Lower Back Pain

Low back aches and pains are one of the most common reasons patients seek health care.  Easily 80% to 90% of adult Americans will experience back pain as they go through life.  Various statistics suggest that 50% of us will have back aches and pains every year.  Perhaps as many as 25% to 30% of us may have back pain on any given day.  It is one of the leading reasons people go see a doctor.

Fortunately, for most of us, the backaches and pains resolve relatively quickly, and it may be another year or two until we have back pain.  A small number of patients with back pain may actually have an episode go on 3 or 4 months.  This is really longer than the average person can tolerate pain but, nonetheless, very few of these episodes of back pain come to surgical intervention.  The APPROPRIATE MANAGEMENT for almost all episodes of back pain is time, moderation of activities, and active and passive modalities.  Basically, you have to live with the episode until it resolves.

There can be many reasons why we have episodes of back pain.  The anatomy of the spine is very, very complex.  The anatomy of the spine becomes even more complex because as you read things or talk to various doctors, we use different words to basically describe the same problems.  So, not only do you have pain, but you become CONFUSED by all the various terms and phrases.

As for the anatomy of the spine, it is very, very complex.  There are huge muscles that can become irritated.  There are many, many ligaments and tendons that can become inflamed.  There are 3 or 4 disks that can degenerate, have tears (with perhaps even a herniation) and then there are 5 or 6 sets of small joints in the back of the spine that can hurt.  For many patients three or four different things can hurt, locations can vary from day to day, different activities can aggravate different structures, and different treatments can help or hurt the different structures that may hurt.

But for almost all episodes of back pain, time and common sense persevere and the episode resolves.  There are a small number of patients that basically develop chronic, day-to-day backaches and pains and then can have episodes of flares and resolution over the course of time.  But again, most episodes of back pain are best managed with nonoperative care.

The list of treatments for back pain is perhaps endless.  The most basic care is time and moderation of activities.  Nothing replaces the first two forms of treatment.  This treatment can be augmented by various active and passive modalities such as:

  • Heat
  • Ice
  • Chiropractic care
  • Massage therapy
  • Acupuncture
  • Medicines such as nonsteroidal anti-inflammatories (NSAIDs), muscle relaxers, narcotics, and steroids
  • Needle injections with steroids such as cortisone injections and epidural injections
  • Braces
  • Exercise including aerobic exercise, flexion exercises, strengthening exercises (the exercises are very, very hard to do in the acute phase of back pain, but over the long haul, they tend to be quite, quite, beneficial)

I am sure, if you get on the internet, there are many other forms of treatment, but I have listed the basic forms of treatment.

Here at Iowa Spine Care, we try to help you by doing an evaluation, trying to make an appropriate diagnosis (I do not order very many expensive diagnostic tests such as MRI scans), and I really try to focus on EDUCATION about the spine condition and then trying to make common sense suggestions that are applicable to the patient’s lifestyle.  For many patients, the best care is to slow down his/her active, harried lifestyle and give himself/herself some tender, loving care.

So, be patient and be a good patient and Iowa Spine Care will help you get through your episode of low back pain.