and a hot water bottle. Hot and cold compression packs can be bought at most pharmacies.

Relax and stay positive

Trying to relax is a crucial part of easing the pain as muscle tension caused by worrying about your condition may make things worse.

  • 10 stress busters
  • breathing exercises for stress

Although it can be difficult, it helps to stay positive and recognize that your pain should get better. People who manage to stay positive despite their pain tend to recover quicker.

Specialist treatments

Exercise classes

  • A GP may suggest attending an NHS group exercise programme if they think it might help to reduce your pain.
  • These programs involve classes, led by a qualified instructor, where you’re taught a mix of exercises to strengthen your muscles and improve your posture, plus aerobic and stretching exercises.

Manual therapy

  • Manual therapy is the name for a group of treatments where a therapist uses their hands to move, massage and apply careful force to the muscles, bones, and joints in and around your spine.
  • It’s usually done by chiropractors, osteopaths or physiotherapists, although chiropractic and osteopathy are not widely available on the NHS.
  • Manual therapy can help reduce back pain, but it should only be used alongside other measures such as exercise.
  • There’s also some evidence that a therapy called the Alexander technique may help with long-term back pain. However, the National Institute for Health and Care Excellence (NICE) does not currently recommend this treatment.

Psychological support

  • A GP may suggest psychological therapy, in addition to other treatments such as exercise and manual therapy.
  • Psychological therapies such as cognitive-behavioral therapy (CBT) can help you manage your back pain better by changing how you think about your condition.
  • While the pain in your back is very real, how you think and feel about your condition can make it worse.
  • If you’ve been in pain for a long time, a specialist treatment program that involves a combination of group therapy, exercises, relaxation, and education about pain and the psychology of pain may be offered.
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Nerve treatment

A procedure called radiofrequency denervation may sometimes be used if:

  • you’ve had back pain for a long time
  • your pain is moderate or severe
  • your pain is thought to originate from the joints in your spine
  • The procedure involves inserting needles into the nerves that supply the affected joints. Radio waves are sent through the needles to heat the nerves, which stops them from sending pain signals.
  • You’re awake while the treatment is being done and a local anesthetic is used to numb your back. You will not need to stay in hospital overnight.
  • As with all procedures, radiofrequency denervation carries a risk of complications, including bleeding, bruising, infection, and accidental nerve damage. Discuss the risks with your surgeon before agreeing to treatment.

Spinal fusion surgery

  • Spinal fusion surgery is another type of surgery for back pain. It may be recommended if there’s significant damage to the bones in your back (vertebrae).
  • Spinal fusion surgery can be used to fuse 2 vertebrae together to strengthen them. This can also help to reduce any related nerve pain as it stops the damaged vertebrae from squeezing the nerves that pass through the spine.
  • It’s possible that this type of surgery could cause permanent damage to some of the nerves in your back. This may lead to some partial paralysis in your legs and bowel or urinary incontinence. This complication is estimated to happen in around 1 in every 200 procedures.

Treatments not recommended

A number of other treatments have sometimes been used for non-specific back pain (back pain with no identified cause) but are not recommended by the National Institute for Health and Care Excellence (NICE) because of a lack of evidence.

These include:

  • belts, corsets, foot orthotics and shoes with “rocker” soles
  • traction – the use of weights, ropes and pulleys to apply force to tissues around the spine
  • acupuncture – a treatment where fine needles are inserted at different points in the body
  • therapeutic ultrasound – where sound waves are directed at your back to accelerate healing and encourage tissue repair
  • transcutaneous electrical nerve stimulation (TENS) – where a machine is used to deliver small electrical pulses to your back through electrodes (small sticky patches) attached to your skin
  • percutaneous electrical nerve stimulation (PENS) – where electrical pulses are passed along needles inserted near the nerves in the back
  • interferential therapy (IFT) – where a device is used to pass an electrical current through your back to try to accelerate healing
  • painkilling spinal injections (although these can help if you have sciatica)

