Does Medication Reduce Back Pain?

Most back pain improves with a few weeks of self-care, including over-the-counter pain relievers, ice, heat and taking care not to lift heavy items or work out too vigorously.  It also helps to get some mild exercise and movement into your day, rather than lying down and staying still for too long – which can make back pain worse. But if these self-care methods don’t relieve your back pain after a few weeks, you should consult with a back pain specialist to improve your symptoms with medications.

The most common first steps in pain-reducing medications is your doctor’s recommendations of acetaminophen (Tylenol, others) or nonsteroidal anti-inflammatory drugs, such as ibuprofen (Advil, Motrin, others) or naproxen (Aleve). Both of these types of medications are effective at relieving back pain, often within a very short period of time after taking them. Always take these medications as directed by your doctor, because overuse can cause serious side effects.

If over-the-counter medications don’t relieve your back pain issues, including secondary pain such as sore hips from compensating for your stiff or painful back, your doctor may also prescribe a muscle relaxant. While muscle relaxants will often lessen back pain, they can cause side effects like sleepiness and dizziness, so you should take them only when you’re done driving for the day, and when you can relax and let the medication ease your pain. Do not take muscle relaxants when you’re at work or if you have to make important decisions, cook, or conduct any other tasks that require focus. Save them for when you’re truly free of all items on your to-do list, and be sure someone is available to care for your kids and pets. Some people are more sensitive than others to the effects of muscle relaxants, and you may be among those who cannot function safely while on a particular type of back pain medication.

Your doctor may also prescribe to you narcotics, such as codeine or hydrocodone, which should be used only for a short period of time and with close supervision by your doctor. Take these medications only as prescribed.

Interestingly, some back pain patients experience relief for chronic back pain from low doses of certain types of antidepressants — particularly tricyclic antidepressants, such as amitriptyline.  You may not feel depressed, or show other signs of depression, but this is among the arsenal of pain-relieving medications that your doctor may consider for you.

Lastly, cortisone injections for back pain are also an option. These anti-inflammatory injections are delivered to the space around your spinal cord (like an epidural is administered during childbirth.) Your doctor might inject cortisone into the facet joints of your vertebrae, decreasing inflammation in those areas that may be the cause of back pain and allowing your spine to regain fuller range of motion and stability. A cortisone injection helps decrease inflammation around the nerve roots, and you might experience back pain relief for up to a few months after your injection.

Ask your doctor about which medications may be ideal to relieve your back pain, and ask for information on possible side effects, as well as – importantly – how long you should take each type of medication suggested or prescribed to relieve your back pain.

Common Questions About Back Pain: What are the Different Types of Back Surgery

There are several different types of back surgery proving successful at resolving patients’ back pain issues, each involving the highest level of surgical technology available today, as well as the skill of a board-certified spinal surgeon. If your spinal specialist advises back surgery, you’ll embark upon a learning process about the different available back surgery procedures – guided by your physician. You always want to get your information directly from your spinal surgeon, since back surgery information online can be outdated or incorrect, and Googling back surgery topics can sometimes cause unnecessary anxiety.   The best course of action for researching back surgery procedures is to prepare a list of questions for your surgeon, and request all of the back surgery literature possible that your doctor can provide you with so that you can fully understand what will be done during your surgical procedure.

Overall, back surgery can accomplish several different pain-relieving goals, including removing portions of the bone to widen the narrowed area in your vertebrae, which can cause back pain. Your spinal surgeon may remove the gel-like middle section of a ruptured disc to relieve pressure on pinched nerves in the back. And sometimes, the damage to a disc is so severe, your doctor has to remove the entire disc and then fuse together the remaining discs.

