How to Diagnose, Treat, and Relieve Lower Back Pain

In today’s times, many working professionals lead extremely stressful lives. Due to high profile corporate jobs, professionals work long hours every day. Many times, their work is done sitting at desks with uncomfortable chairs, for prolonged hours, or in incorrect positions. This has led to many cases of lower back pain amongst corporate professionals. Let’s take a detailed look at this growing condition.

Understanding Back Pain

Back pain is usually characterized by pain originating from the spine’s bones, joints, nerves, and muscles. It is felt either as a dull ache that increases in pain or as sharp jolts coupled with piercing or burning sensations.

Back pain is usually experienced in the lower back. This occurs because the lower back consists of many bones and other vital body parts:

  • Small and complex joints
  • Tendons and muscles and other soft tissues
  • Spinal discs with their gelatinous inner cores
  • Highly sensitive nerves and nerve roots that travel from the lower back down to the legs and feet

Back pain can be defined as acute (severe) or chronic (long-lasting). It is also described as being continuous or intermittent. Back pain is also capable of spreading to the arms or legs. In such cases, patients can experience pain along with other symptoms such as weakness, numbness, and tingling sensations in the affected area.

Diagnosing Back Pain

The doctor may examine the patient, and ask him to describe the pain in terms of location, pain type, and severity. The doctor may also ask the patient about the history of the condition – When did it start? How long has it been there? What problems are being faced due to it? In worst cases, or as a precautionary step, a patient may be asked to get an X-ray, CT, myelogram, or an MRI scan done to determine the severity of the problem.

Types of Diagnosis:

Three types of back pain may be diagnosed via an examination:

  • Axial Lower Back Pain: This type of back pain is most common among patients. It is confined to the lower back, and the patient experiences either sharp or dull pain. It does not spread to the legs or other parts of the body. However, the pain can be severe enough to limit the patient from performing everyday activities, like walking or sitting up straight. It can also worsen if the person is sitting in one position for a long period of time. Generally, axial back pain is acute. However, if the condition is not diagnosed and treated, it can turn into chronic pain.
  • Sciatica: Also known as lumbar radiculopathy, sciatica occurs when a person is suffering from a lower back problem. The primary cause for this condition is compression of the sciatic nerves (hence the name). Symptoms of this condition include pain, numbness and/or weakness. With sciatica, the pain spreads to one side of the body. It begins at the lower back, then spreads to the gluteus (buttocks), followed by the leg, and many times, the foot.
  • Lower Back Pain with Referred Pain: This is the most severe type of back pain, and is similar to axial back pain. The patient experiences dull pain and aches that change in intensity from time to time. The pain begins in the lower back, but then spreads to the buttock, groin, upper thigh, and in worst case, the knee.

Treating Back Pain

The course of treatment for lower back pain depends on the severity of the pain and the patient’s medical history. However, there are four common treatments that are prescribed:

    • Rest: Perhaps the best way to treat lower back pain is to take the simplest route – cease your daily activities for a few days and take complete bed rest. There is a simple reason behind this – bed rest gives the damaged tissues time to heal, which will lead to a reduction in the pain.

We also recommend that once the rest period has been completed, you perform certain exercises to maintain muscle strength and joint mobility and flexibility. This will ensure that the body will stay healthy, and be in a better position to tackle future cases of back pain.

  • Heat and Ice Packs: The main objective of utilizing heat of ice packs is to reduce inflammation caused due to the back pain. Depending on your preference, you can use either ice or heat, or you can alternate between them.
  • Medications: Your doctor may also prescribe certain over-the-counter medications to help relieve the pain. Here are a few examples of these medications:
    • Oral Pain Medications: These are provided in either pill or liquid form. Examples of this medication type include acetaminophen and Tylenol.
    • Topical Medications: These medicines are applied externally on the pain area, and are used to treat localized pain. Many of these can be bought over the counter at drugstores without a prescription. Examples of these pain relievers include Capzasin, Zostrix, and Aspercreme.
    • Injections: In cases where the patient is suffering from severe pain, the doctor can also prescribe injections containing pain relieving and anti-inflammatory medications. The medications are injected into the area where the pain source is located.
  • Physiotherapy Exercises: Exercise is an important part of the healing process, as it helps the body maintain a certain amount of muscle strength, mobility, and flexibility. Physiotherapy exercises are designed to help the body distribute nutrients to the damaged joints and tissues, and thus aid the healing process. It also helps relieve stiffness and prevent weakness. This can also prevent the back pain from relapsing within a short time period.
    While the exercise program may differ depending on the severity of the back pain, patients are taught a few common exercises:

    • Neck and Shoulder Stretches: These are designed to alleviate stiffness in the back and neck.
      • Flexion Stretch: This exercise can be performed in a sitting or standing position. Slowly bend your head down bringing your chin down to your chest. Do this slowly till you feel a stretch in the back of your neck and back.
      • Lateral Flexion: A similar exercise involves the ear and shoulder. Slowly move your head to one side and try to touch your ear to your shoulder. Don’t push your shoulder up while performing this exercise. Do this until you feel a stretch in your neck and the opposite shoulder. Switch to the other side and repeat the exercise.
    • Back Exercise Stretches: These exercises are designed to increase a patient’s mobility, while reducing pain and discomfort. The best time to perform these exercises would be in the morning after you wake up. The reason is that the back will be stiff after sleeping in one position for many hours.
      • Knee to Chest Stretch: Lie on your back with your legs straight. Bend your left leg at a 90o angle, placing your foot flat on the floor. Place your hands on your left knee, and slowly pull it towards your chest. Ensure that your right knee is not lifted off the floor. Do this until you feel a stretch in your lower back. Hold the position for 5 seconds, and then slowly release. Repeat the action with the right leg.
      • Back Flexion Exercise: Lie on your back, with both your knees bent at a 90o angle. Place your hands on your knees and pull them towards your chest. At the same time, slowly lift your head forward towards your chest. Both these actions will help stretch your neck as well as the muscles in your back. Repeat until comfortably tired.
    • Hips and Gluteus Stretches: These stretching exercises are designed to flex the muscles of the lower back, and maintain flexibility of the spine.
        • Hip Stretch: Stand with your legs apart, and ensure that the feet are in line with your shoulders. Take your right foot about half a step back. Bend the left knee forward while shifting the weight to your right hip. Keeping the right leg straight, bend forward further and try to touch the toes of your right leg. This should help stretch the outer hip.
        • Piriformis Muscle Stretch: The piriformis muscle is located at the front part of the sacrum, the part of the spine that is connected to the gluteus. The piriformis muscles can also contribute to lower back and leg pain.

      Exercise: Lie down on your back, and cross one knee over the other. Place your hands on the bent knee, and slowly pull the knee towards the chest until a stretch is felt in the gluteal area.

Tips:

  • Initially, take the help of a physiotherapist when performing these exercises. Once you have learnt them properly, the physiotherapist may allow you to perform them at home on your own.
  • Don’t force your body to stretch, as this will cause more pain. Also, don’t try any other difficult exercises other than the ones mentioned above or suggested by the physiotherapist.
  • Ensure that the floor is clean and flat. For safety reasons, use a towel, a mat or any medium that provides enough grip, when performing the exercises.

The right diagnosis, treatment, and exercises can help patients relieve themselves from lower back pain effectively.