Lower Back Pain: Treatment, Procedure, Cost and Side Effects

The low back or lumbar spine is a remarkably well-engineered structure which connects the bones, nerves, joints and ligaments. All the muscles work together to provide flexibility, strength and support. However, there is a disadvantage to this complex structure. It leaves the lower back susceptible to pain and injury.

Medical treatments aim to provide relief by reducing the pain. On the other hand, these treatments are not known to treat the underlying conditions in the human body. The work of a doctor is to typically prescribe treatments along with specific regimens and physical therapy. Lower back pain may occur due to a surgery, sprain or any other cause. To guide the treatment, it is important that there is an accurate diagnosis identifying the underlying cause.

Pain is itself a symptom that occurs mainly due to injury of bodily tissues. However, some of the symptoms that are associated with pain are:

• Depression
• Flu-like symptoms
• Loss of appetite
• Numbness
• Muscle spasms
• Inability to concentrate
• Sleep disturbances
• Unexpected weight loss

When a person experiences low back pain together with some other symptoms it may be indicative of a life-threatening ailment. A person should consult a doctor before undergoing any treatment. The doctor will take the final call on whether a person is eligible for treatment or not.

Lower back pain is a common health condition. The main causes include:

1. Mechanical injuries:

   These include strain and sprain.

   The strain occurs when the muscles are torn or pulled out due to damage that occurred after too much stretching of the muscles.

   A sprain occurs when over-stretching causes tearing of the ligament.

   Sprain and strain are caused due to improper posture, lifting of heavy objects, sports injuries, and sudden movements such as falls.

2. Soft tissue injuries:

   These include injury to the intervertebral discs, nerve root compression, impaired spinal joint movements.

The diagnosis of lower back pain can be done in the following steps:

• Patient history: The details of symptoms and medical history of the patient is asked. The details usually include a description of symptoms, physical activities, habits including sleep habits, posture, and injuries.
• Physical examination of the patient: This step includes palpating the patient, neurological examination, test for a range of motion, reflex, and leg raise.
• Other diagnostic tests: Such as X-rays, CT scans, and MRI. injection studies are also preferred in some cases.

There are many treatment options available depending on an individual’s needs. These include medicinal remedies, administration at home, alternative care, or even surgery. A person diagnosis determines certain treatments which are more effective than others. In many cases, combination treatment has proven to be the most beneficial.

The common medical treatments associated with lower back pain are muscle relaxants, back braces, narcotic pain medications and epidural steroid injections. In some cases, a surgery is considered if the lower back pain is severe is not getting better even after 6-12 weeks of medications. Surgery is performed only in rare cases and by the patient’s full consent.

Muscle relaxants are known to increase the movement of tense muscles, act as a depressant of the central nervous system and relieving pain from muscle spasms. In case of chronic pain management, these medications don’t provide any relief.

Narcotic pain medications are known to treat acute, intense or short-term pain. These are also known as painkillers or opioids. These work by weakening the signals which are sent to the brain in order to alter one's perception of pain. Owing to the reason that narcotic medications can become addictive in case of long term treatment, it’s treatment is limited to short-term usage only. These may also have quite a lot of side effects.

Back braces are yet another method of providing relief and comfort to a patient. It possibly reduces the pain as well. It is like an inelastic corset worn daily along with a few physical therapies.

Epidural steroid injection treatment is associated with a steroid which is directly administered into the dural sac’s outer part, which surrounds the spinal cord. Fluoroscopy is a live x-ray which is used to direct the needle to the corrected area. This injection’s aim is to relieve pain temporarily followed by a reducing the inflammation of the compressed nerve root.

Some of the side-effects of low back pain relief are: fatigue, soreness, muscle twitching, lightheadedness, emotional distress and bruising. Some medications relieve pain and their side effects include indigestion and other gut problems, headaches, dizziness and drowsiness. Prolonged usage of medications can affect kidneys, liver, heart and blood circulation and can also cause fluid retention. Furthermore, some of the side-effects of analgesics are constipation, drowsiness, skin rashes, dry mouth, upset stomach and ringing in the ears.

Lower back pain is a common health condition. Some preventive measures including exercises are there which can be followed for the control and management of the pain. These exercises are based upon the concept of increasing blood flow to the spine, adequate stretching of muscles, enhancing range of motion, increasing resistance to strengthen and condition the affected muscles, and exercising core muscles. Some of the much-required ways that need to be followed include the following:

• Strengthening of core muscles- It includes making the muscles of the trunk stronger to provide sufficient support to the spine. This includes some exercises such as cardiovascular exercises, water therapy, and ball workouts.
• Using an ergonomic office chair that facilitates proper alignment and support to the spine.
• Following proper measures, while performing the tasks such as lifting.
• Avoiding even a little stress on the affected musculatures during everyday physical activities.
• Prolonged bending should be avoided.
• Stretching of hamstrings.
• Staying active, hydrated, intake of adequate diet, quitting habits such as alcohol consumption and smoking.

