Back Pain - Causes And Treatment (Part 2 Of 3)

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How is back pain diagnosed?


In order for your physician to discuss the proper treatment for your back pain, he will need to do a thorough medical history and physical exam. You will need to give a clear concise description of your pain. Your physician will need to know how the pain started, what you were doing when it started, how severe it is, does it come and go or is it constant, and what makes the pain better or worse. You will need to undergo some diagnostic tests. Common tests done to diagnose back pain are x-rays, bone scans, and MRI's. These diagnose problems due to bone or soft tissue injuries. Your doctor may order blood and urine tests to look for infection. If your physician feels the pain might be caused by a nerve problem, then you will have an EMG(electromyography) or nerve study. An EMG is an assessment of the electrical impulses of nerves and the response of the muscles.


How is Back Pain Treated?



The common goals of treatment are to relieve back pain and to restore mobility. Treatment varies depending on the severity and type of injury. The most common and basic treatment used for strains or minor injury is Rest. Heat can be used to promote circulation to the area and relieve spasms. Cold packs can be used to decrease the swelling in the affected area of the back. Common OTC (over the counter) medications such as Aspirin, Motrin, Tylenol, and Aleve are prescribed to help the pain and inflammation.

Long term bed rest is not usually recommended because it can make recovery slower and can ultimately cause other problems. Usually the doctor will have you gradually resume normal activities after 24-72 hours of rest. He may start you on a physical therapy program which should include heat, massage, ultrasound and an individualized exercise regimen. If the pain does not subside and it is interfering with your normal daily activities, your doctor may order prescription pain medications such as Darvocet, Vicodin, or Percocet and anti-inflammatory agents to relieve muscle spasm.

If your pain becomes chronic and all other treatments have failed, your doctor may refer you to a Back or Pain specialist. Because the back is a complex entity, specialists are more up to date on new advances in the treatment of back pain. Some treatments you might encounter are epidural nerve block (injection of anesthetic, anti-inflammatory, or steroid into the epidural space of the back for long term pain relief)and trigger point injections(injection of steroids and anesthetic into the muscle that is triggering pain.)This should also provide long term pain relief. Other medications such as antidepressants and anticonvulsants have been found to help relieve pain caused by nerve injuries.

Other types of treatment include:

Use of TENS(transcutaneous electrical nerve stimulation) unit. Electrodes are placed on 2-3 painful areas of the back and attached to a unit that provides mild electrical stimulus to the area in order to relieve pain.

Chiropractic adjustments of the back.

Acupressure or acupuncture treatments.

Relaxation and breathing techniques and stress management instruction.

Massage and basic stretching exercises to promote mobility and relieve spasm.

Yoga-and Pilates- This can help relieve pain and stress. Some Yoga postures may help relieve low back pain and help improve strength, flexibility and balance. Yoga is good for stress reduction and can help with the psychological aspects of pain.

Aquatic or water therapy- This can be very beneficial in relieving pain and improving mobility in those with chronic low back pain. There is no resistance to movement in the water, and water is soothing, comforting, and relaxing for the body.

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