Addressing and treating lower back pain | TahoeDailyTribune.com

Addressing and treating lower back pain

Zachary Child, MD

Back problems can be severe. A natural alarm in the body signals a sudden, debilitating onset of gripping back pain. It not only hurts, but interferes with your ability to work, play, and participate in your daily activities.

Most adult Americans, between 80 and 100 percent, will experience severe lower back pain at least once in their adult lives. Fortunately, only a small percentage will need attention from a spine surgeon. Below are options to address lower back pain prior to considering surgery.

Heat or ice can be very effective at relieving some acute pains and spasms. Depending on your preference and area of pain, try an ice pack, a hot shower, or a heating pad.

Nonsteroidal anti-inflammatories, NSAIDs, are another core treatment. They act in two ways. One, they are a pain reliever usually bringing relief within 30 minutes to an hour. Two, NSAIDs break the biochemical chain of inflammation, or cyclooxygenase (COX) pathway. This requires a sustained treatment from several days to two or three weeks. Ulcers can be common if NSAIDs are not taken with an antacid or food. Specific dosage amount and schedule should be obtained from your primary care provider.

Renewed attention has been placed on the non-pharmacologic therapies for lower back pain. Several recent meta-analysis studies show yoga and mindfulness-based stress reduction have the best outcomes reported by patients. These approaches were compared to exercise, psychological therapies, multidisciplinary rehabilitation, massage, chiropractic care, and acupuncture. However, some scientific data shows positive results for patients who tried the other options described above. My advice is try different options and focus on treatments that work well for you.

Finally, a physician or rehabilitation specialist may recommend steroid anti-inflammatories. These can be taken orally or through injections, but require a prescription or referral. Steroid anti-inflammatories work best for sciatica, a radiating arm or leg pain. This treatment takes about six weeks to see results.

Addressing lower back pain will take a “tincture of time.” Watchful waiting and pain monitoring should be implemented throughout the treatment process. An MRI and other screenings may also be necessary during this period. If symptoms remain unresolved after other treatment options are taken, a referral to the spine surgeon is the last step.