Below is a list of some of the different types of back surgery that may be the customized choice for your back damage or condition:

• Discectomy. In this type of back surgery, your spinal surgeon will remove the herniated portion of a disc to relieve irritation and inflammation of a nerve.
• Laminectomy. This back surgery procedure involves removing the bone overlying the spinal canal, which then enlarges the spinal canal to relieve nerve pressure caused by spinal stenosis.
• Fusion. Spinal fusion permanently connects two or more bones in your spine. When the vertebrae are fused, you get added stability to your spinal movements, or relief of pain from a spinal fracture. Occasionally, spinal surgeons will opt for spinal fusion to eliminate painful motion between vertebrae that can result from a degenerated disc or injured disc.
• Vertebroplasty. During this type of back surgery, your surgeon will inject bone cement into compressed vertebrae to stabilize fractures or compressed vertebrae, which can relieve pain. A balloon-like method may be used to expand the vertebrae area, allowing your surgeon to inject the bone cement into the treatment area for optimal results.
• Artificial discs. Your spinal surgeon may find that your discs are in an advanced stage of degeneration, and that implanted artificial discs are necessary for the creation of a spine that functions better and without compression to the nerves. Artificial disc technology is advancing every day through rigorous studies and testing, and your surgeon can introduce you to the materials and information about having new discs implanted for your spinal pain relief.
• TOPS (Total Posterior Spine) System.  A mechanical implant device that stabilizes the spine without eliminating the independent motion of the individual vertebrae, as spinal fusion does.

Since back surgery is a complex procedure, work with your spinal surgeon to explore all your options.  Every situation is different and you need to feel secure that you have fully researched which type of back surgery would be best for you, and if back surgery is necessary at all. And of course, your doctor will guide you through all the information you need regarding recovering from back surgery and what you can expect for your post-surgery lifestyle.

reference: www.mayoclinic.com

Common Questions About Back Pain: Do You Need Back Surgery?

If you’re experiencing ongoing or severe back pain, you’re likely wondering if you’ll need back surgery to finally rid yourself of that constant back ache or debilitating back pain. The answer will come once your spinal surgeon assesses your back pain or back injury symptoms, and takes a full medical history, to review your general health level and medical issues.  But before you panic, keep in mind that back surgery is generally needed only in a small percentage of back paincases. Most back pain can be resolved by a range of non-surgical options that can keep you off the operating table and have you feeling better soon.  Some of these are as the application of ice or heat, anti-inflammatory medications, physical therapy, and massage.  Changing your diet with the goal of losing weight can also help take pressure off the nerves in your back and once the initial discomfort is lessened, exercise can also provide non-surgical relief.

However, when conservative treatments don’t help, back surgery may be your physician’s advice.  This is often the case when your doctor is seeking to get you relief from back pain that’s limiting your lifestyle, interrupting your sleep and preventing you from being active and at your best.

Here are the symptoms and conditions that might mean back surgery would be an optimal solution for you:

• If you have a back injury or condition that causes compression to your spinal nerves, causing debilitating back pain or numbness along the back of your leg.
• If you have a bulging disc or ruptured (herniated) discs, which means the the rubbery ‘cushions’ separating the bones in your spine aren’t at their best and are causing discs to move without the cushioning they need.
• If you have fractured vertebrae or other damage to your spinal column from a back injury. A fractured disc will cause pain, and also leaves your spine unstable, often causing additional back pain.
• If you have fractured vertebrae or other spine issues such as osteoporosis.
• If your prescribed conservative remedies including medication and physical therapy for back pain aren’t bringing you relief, and you’re still suffering from back pain and other systems after a longer-than-usual amount of time.

You may also be diagnosed with a condition that causes back pain and additional progressive nerve compression:

• Scoliosis, a curvature of the spine that can compress nerves in the back
• Spinal stenosis, a narrowing of the spinal canal typically caused by arthritis
• Spondylolisthesis, the forward slippage of a segment of the spine
• Degenerative disc disease, the development of pain in a disc as a result of its normal wear and tear over time
• Radiculopathy, the irritation and inflammation of a nerve caused by a herniated disc
• Kyphosis, a humpback deformity
• And other degenerative disc conditions

Your spinal surgeon’s primary goal is to eliminate your back pain and to return your quality of life.  When a progressive condition is diagnosed through testing and examination, back surgery may certainly move to the forefront of your surgeon’s mind.  It is their job to consider your best and personalized options for ridding you of back pain before your current condition deteriorates further.

http://www.mayoclinic.com/health/back-surgery/HQ00305

Who Can Get Back Pain?

Back pain is not just a symptom of aging. Anyone, of any age, in any physical condition, can and will likely experience back pain at some point in their life. So if you are experiencing back pain, don’t think that you’re alone. There are plenty of seventeen year-old athletes who experience back pain and thus seek the same medical care that you do for your own back issues.

