Back Pain

Back pain can be very distressing problem. Its one of the leading causes of lost working hours.

Back pain always starts acutely. There are several causes most common is back injury which can be due to lifting heavy objects. Other causes include accidents e.g. falling down. The trauma usually also involve the muscles of the back causing them to go into spasm leading to more pain and limited back movement. Sometimes disease can affect the back like degenerative disc disease or inflammatory joint disease in which cases other joints might be involved as well.

Its important to differentiate early the causes of back pain and to role out some serious conditions like fractures, cancer, infection.

During acute stage of back pain, keeping active and taking non steroidal pain killers is usually successful in relieving the pain. Acupuncture has also been found useful for acute back pain. Simple mechanical back pain usually resolves within 1 week or 2.
If back pain persists for more than 3 months then it has entered a chronic stage. Chronic back pain is a real problem. It imposes a huge change on life style; people become less active and less sociable. Emotionally, patients become depressed and more irritable. It can even be bad enough to disturb normal sleep pattern which is has huge impact on the patient physically and psychologically.

Chronic back pain is difficult to treat. Most common ways of management include pain killers, physiotherapy especially swimming and range of motion exercises. Massage therapy helps in relieving spastic muscles as well as using heat e.g. taking hot showers, using electrically heated towels ..etc. Many patients find placing a pillow between the knee during sleep helps as well. Loosing weight can also be a big plus.

Electrical stimulation using TENS machine benefit some but not all. When the pain of the back radiates down to the leg then a nerve root is most probably involved. Options of treatment change from injections given under fluoroscopy or in the clinic like epidural steroid injection or facet injection to more invasive procedures like nerve ablations or even back surgery.