More than 26 million Americans between the ages of 20-64 endure frequent low-back pain. It’s the leading cause of disability in Americans under age 45 and it becomes more common with age.
Fortunately, there are options for pain sufferers besides going under the knife. Non-surgical treatment for low-back pain can work as well as surgery in many cases, sparing patients invasive procedures and potential surgery-related complications.
The most important thing is to figure out the source of the back pain, says Sheeraz Qureshi, MD, MBA, chief of spine trauma at Elmhurst Hospital Center and assistant professor, orthopedic surgery, who specializes in spine surgery at Mount Sinai Hospital’s School of Medicine in New York. Patients with low back pain generally fit into three categories: axial (mostly 100 percent of the pain is related to muscle strain or degenerated disk disease), herniated disks (tends to affect people ages 20 to 60 who experience pain running down the leg) and spinal stenosis (generally affects seniors with pain in the back, buttocks and thighs).
For axial back pain people can try non-operative options for as long as they want, says Dr. Qureshi. “But for a herniated disk or spinal stenosis, if non-operative treatments don’t help after three months, it’s time to figure out what is going to get them better,” says Dr. Qureshi. Here’s a look at non-surgical treatment options:
*Medication. Doctors may advise over-the-counter anti-inflammatory medications like Advil or Aleve, or prescription medication like steroids. Over-the-counter medication can be taken for 10 days to two weeks but if people need it beyond two weeks, see a doctor for pain, says Dr. Qureshi. “The thought is that a component of the back pain is related to inflammation and anti-inflammatory medications should relieve the pain.”
*Physical Therapy. Patients are taught exercises designed to reduce pain and improve function. Yoga and Pilates—techniques patients can continue long after working with a physical therapist—are included under the physical therapy umbrella. According to the National Institute of Neurological Disorders and Stroke, exercise is an effective way to speed recovery from low-back pain. “Physical therapy strengthens the sleeve of the muscles around the back, taking the load off the disk,” says Dr. Qureshi. It’s good for those with axial back pain but physical therapy isn’t going to solve the problem for a herniated disk or spinal stenosis.”
*Injections. There are several types of injections to treat (and sometimes diagnose) specific low back conditions. They typically offer immediate pain relief. Epidural steroid injections deliver numbing drugs mixed with steroid medication delivered around the nerves right to the spot of pain. Other injections include selective nerve root block (SNRB), facet joint block, facet rhizotomy and sacroiliac joint block.
Back pain is the most common reason people use complementary and alternative medicine (CAM). According to a national survey published in the Journal of the American Board of Family Medicine, the majority of people who used CAM for back pain perceived benefit.
Chiropractic care can be helpful but it’s important to have an accurate diagnosis so treatment doesn’t make the problem worse, says Dr. Qureshi. “People with back pain once a year or with an injury from heavy lifting often benefit from chiropractic treatment but if there’s a true herniated disk, this type of treatment can be too aggressive.”
Chiropractors focus on the alignment of the spine. Treatment often involves manual manipulation or adjustment of the spinal column. Doctors of Osteopathy and physical therapists also specialize in manual manipulation.
Acupuncture has been proven to be a potential remedy for back pain in some patients, says Dr. Qureshi. “It’s noninvasive and the needles regulate the flow of vital energy through the body.” According to the National Center for Complementary and Alternative Medicine (NCCAM), combining actual acupuncture with conventional treatment was more effective than conventional treatment alone for relieving chronic low-back pain.
CONNECT THE DOTS
To learn more about lower back pain, visit the websites, Mayo Foundation for Medical Education and Research, American Academy of Orthopaedic Surgeons, and National Institute of Arthritis and Musculoskeletal and Skin Diseases.
PREVIOUS POST
