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Managing Chronic Low Back Pain

Most people suffer from low back pain at some point. It is one of the most common reason for visits to the doctor, pain medicine, and surgery. Most people will get better on their own in a few days or weeks. However, others may have chronic pain (longer than 12 weeks). And this pain can have a big impact on their day to day life.

How Back Pain Happens

The back is a strong column of bones, nerves, ligaments, and muscles. Gel like discs sit between the bones to provide a cushion to the bones and nerves. The back lets you do a wide range of movements and keep you upright. Unfortunately, if any part of this system is damaged it can make even basic movements very painful. Strains and sprains to the muscles or ligaments can lead to muscle spasms. The nerves can become pinched or irritated and cause shooting, burning, or tingling pain.

Chronic back pain is often due to a gradual wear and tear on the back. Some of these changes are due to aging. Other are created or made worse by repeated stress or strain on the back. Excess strain can be caused by:

Being overweight
Injuries at work
Poor posture
Poor workspace design

Medical conditions that may lead to chronic back pain include:

Medical problems, such as arthritis, spinal stenosis, tumors, infections, or fractures that result in injury to bones
Spinal defects, some of which may be found at birth
Prior surgery or back injury

Many times, there is no clear cause of low back pain.

Treatment Methods

Pain can be very limiting. To help manage pain your doctor may recommend:

Warm and cold compresses
Medicines, such as
- Pain and anti-inflammatory medicines
- Antidepressants
- Muscle relaxers—short term use only
- Opioid therapy—short term use if other treatments do not work
Balneotherapy—the use of hot and cold baths and spas

Back pain can make day to day life difficult. The following may help you develop skills to help you manage the changes:

Cognitive-behavioral therapy(CBT)—to decrease stress of chronic pain
Occupational therapy—develop less painful options for daily care activities

The following may also help prevent or slow future damage:

Physical therapy
Exercise and strength training
Relaxation

Alternative Therapies

These therapies may give you some relief. They should be used along with standard medical treatment.

Here are some alternative therapies that may treat chronic low back pain:

Chiropractic—may help to release muscle imbalances in the spine
Osteopathic manipulative treatment—may realign joints and increase range of motion
Acupuncture—may help tight tissue relax
Massage therapy—may help relax tight muscles and improve blood flow

Steps to Manage Chronic Pain

If you have chronic pain, keep in mind:

People in chronic pain often end up isolating themselves. This can make pain worse. Look for resources such as your medical team, family, friends, or support groups. This is the first step to gain control over your pain and your life.
The best treatment program will need to address all the facets of chronic pain. This includes mental health, relationships, career impact, and physical concerns. Looking for a treatment for only one of these problems will not work.
Your goal should be to return to your normal activities, not only to reduce your pain.
Look ahead to imagine what it will be like to have no pain. But also look back to measure your progress. It is easier to succeed when you see how far you have come.
Many companies have programs to help set up safe work areas. Ask about your company's program. They may be able to make improvements in your work area to reduce stress on your back.

Think about going to a doctor who specializes in physical medicine or chronic low back pain. These doctors may have more options for you.

RESOURCES:

American Academy of Physical Medicine and Rehabilitation
http://www.aapmr.org

American Society of Exercise Physiologists
http://www.asep.org

CANADIAN RESOURCES:

Canadian Society of Exercise Physiology
http://www.csep.ca

Health Canada
http://www.hc-sc.gc.ca

REFERENCES:

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Last reviewed August 2017 by EBSCO Medical Review BoardMichael Woods, MD, FAAP Last Updated: 4/20/2018

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