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Commentary: Top Treatment Options for Lower Back Pain with Pain Management

By Brandon Claflin, Special to California Business Journal

Lower back pain is one of the most common injuries and ailments people experience. Over 80
percent of Americans experience some form of lower back pain at least once in their lives, while 25 percent experience it more than once.

Although popular opinion assumes that low back problems are a normal part of aging, the fact is younger people can suffer from them, too. Finding the right treatment for this condition is essential to preventing it from becoming chronic and/or causing further damage.

Dr. Brandon Claflin of Oklahoma is a doctor of osteopathic medicine and a diplomate in physical medicine and rehabilitation (PM&R), with subspecialty board certification in pain medicine. His mission is to help people suffering from chronic lower back pain live without this pain disrupting their day-to-day activities. He’s known for simultaneously providing high-quality care while reducing unnecessary costs through the use of cost-effective treatment plans for patients.

What is Lower Back Pain?

The lower back is made up of a series of bones called vertebrae. Between each vertebra are discs that act as cushions between the bones and provide flexibility to help you bend and twist. Ligaments attached to the vertebrae hold everything together, providing stability and support. When your body moves, these discs can bulge or rupture, causing pressure on the spinal cord. This can lead to pain, numbness, or weakness in your legs (sciatica).

Lower back pain is a common problem that affects the lumbar region (i.e., between the bottom rib and the top of the hip bone). Pain may be constant or intermittent, with varying intensity from mild to severe. It’s often described as a dull ache or a more sharp pain. It can occur suddenly or develop slowly over time. It may radiate into one or both buttocks and legs or even down through the inner thigh (sciatica).

Lower back pain may be acute (sudden) or chronic (long-lasting). Acute lower back pain lasts less than four weeks and is often caused by muscle strains or sprains. Chronic lower back pain lasts more than three months and may be caused by degenerative changes in the spine (e.g., arthritis).

What Causes Lower Back Pain?

Lower back pain is not a specific disease or condition but a symptom resulting from many different problems. It can occur along with other symptoms, such as muscle spasms, tingling, numbness, or weakness in the legs. These occurrences can cause pressure on the nerves that exit from the spinal cord through openings called intervertebral foramina. Irritation of these spinal nerve roots can cause pain in the lower back and legs.

There are many different causes of lower back pain. Most fall into one of three categories:

1. Medical Conditions

Some medical conditions can cause lower back pain, including herniated (slipped) discs and osteoarthritis. A herniated disc occurs when part of the gel-like center material in between the vertebrae bulges out through a tear in its outer covering (annulus fibrosus). This bulge puts pressure on nearby nerves.

2. Injuries

These include sprains or strains from physical activity, falls, or accidents. Strains are injuries to the muscle fibers and tendons, while sprains involve damage to the ligaments that surround joints. Strains and sprains can occur from overuse or trauma. For instance, someone lifting heavy objects may strain their lower back muscles or sprain a ligament.

3. Poor Posture and Repetitive Movements

Poor posture is one of the most common causes of back pain. The spine has natural curves that absorb shock and withstand gravity. However, when not in their natural position, the discs between the vertebrae can become misshapen and bulge outward. This can lead to inflammation of nearby nerves, which may cause pain in the lower back.

Repetitive movements, such as bending over to pick up heavy objects, or sitting at a computer for hours, can also cause strain on your lower back muscles and joints. This can lead to muscle spasms or inflammation around the joints. If not treated promptly, it may result in chronic lower back pain.

Top Treatment Options for Lower Back Pain

The best treatment for lower back pain depends on the cause and severity. The initial approach to mild to moderate lower back pain is often self-care: rest, stretching and strengthening exercises, heat therapy, massage therapy, and medication. More severe cases may require steroid injections or surgery. However, for cases that require specialized pain management, seeking professional assistance from a clinic such as Neuragenex Pain Management Clinic in McDonough, Georgia, which provides comprehensive and expert care is a notable option.

Non-Surgical Treatments for Lower Back Pain

1. Adjust Your Posture

If you are experiencing recurring low-grade lower back pain episodes, it may be time to assess your posture habits – and improve them. Poor posture can strain muscles in your lower back and lead to chronic muscle tension and pain. Maintaining good ergonomic habits at work and home is one way to avoid poor posture. Here are some tips for cultivating good posture:

Stand up straight and tall when standing or sitting for long periods. This helps prevent slouching.
Don’t bend over with your shoulders rounded forward. Try bending from your knees, if possible (e.g., when picking up something from the floor).
Don’t carry heavy items in one hand. Use both hands.

2. Oral Medications

According to Dr. Brandon Claflin of Oklahoma, “The first line of treatment is over-the-counter medications, like Tylenol, or anti-inflammatory medications. Muscle relaxers or non-narcotics may help with nerve pain, including common arms or herniated disc treatments. When opiates are prescribed, they’re for short amounts of time and under discretion.”

Acetaminophen (Tylenol®) or non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil®) or naproxen (Aleve®) are available in over-the-counter (OTC) form and should be used for short periods—two weeks at most.

Opioids are powerful pain medications, including morphine and oxycodone (OxyContin®), prescribed for chronic pain conditions. They can be addictive and should be taken only under a doctor’s supervision. Also, talk with your doctor about their potential side effects, which may include nausea and constipation.

3. Stretching Exercises

If tight muscles are causing your back pain, stretching exercises can increase flexibility and release the tension on irritated nerves. It is vital to gently stretch, to avoid further irritating any damaged tissues in the spine or surrounding areas.

4. Heat Therapy

Heat therapy can help relax tense muscles and reduce inflammation around joints or the spine. Importantly, don’t use heat for more than 20 minutes at a time. Prolonged exposure can cause damage if used too often or for too long.

Surgical Treatments for Lower Back Pain

Surgical treatments are not recommended for most people with lower back pain. It is usually considered only after other treatments haven’t worked. Surgical options are as follows:

1. Decompression Surgery

Decompression surgery

removes part of the vertebrae, which will relieve pressure on the spinal nerves. This surgery helps restore function and relieves back pain due to herniated discs or spinal stenosis. There are two primary types of decompression for low back pain:

Microdiscectomy removes the herniated portion of a disc that’s pressing against an adjacent nerve root. The goal of a discectomy is to relieve nerve pressure and restore the range of motion in the affected area. The surgeon will remove the damaged tissue, then stitch or fuse the remaining healthy portion of the disc using bone grafts and screws or hooks.
A laminectomy is a surgical procedure employed to relieve pressure from spinal nerves caused by protruding bones (laminae) in your back. During this procedure, first, the surgeon extricates one or more laminae between two vertebrae, then applies bone grafts to repair any damage caused while removing the bone structure.

2. Lumbar Spinal Fusion Surgery

Lumbar spinal fusion surgery

is performed to treat degenerative disc disease and other spine conditions. In this procedure, the disc that has been damaged or torn is replaced with a bone graft. The objective is to stabilize the vertebrae to prevent them from moving around as much and causing pain.

Summary

It is comforting to know that lower back pain can be treated and that many options are available for achieving a full recovery. I hope this article has helped you better understand lower back pain and available treatments. The first step in managing lower back pain is to work with your healthcare team to seek the proper treatment specific to your needs and medical history. Likewise, finding a treatment option that fits your lifestyle, financial situation, and personal preferences is essential. When suitable treatment is matched for relieving your lower back pain, remember that it is important to maintain your treatment schedule – which may mean adjusting it as needed.