Back Pain and Other Back Problems
Low and Upper Back Pain
Back muscle pain can be chronic or acute depending on the symptoms displayed by the patient. It’s the result of the patient’s lumbar spine being affected by certain conditions and disorders. Sciatica is another common condition that comes along with low or upper back pain; it involves acute and moderate pains from the back all the way down to the back of the thighs.
Low back pain is a condition that more than 80% of people in the United States experience at some point in their lives. This condition is among the most common reasons for people to pay their doctors a visit, and it accounts for as much as 75 billion dollars spent by the government every year.
Low back muscle pain occurs in a variety of ways:
• Localized. When low back pain is localized, the person suffering from it experiences discomfort and soreness upon the palpation of specific spots.
• Diffuse. This kind of pain affects a bigger area and lies in deeper layers of the body tissue.
• Radicular. As the nerve roots get irritated, this pain is likely to occur.
• Referred. The patient feels pain in his or her lower back, but the inflammation nidus is somewhere else – in the lower abdomen or in the kidneys.
If a patient is experiencing severe low back pain that has not spread down to the legs, the most likely diagnosis is a muscle sprain. The symptoms commonly take place within a day of muscular strain (lifting some weight, for instance). This type of pain is commonly localized, and the spot is easily found by the doctor. The most general recommendation is resting for some time.
However, not all cases are so simple. In most cases of low back pain, the first visit is paid to the primary care physicians instead of narrow specialists.
When the doctor begins his work with the patient, he will be interested in different characteristics of the pain, such as its onset, where it’s located, what activities or postures make it worse. Some signs may indicate that the pain is caused by the abnormal condition of some organs, so the doctor may also ask for information concerning the medical history of your family, history of peptic ulcers, kidney stones, heart murmurs or urinary tract infections. This information can help the doctor understand what is causing your back problems.
The doctor will always carefully examine the patient, especially if this is the first visit. Some conditions require emergency treatment, that’s why examination will involve palpation of your back and hips. Some other tests the doctor is likely to run include placing the patient’s legs in different positions to check for the presence of disc herniation or root irritation. In order to eliminate any suspicions of ankylosing spondylitis, the flexibility of the patient’s lumbar vertebrae can be measured.
If the doctor has reasons to believe the condition of the patient has to do with muscle overuse or strain, there is usually no need for imaging studies. X-rays are commonly performed on people displaying possible symptoms of cancer, pelvis or abdominal disease, bone fractures or inflammation impossible to detect otherwise. MRIs are quite rare and reserved for the cases of certain tumors.
Although in the process of scanning some abnormalities may be found, they are not necessarily responsible for the pain experienced by the patient. In some patients minor abnormalities are not likely to create any problems at all, as these people learn to live with them. Therefore, the doctor has to analyze the results and compare them with the information he has from the patient’s medical history.
No matter what form of treatment is chosen, it will be either aimed at relieving the symptoms or preventing the pain from interfering with the healing process.
Acute back and shoulder pain is commonly treated with NSAIDs - nonsteroidal anti-inflammatory drugs (ibuprofen, muscle relaxants, aspirin). There are also more simple methods that can be used when at home – application of heat and cold on the painful area, for instance.
People suffering form chronic back pain are usually prescribed a complex of treatment to deal with their back problems: physical therapy, alteration of lifestyle and taking medications. Some patients take NSAIDs, while others need to consider other kinds of treatment if they have a history of hypertension, stomach ulcers or kidney problems. Patients taking NSAIDs for a long period of time (more than 5-6 weeks) should be regularly examined by the doctor.
The most important part of any treatment is diagnosis – it should be accurate and based on reliable information. While traditional medicines work for most patients, sometimes alternative ways should be considered.
The prognosis for the patients suffering from severe low back pain is very good, with 80% of people recovering completely after a month or so. However, in each case the prognosis depends on the real reason that caused the condition.
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