LIFESTYLE CHANGES TO TREAT LOWER BACK PAIN

  • Replace your mattress – The softer your mattress, the less evenly your weight will be distributed, and the more likely you are to experience discomfort. A medium to firm mattress is your best option. Before you commit to a new mattress make sure you’ve diagnosed exactly what your back issues are. Do some research to figure out what kind of mattress will suit your needs. The Emma mattress is an excellent option or browses more mattress reviews.
  • Change how you sleep – Pain can cause difficulty sleeping and lack of sleep can make the pain even worse – it’s a vicious cycle that’s hard to break. Small changes like rearranging your sleeping position, reducing or increasing the number of pillows, or relaxing with a hot shower before bed can make a difference.
  • Change your clothes – Constrictive clothing like skinny jeans and Spanx can restrict the spine’s normal range of motion and inhibit normal conditioning of muscles. This causes the lower back to become more susceptible to strain and injury, say experts. So let it all hang out, ladies – doctor’s orders.
  • Get online – The Mayfair Clinic offers the Back in Shape Programme – free to join, or £15 per month for Premium membership, it’s ideal if you’re housebound and need expert advice. Or take a look at the clinic youtube channel.
  • Exercise your core – Exercising the muscles in your abs and back can have a positive impact on lower back pain. Even doing something as simple as correcting your posture while you’re sitting at your desk has a lasting effect. If you feel like taking it a step further, practice sitting upright on an exercise ball for 30 minutes a day, or take up Pilates.
  • Have a foot check-up – According to a study in the journalRheumatology, women whose feet roll inwards when they walk may be especially prone to lower back pain. If you suspect that your feet might not be helping, it’s worth speaking to a specialist about your concerns. You can then look into taking extra measures, such as wearing orthotics to correct the arch of your feet.
  • Keep moving – You may think the best way to deal with pain is to lie still, but there’s nothing worse for lower back pain. Stretch your body out, go for a walk, and enjoy the fresh air. Even better, take part in a yoga class.
  • Get a massage – Research found that those who received weekly massages experienced less pain after 10 weeks compared to those who didn’t. General relaxation rubdowns also worked as well as structural massages that target specific body parts. Another study revealed that 63% of people experienced a moderate improvement in lower back pain when they underwent six osteopathic manual treatments over 8 weeks, with 50% reporting substantial improvement.
  • Try acupuncture – A 2013 study reported that acupuncture might actually provide more relief than painkillers. Acupuncture works by changing the way your nerves react and can help with inflammation around the joints.
  • Stop smoking – Smoking compromises blood supply to the spine, which can cause the intervertebral discs to age more quickly. This increases susceptibility to injury and herniation.
  • Sit less – In recent years, sitting has been coined the new smoking and for good reason – sitting in a chair puts 30% more pressure on the spine than standing or walking. If you sit at a desk all day (or on the sofa all evening), get up and walk around at least once an hour. Avoid slouching and, if you can, adjust your seat so it tilts slightly back.

When to Contact a Medical Professional

Call your provider right away if you have:

  • Back pain after a severe blow or fall
  • Burning with urination or blood in your urine
  • History of cancer
  • Loss of control over urine or stool (incontinence)
  • Pain traveling down your legs below the knee
  • Pain that is worse when you lie down or pain that wakes you up at night
  • Redness or swelling on the back or spine
  • Severe pain that does not allow you to get comfortable
  • Unexplained fever with back pain
  • Weakness or numbness in your buttocks, thigh, leg, or pelvis

Also call if:

  • You have been losing weight unintentionally
  • You use steroids or intravenous drugs
  • You have had back pain before, but this episode is different and feels worse
  • This episode of back pain has lasted longer than 4 weeks

Prevention

There are many things you can do to lower your chances of getting back pain. Exercise is important for preventing back pain. Through exercise you can:

  • Improve your posture
  • Strengthen your back and improve flexibility
  • Lose weight
  • Avoid falls

It is also very important to learn to lift and bend properly. Follow these tips:

  • If an object is too heavy or awkward, get help.
  • Spread your feet apart to give your body a wide base of support when lifting.
  • Stand as close as possible to the object you are lifting.
  • Bend at your knees, not at your waist.
  • Tighten your stomach muscles as you lift the object or lower it down.
  • Hold the object as close to your body as you can.
  • Lift using your leg muscles.
  • As you stand up with the object, do not bend forward.
  • Do not twist while you are bending down for the object, lifting it up, or carrying it.

Other measures to prevent back pain include:

  • Avoid standing for long periods. If you must stand for your work, alternate resting each foot on a stool.
  • Do not wear high heels. Use cushioned soles when walking.
  • When sitting for work, especially if you are using a computer, make sure your chair has a straight back with an adjustable seat and back, armrests, and a swivel seat.
  • Use a stool under your feet while sitting so that your knees are higher than your hips.
  • Place a small pillow or rolled towel behind your lower back while sitting or driving for long periods.
  • If you drive a long distance, stop and walk around every hour. Bring your seat as far forward as possible to avoid bending. Do not lift heavy objects just after a ride.
  • Quit smoking.
  • Lose weight.
  • Do exercises on a regular basis to strengthen your abdominal and core muscles. This will strengthen your core to decrease the risk of further injuries.
  • Learn to relax. Try methods such as yoga, tai chi, or massage.

References

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