While getting older can be a cause of back pain, as your body’s discs, joints, muscles and ligaments carry you through your life for a longer amount of time, and while many people experience their first back pain episodes while in their 30s and 40s, there are other top causes of back pain:

• Being overweight. When you’re carrying extra weight above your ideal body weight, that can put extra pressure on your spine, muscles and joints, leading to back pain.
• Not being physically fit. People who do not exercise on a regular basis, and thus lack good muscle tone and bone strength, often experience more back pain.
• Heredity. Some causes of back pain, such as ankylosing spondylitis, a form of arthritis that affects the spine, can have a genetic component.
• Your job. If your job requires you to lift heavy boxes, or push or pull heavy loads, you might experience greater back pain.
• Lifting heavy items. Or people. Like grandchildren who may be growing and getting heavier, yet you still want to lift them. And if you’re a caretaker of an ill relative, lifting them can aggravate your back as well.
• Sitting too much. If you sit at a desk or worktable for too many hours in a row, with poor posture and without getting up to stretch and walk around a bit, you might experience back pain.
• Smoking. If you’re a smoker, you may experience back pain, because your body might not be able to get enough nutrients to the discs in your back. You might also have a smoker’s cough that puts pressure on your body and affects your back. And smokers are also slow to heal, so your back pain might be longer-lasting.
• Other diseases. Some types of arthritis and cancer can cause back pain.

In short, anyone can get back pain. And perhaps you see yourself in several of the above causes, so take steps now to help prevent back pain or help lessen your back pain symptoms.

What Is Back Strain?

Hearing “It’s just a back strain” may not be very comforting when you’re experiencing severe back pain. While back strain may sound like a minimal back injury, it can cause you a great deal of discomfort, perhaps sleepless nights, back spasms that can cause severe lower back pain and in some cases, immobility. Many people with back strains go to the emergency room for relief.

Most lower back pain episodes are caused by damage to the muscles and/or ligaments in the lower part of the back. When you have back strain, you may have one or both of the following:

• A muscle strain, caused when a muscle is over-stretched or torn, resulting in damage caused to the muscle fibers (also called a pulled muscle).
• A lumbar sprain, caused when ligaments – the tough fibrous tissues connecting the muscles to the bones and joints — are stretched too far or torn.

Strain and sprain are often used interchangeably, since the treatment and prognosis for both of these are the same. So one is not worse than the other, although the amount of pain you’re experiencing may make you think that what you have is indeed the worse of the two. Especially since you cannot see inside your back, your imagination may conclude that you have something much worse than a back strain or sprain. Patients experiencing pain can often jump to dramatic conclusions and envision difficult treatments ahead.

It can calm your worries to understand what a back strain is. When the muscles or ligaments in the lower back are strained or torn, the area around the muscles will likely become inflamed. That back inflammation leads to back spasms that can cause your severe back pain and immobility.

“How did this happen to me?” is likely the next question on your mind. Back strains are often the result of a movement or movements that put undue stress on the lower back. Motions like lifting a heavy object, lifting multiple heavy objects (such as with landscaping using large rocks or bricks,) lifting and twisting, a sudden and single twisting motion (like your last golf tee-off of the day,) or a fall are just some of the movements that can cause back strain.

Symptoms of back strain may range from a mild ache to sudden, debilitating pain often localized in the lower back. The pain of a back strain is likely to be located in the low back, and not radiate down your leg (as with sciatica.) Your back may be sore to the touch, pain comes on suddenly and strongly, you may have those muscle spasms in your lower back, and you might find standing or walking to be more uncomfortable than resting.

With a doctor’s care and pain-reducing medications, you may find your back strain’s worst pain subsiding quickly, but with back strain, you may experience a lower level of pain, or flare-ups of pain, for a few weeks to a few months, depending on how severe your back strain is. And how well you rest after being diagnosed. Self-care is essential with back strain, so that those stretched or torn muscles of ligaments can heal well. Most back strains and sprains are much better after 3 to 4 weeks, since the large muscles in your back have a good blood supply, which delivers healing nutrients and proteins to your injury site for healing to take place. You might not be able to see that happening, but as you heal from your back strain, that’s what’s happening beneath the surface.

