This is one of a series of articles answering questions in this POST: 108 Most Asked Questions For Drugstore Marketing Activities
I usually advise people that options are nothing (leave it alone), exercise, medications, injections, surgery, or other (non-traditional like acupuncture, tai chi, or even cognitive behavioral therapy). Most people will do well with exercises and medication if needed. Surgery is usually done for so-called radicular or sciatic pains that don’t get better with exercises, medications, or time. Injections may be considered for pain not relieved with time, exercise, or medication.
—-Answered by Russell DeMicco, DO.
ack pain is considered chronic if it lasts three months or longer. It can come and go, often bringing temporary relief, followed by frustration. Dealing with chronic back pain can be especially trying if you don’t know the cause.
Back pain rehabilitation specialist Andrew Nava, M.D. , offers insights into common chronic back pain causes and nonsurgical treatment options—and advises not to give up hope.
Common Causes of Chronic Back Pain
Chronic back pain is usually age-related, but can also result from a prior injury. The most common causes include:
Arthritis of the spine —the gradual thinning of the cartilage inside the spine
Spinal stenosis —narrowing of the spinal canal that may lead to nerve pain
Disc problems, such as a herniated or bulging disc
Myofascial pain syndrome—unexplained muscle pain and tenderness
In some cases, it’s difficult to pinpoint the cause of chronic back pain. “If your doctor has exhausted all diagnostic options, it’s time to seek a second opinion from a back pain specialist,” recommends Nava. It’s important not to make rushed decisions or undergo extensive medical procedures until the origin of the pain is found. Not only may they not help; they could make the pain worse, warns Nava.
If the source of the pain is not known or can’t be treated, your best option may be to work with your doctor on reducing the flare-ups and making the pain manageable with nonsurgical treatments.
Nonsurgical Treatments for Chronic Back Pain
Physical Therapy
Exercise is the foundation of chronic back pain treatment. It’s one of the first treatments you should try under the guidance of your physician and spine physical therapist. However, the same set of exercises doesn’t work for everyone, says Nava. The exercises have to be tailored to your specific symptoms and condition. Maintaining the exercise routine at home is also a big part of success.
Physical therapy for chronic back pain may include:
Retraining your posture
Testing the limits of pain tolerance
Stretching and flexibility exercises
Aerobic exercises
Core strengthening
Mindfulness and Meditation
Chronic back pain is straining both physically and emotionally. To manage the frustration, irritability, depression and other psychological aspects of dealing with chronic pain, you may get referred to a rehabilitation psychologist. This specialist may recommend meditation, yoga, tai chi and othercognitive and relaxation strategies to keep your mind from focusing on pain
Diet
Some diets are highly inflammatory, especially those high in trans fats, refined sugars and processed foods. Consult with your doctor to see if your diet could be contributing to your chronic back pain and how you could change it. Maintaining a healthy weight could also help lessen your back pain by reducing the pressure on your spine.
Lifestyle Modifications
When you have chronic pain, it’s important to accept your limitations and adapt. “Listen to your body and learn to pace yourself,” suggests Nava. Take a break when mowing the lawn, or make several trips when carrying groceries. Take note of the activities that worsen your pain and avoid them if possible. Not only could this help your back feel better, it could also prevent the underlying condition from advancing. Another important lifestyle change to try is giving up smoking. Nicotine is scientifically known to accentuate pain and delay healing.
Injection-based Treatments
Nerve blocks, epidural steroid injections, nerve ablations and other types of injection-based procedures are available for chronic back pain. They are used when the source of the pain is known and can sometimes help rule out certain causes if the treatment doesn’t work. Injections may stop or lessen pain for a certain period of time, but are not intended as long-term solutions and shouldn’t be used in isolation.
Alternative Treatments
Acupuncture, massage, biofeedback therapy, laser therapy, electrical nerve stimulation and other nonsurgical spine treatments can also make a difference for chronic back pain. Talk to your spine specialist about alternative treatments that could benefit you.
Pharmacologic Treatments
Analgesics, anti-inflammatory drugs, muscle relaxants and other medications can be used to help control chronic back pain. However, most come with unwanted side effects and are not intended for prolonged use.
“Opioid medications generally shouldn’t be used as the first, the only or the long-term line of treatment for chronic back pain,” recommends Nava. Many of them are addictive and don’t address the underlying cause of your pain. Opioids should be prescribed only after a thorough exam by a specialist and if other drugs have failed to provide relief. If you find yourself relying on opioids to get through the day, it may be time to seek a second opinion.
—-By hopkinsmedicine.org
Alternative and complementary treatments such as acupuncture, acupressure, and massage may relieve pain associated with a herniated or bulging disc.
If you’re considering these treatments, you should consult a complementary and alternative medicine (CAM) practitioner. This title can be confusing—even though alternative medicine and complementary medicine follow the same methods, they are different in that alternative forms are used in place of conventional medicine, whereas complementary treatments are used with conventional medicine.
acupuncture needles positioned down spine
Traditional acupuncturists aim to free up Chi channels, known as meridians, by inserting extremely thin needles into specific points in your body’s meridians. Photo Source: 123RF.com.
Exploring alternative methods may not only make you more relaxed and pain free but also keep you out of the operating room. For a herniated disc, you may want to try:
Acupuncture: This ancient Chinese practice is rooted in the belief that everyone has an energy force called the Chi (sometimes spelled Qi, but both are pronounced “chee”). When the Chi is blocked or unbalanced, your body may respond with pain and illness. Traditional acupuncturists aim to free up Chi channels, known as meridians, by inserting extremely thin needles into specific points in your body’s meridians.
Based on your specific diagnosis, the practitioner will likely insert multiple needles that are left in for about 20-40 minutes.
It has also been suggested that acupuncture triggers the release of endorphins into the blood stream. Simply put, endorphins are your body’s natural pain relievers. As such, their release decreases your perception of pain.
Similarly, the Gate Control Theory may play a role in acupuncture’s effectiveness at reducing pain. This theory asserts that pain signals travel slowly from the area of injury to the spinal cord into the brain because the nerves can only handle a limited number of signals at once. Acupuncture is thought to generate faster signals to crowd out the slow-moving pain signals, thus blocking out the pain.
Acupressure: Not surprisingly, acupressure is very similar to acupuncture. Both are ancient techniques that restore a healthy flow of energy through the body by stimulating specific meridian points. But acupressure simply relies on fingers, hands, and elbows—not needles—to administer pressure. Acupressure is for people of all ages but not for pregnant women (some acupressure points may cause miscarriage) and those with high blood pressure.
Massage: When received regularly, massage may offer chronic low back pain relief. A massage involves the stroking, kneading, and manipulation of your back tissues. These movements increase blood flow, which delivers more oxygen and nutrients to the muscles. Extra blood also carries away waste byproducts that may accumulate over time.
While massage is not a proven treatment for herniated discs, it’s generally safe and free of side effects. However, massage may not be right for you if you suffer from osteoporosis, deep vein thrombosis, skin infections, open wounds, or arthritis in or near the area to be massaged.
There are more than 100 types of massage techniques. A Swedish massage, for instance, uses long strokes to impact the superficial layers of your muscles. In contrast, a deep tissue massage uses direct pressure and slow strokes to soothe your deep layers of muscle and relieve chronic muscular tension. Your massage therapist will work with you to determine what specific massage will best reduce your pain.
When you start any new medical program, let your practitioner know if you have any health conditions besides pain from your herniated disc. It’s also important to note that these treatments are most effective when used as complementary treatments (that is, combined with conventional medicine).
—-By spineuniverse.com