April 18, 2016
The National Institutes of Health estimates that 80 percent of adults will experience back pain at some point. The pain can be acute, lasting a few days or weeks, or chronic, lasting three months or more. Some people may spend the majority of their adult lives coping with some level of back pain.
The prevalence of the problem is due in part to the many causes of and contributing factors to back pain. However, there also is a wide range of treatment options available. “Conservative therapy is always the first choice, with varying levels of treatment available from there,” said Michael Seiff, MD, FACS, of the Spine and Brain Institute and Chief of Neurosurgery at Sunrise Hospital & Medical Center.
While back pain may be considered the norm for some people, the increasing number of effective treatment options can help change that.
Ways to treat back pain
When beginning to seek treatment for chronic back pain, physical therapy is a great first choice. “Physical therapy is the mainstay of conservative treatment modalities,” Seiff said. “Nine times out of 10, this will help.” Physical therapy can assist with strengthening, stretching and mobility. However, it may need to be used in conjunction with other treatment methods. Some patients may not get enough relief from physical therapy alone.
Yoga, Pilates and other core-strengthening and stretching exercises:
Exercises that help strengthen, stretch and elongate the core can help treat back pain, prevent it from occurring and prevent it from getting worse. “In very many cases, improving one’s core strength can lead to significant improvements. Many patients address this quite successfully with yoga or Pilates,” Seiff said.
“Like physical therapy, chiropractors can be a first line of defense when treating back pain or can be a good second option if physical therapy is unsuccessful,” Seiff said. Chiropractors may be especially helpful for treating back pain that stems from malalignment issues of the spine.
Acupuncture is an increasingly accepted method for pain management of all types. While acupuncture may not solve the root problem causing the back pain, it may provide temporary relief from pain and discomfort.
“Surgery is always reserved as the last choice but may be necessary for some patients,” Seiff said. There are multiple surgery options available, depending on the patient, but an increasing number of spinal surgeries are being done using minimally invasive surgical methods.
While noninvasive methods always should be considered first, if those methods aren’t successful, the person may want to consider other treatment options such as injection therapy. “A physician who specializes in pain management can evaluate a patient’s candidacy for injection therapy,” Seiff said. Injection therapy involves a steroid being injected directly into the spine to reduce inflammation. This can help manage pain as well as be a diagnostic tool for doctors to help determine the source of the pain.
Cause and effect of back pain
“Chronic back can affect every aspect of someone’s day-to-day life, making it difficult to complete even minor tasks,” Seiff said. As a person’s quality of life is affected, it can hinder job performance and social life, and can lead to depression. The cause of back pain can depend on age, body weight, general health, medical history, fitness level and other factors. Elderly people are subject to degenerative changes and complications of osteoporosis, though middle-age people also may experience degenerative changes.
Seiff notes that everyone over the age of 30 may have degenerative changes to some degree, but this may be more symptomatic for some people than others.
Another common cause, across the board, is poor posture. “Prolonged sitting at work, for example, in a poorly designed chair can cause back problems and back pain,” Seiff said.
What to do if you’re struggling with back pain
The sooner you speak with a doctor, the better. Some back pain is temporary, caused by stress and/or strain, and can clear up on its own in a couple of days or weeks. But if your back pain persists or worsens, a doctor can help determine the next steps.
Seiff recommends visiting your general care physician or health care practitioner first. “They are your best advocate to let you know if you should be referred to a specialist or if it is a problem they are comfortable treating initially,” Seiff said. From there, you may be recommended to see a physical therapist, a chiropractor, a pain-management physician, a neurologist and/or a surgeon.