While sleeping is one of the most comforting activity an individual can do, one can feel discomfort in case of Back Pain, here are some of the sleeping positions that can make your feel comforted:

• On the back with knee support: Minimize pressure and ensure a good alignment of the head, neck, and spine by distributing the body’s weight eventually. Straighten your back on the floor supporting your head with the pillow and fill any gap that is between you and the mattress to support.
• Side position: To be in the correct position, roll onto one side of the bed and use pillows to support your head and neck. Pull your knees up slightly and put your second pillow between your legs. You can also use one big pillow if you change the side throughout the night.
• Fetal position: To sleep in the fetal position, lay down on the bed like a fetus. Fill any gap that is between you and the mattress to support. This position will open up the spine and aid the Back Pain.
• Lay front with a pillow under the stomach: One of least recommended sleeping positions amongst all, the position is only recommended in highly critical conditions like a herniated disk or degenerative disk disease, were laying down on the bed is highly discomforting. Lay down on your belly and place a slim pillow below the hips and abdomen. Avoid keeping a pillow under your head, if necessary use a flat pillow.
• Reclined on the back in a chair or bed: In the case of isthmic spondylolisthesis, using a reclined chair or bed for sleeping may reduce Back Pain during sleep. It is advisable to use the support chairs and beds while sitting and laying down.

The recovery period of a patient who has undergone low back surgery depends on several factors, including the condition of the patient before the surgery, the experience and skill of a surgeon and the extensiveness of the surgery. A microdisectomy is considered minimally invasive for a patient with a lumbar herniated disk. In this case the patient usually does not have to stay in the hospital overnight and the recovery period lasts a week. Doctors advise the patient to avoid activities which put exertion on the spinal structures. Physical therapies are typically prescribed to encourage healing and rebuilt the range of motion, flexibility and strength.

For a soft-tissue injury to heal properly with the help of medications or alternative therapy it may take between 3-6 weeks for full recovery. This is the average reported timing. In case of chronic pain it may also take longer than this period.

The cost of surgical treatment for low back pain is Rs. 3,25,000 to Rs. 5,20,000. The cost of medication ranges from Rs. 315 to Rs. 500.

Analgesics, acupuncture and massage therapy helps to deal with low back pain. But this pain is a sharp and sudden sensation that may occur due to a number of reasons. A person undergoing a surgery will experience pain even if he had had medication and had undergone treatment for it before. An accidental cut on your body or a broken bone can also herald the onset of low back pain. Thus this sensation is never permanently cured.

Food has an important role in the control and management of lower back pain as it impacts our health in both positive and negative ways. Hence it is important for us to know about the food items which help in minimizing the symptoms of lower back pain. Those foods include specifically anti-inflammatory eatables which include the following:

• Coldwater fishes such as salmon and sardines which serves as omega-3 fatty acids sources.
• Seeds rich in fibres such as flax seeds and chia seeds.
• Fruits which include berries, strawberry, cherries, avocados, red wine, pomegranate, grapes, and watermelon.
• Vegetables such as kale, spinach, broccoli, beets, and carrots.
• Beverages such as herbal teas, green tea.
• Herbs and spices like cinnamon, ginger, garlic, basil, rosemary, and curcumin.
• Lean Protein sources include chicken, turkey, beans, and cocoa.

Lower back pain is one of the most commonly occurring health conditions in today’s life which may be caused by mechanical as well as soft tissue injuries. Exercises may prove to be an effective remedy in such cases along with the proper treatment plan. These exercises are based upon the concept of increasing blood flow to the spine, adequate stretching of muscles, enhancing range of motion, increasing resistance to strengthen and condition the affected muscles, and exercising core muscles. Those exercises include:

• Exercises for strengthening of core muscles: It includes making the muscles of the trunk stronger so as to provide sufficient support to the spine. These types of exercises include:
  • Cardiovascular exercises: Low impact cardiovascular exercises are usually preferred. It includes normal walking as well as brisk walking.
  • Water therapy: It is preferred in chronic cases of low back pain. The buoyancy force of water provides a supportive effect in such exercises. It facilitates an enhanced range of motion as well as resistance that allows it to take care of injured muscles.
  • Ball-workouts exercises: It involves exercises in which a ball is used to be seated for approximately 30 minutes. Core exercises are also performed using the ball.

There are several alternative treatment methods for lower back pain. These include releasing your inner endorphins which is the natural hormones created within the body. There are three ways in which you can do so. These ways include meditation, massage therapy and aerobic exercise. Other methods include exercising to the core, getting enough restorative sleep, cold or hot therapy (application of a cloth dipped it cold or hot water to the painful area), and stretching exercises.

Summary: Lower back pain is one of the most commonly occurring health conditions in today’s life which may be caused by mechanical as well as soft tissue injuries. Its cure is not possible although it can be controlled and managed through self-care activities. Exercises may prove to be an effective remedy in such cases along with the proper treatment plan. These exercises are based upon the concept of increasing blood flow to the spine, adequate stretching of muscles, enhancing range of motion, increasing resistance, and exercising core muscles.