Ways to get relief from back pain

Marek Kurowski, M.D.

Millions of Americans suffer episodes of back pain each year. According to the American Association of Neurological Surgeons, back pain is the second most common reason that adults see a doctor.

Your spine is made up of a series of small bones called vertebrae and is divided into three sections: the cervical (neck), thoracic (upper back) and lumbar (lower back). Disks of cartilage separate and cushion the vertebrae.

While pain can occur anywhere in the back, most back pain occurs in the lower back because that’s the part of the spine that bears the most weight. The lumbar region includes five vertebrae, along with muscles and ligaments, and supports most of the weight of the upper body. It also does most of the work of bending, stooping, sitting, and lifting. Wear and tear and injury can cause discomfort ranging from a mild ache to sudden, sharp, debilitating pain.

Fortunately, most low back pain goes away on its own in a few days to a few weeks. This short-term, or acute, low back pain is usually caused by an injury to the structures of the low back or by arthritis. Pain that lasts three or more months is called chronic back pain. The cause of chronic pain is often difficult to determine.

Pain is a Symptom

Low back pain is a symptom of a problem, rather than a disease itself. Conditions that cause it can be the normal aging process, or sprains, strains or spasms in muscles and ligaments, or a bulging disk.

Although the cause of a large number of back-pain cases are unknown, there are five major severe low-back-pain conditions:

r Disk degeneration. Disks can deteriorate with age; that deterioration can lead to inflammation and irritation in the spine, causing pain.

r Sciatica. The sciatic nerve, is actually a bundle of lumbar nerves, can become irritated by a herniated disk, a condition called spinal stenosis. The nerve also can be irritated by an abnormality in a vertebra that puts pressure on it. Sciatic pain can be felt in the lower back, the buttocks, the calf and the foot. The pain can range from a mild tingling or ache to severe, and it is usually worse at night. Sciatica is aggravated by long stretches of standing or sitting.

r Lumbar spinal stenosis. Spinal degeneration narrows the canal through which the spinal nerves travel. The degeneration occurs with age, because over time, the disks dry out and shrink. If the disk then becomes inflamed from a minor injury, it can put pressure on a spinal nerve, causing pain. Spinal stenosis usually is associated with osteoarthritis of the spine.

r Osteoarthritis. Osteoarthritis can affect the cartilage in the disks, the vertebrae or both anywhere along the spine. This condition causes pain and muscle spasms. Spinal nerves also can become pinched, which is another cause of back pain.

r Herniated (slipped) disk. A damaged or bulging disk may pinch or irritate a nerve root, causing pain.

Treatment options

Treatment of back pain depends on several factors. If the pain occurs because of an accident or injury, or if a fever is present, you should see your health care provider immediately. Pain not accompanied by fever or not associated with an accident or injury may not need immediate treatment.

You should wait a few days to see if the pain subsides. You should curtail normal activities for several days until symptoms ease. A good night’s sleep is also important in recovering from back pain. You can take an anti-inflammatory medication such as ibuprofen and try hot showers to relax the muscles. You can also alternate mild hot and cold packs for 20 minutes, up to 4 times a day, to the affected area. If this doesn’t help, call your primary care physician.

If you have chronic back pain, your treatment may also include anti-inflammatory medication, muscle relaxants, physical therapy, steroid injections, traction, ultrasound, electrical stimulation, alternating ice packs with heating pads.

Your doctor may also advise you to make lifestyle changes such as losing excess weight, exercising for at least 30 minutes each day, adding core strengthening exercises and improving your posture when sitting and standing.

Surgery may be recommended if these remedies don’t work after trying them for a period of time. The most common reasons for spinal surgery are spinal stenosis and sciatica.

These are possible signs that surgery may be needed:

r Leg or back pain that limits normal activity, resulting in an unacceptable quality of life

r Weakness or numbness in the legs

r Difficulty walking or standing

r Pain continues despite medication and physical therapy

There are a variety of specialized surgical options available to address specific problems. Surgery may involve the removal of some of the gel-like material in the affected disk, removing a small piece of bone near the disk to allow more space without pinching a nerve, or fusing disks if several are affected or in cases of spinal degeneration.

Marek Kurowski, M.D., is board certified by the American Board of Medical Specialties (ABMS) and holds a sub-specialty certification in Pain Medicine and completed a Pain Medicine Fellowship accredited by the Accreditation Council for Graduate Medical Education (ACGME) at The Pennsylvania State University College of Medicine, Milton S. Hershey Medical Center, Hershey, PA. He is also Board Certified by the American Board of Physical Medicine and Rehabilitation. Dr. Kurowski completed his residency in physical medicine and rehabilitation at the Albert Einstein College of Medicine, Montefiore Medical Center.

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Dr. Kurowski utilizes a variety of interventional treatment options to address spinal, upper and lower extremity, sports and overuse, and neurological injuries and pain. New patients are being accepted at Haven Pain Management, located on the second floor of UPMC Susquehanna Lock Haven. Please call (570) 893-5437 for more information or to schedule an appointment.

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