Guidelines for the treatment of lower back pain

21st September 2007 at 12:02 BST by Dr C.A.Jenner MB BS, FRCA. Permalink.

This article gives the guidelines for the treatment of lower back pain.

Guidelines for the treatment of lower back pain

Introduction

Lower back pain is typically described as a sudden, persistent, sharp or dull pain below the waist. This type of pain mostly occurs due to muscle strain associated with prolonged heavy physical work and faulty posture. Lower back pain can be typically classified into two main types, including acute and chronic back pain. While acute back pain is short term, generally lasting from a few days to a few weeks, chronic back pain is defined as a pain that lasts for more than three months.

Treatment – The Plan

When formulating the treatment plan for lower back pain, it is first important to analyze the stage of the problem. If the lower back pain has just recently developed, the treatment plan usually begins with conservative methods, the most important being reducing the strain on the spine. For instance, a patient who has developed lower back pain just a few days or weeks back, the immediate step for treatment adopted will be to avoid lifting heavy objects and observe caution while bending and performing other bodily movements. In the further sections, we've briefly explained the various treatment options involved in treating lower back pain.

1) Medications

Various types of medicines are usually taken for relief from lower back pain. These include both, the self-prescribed over-the-counter medicines as well as those prescribed by the doctor. Here we briefly the various medications involved.

1. Over-the-counter analgesics – These basically include NSAIDs such as aspirin, naproxen and ibuprofen, taken in order to reduce stiffness, swelling and inflammation. Counter-irritants in the form of a cream or spray are also applied.
2. Anticonvulsants – These drugs are basically helpful in controlling the seizures and are prescribed for treating certain types of nerve pain, generally administered along with analgesics.
3. Antidepressants – Tricyclic antidepressants such as amitriptyline and desipramine have been found quite effective in reducing pain and inducing sleep.
4. Opioids – Opioids such as oxycodone, codeine, hydrocodone and morphone are commonly prescribed to manage severe chronic as well as acute back pain.

2) Biofeedback

Biofeedback is a highly effective form of treatment for lower back pain. In this treatment, using a special electronic machine, the patient is trained to observe and gain control over specific bodily functions, such as muscle tension, heart rate and skin temperature. This form of treatment produces highly positive results, especially when used in combination with other remedies.

3) Acupuncture

One of the leading complementary alternative therapies, acupuncture involves the insertion of needles along precise points throughout the body. Experts point out that this particular process triggers the release of naturally occurring painkilling molecules, known as peptides, keeping the body's normal flow of energy unblocked.

4) Interventional Therapy

This form of treatment eases lower back pain by blocking nerve conduction between the specific areas of the body and the brain. Tools used in this form of therapy include injections of local anesthetics, steroids or narcotics into the affected soft tissues, joints and nerve roots.

5) Transcutaneous Electrical Nerve Stimulation (TENS)

This form of treatment uses a battery-powered device that sends mild electric pulses along the nerve fibers in order to block pain signals to the brain.

6) Surgical Remedies

Surgical intervention is sought in cases where all other forms of treatment have failed to provide relief from lower back pain. The various types of surgeries that can be performed for the purpose include:

• Discectomy
• Foraminotomy
• IntraDiscal Electrothermal Therapy (IDET)
• Nucleoplasty
• Radiofrequency lesioning
• Spinal fusion
• Spinal laminectomy

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