What is Failed Back Surgery Syndrome?

Failed back surgery syndrome (also called FBSS, or failed back syndrome) is a generalized term used to describe ongoing pain after back surgery. After going through a spinal surgical procedure, of course both you and your surgeon desire your complete painlessness.  But, even with the best spinal surgeon and the best indications for your spinal surgery success, there is always a small chance that back pain may continue after surgery and recovery (studies report continued back pain after 5% of all spinal surgeries ).

What causes Failed Back Surgery Syndrome? There are many reasons why a back surgery might not result in a completely pain-free existence, partially owing to the fact that spine surgery is only able to accomplish stabilizing a painful joint and decompressing a pinched nerve. If your back condition involves more than these two pain-causing situations, your spine surgeon will need to continue your care and explore additional solutions to your back pain condition.

Back surgery is reported to be 95% successful at changing anatomy that causes pain and correcting the physical results of a back injury.  But it’s also important to realize that back surgeryisn’t a cure-all for every type of back pain-causing condition. Since the spine is a very complex part of your anatomy, with many vertebrae, nerves, and cushioning between your discs, it can be a complex process to get to the root of what’s truly causing you pain.

Your back surgeon will thoroughly assess your back pain condition, and use top technology to diagnose your back pain causes, but it’s important for you to have realistic expectations of what back surgery can and cannot accomplish for you. If you experience Failed Back Surgery Syndrome, your skilled physician will then conduct additional tests and map out a plan of action to remedy as much of your back pain as possible. All valuable things take time, so don’t set yourself up for possible disappointment by expecting a quick fix to any back pain. It may take an extra procedure or extra treatment after your back surgery to get you feeling much better.

If you do have great success after your back surgery, then you’re in that fortunate 95% of back pain patients whose symptoms lessen and whose lifestyle will very soon be active and more comfortable again.

Sleep Tips for Back Pain Sufferers

Sleep provides important healing and rejuvenation to your back. When you’re suffering from back pain, it can be difficult to get a solid and healthy good night’s sleep. Lying down can be painful, and sleep simply doesn’t come. One of the many unpleasant symptoms of inadequate rest is being even more sensitive to pain. So it’s essential to take the smart steps necessary to improve your ability to sleep.

It may seem to be an impossible goal, but there are ways to improve your sleep quality while dealing with back pain:

• Get a new mattress. A soft, old mattress that sags and provides inadequate lumbar support may be the culprit causing your back pain. When you sleep with your back arched on a mattress with the slope downward right at your hip level, you’re creating a terrible arch in your spine that can compress nerves and even cause disc damage. Upgrading to a top-quality new, medium-firm mattress that has no sag or slope and can cradle your body in a more natural and healthy position. Yes, a quality mattress is often pricy, but it’s worth the investment to improve your back pain.  Add in a posture-correcting orthopedic-approved pillow for your neck and head.  It will properly position your spine for better sleep and potentially less pain.
• Sleep in a back-supporting position. One preferred position is lying flat on your back, and placing one or two pillows beneath your knees so that your spine is in a neutral, non-arched position while you sleep. If you prefer to sleep on your side, place one pillow between your slightly-bent knees while you lie on your side, and place another pillow against your chest, with your arm draped over it. This second pillow position prevents you from twisting your upper body and keeps your spine in neutral alignment as you sleep. Don’t sleep on your stomach, since this position arches your back and aggravates the spine, nerves and muscles affected in your back pain condition. Some frequent stomach-sleepers place a tennis ball in their pajama front pocket to prevent them from rolling over onto their stomachs during the night.
• Reduce stress. Stress is a cause of chronic back pain, so focus on eliminating the sources of your stresses through meditation or deep breathing methods, journaling, limiting exposure to stressful people, lightening your load of life obligations such as running committees and other stressful jobs, or even getting short-term psychotherapy to deal with larger stressful issues in your life.
• Limit or eliminate caffeine. You might be more sensitive to caffeine than you realize, and even moderate use can affect your sleep quality.
• Don’t eat before bedtime. Limiting your snacking can help prevent nighttime indigestion or acid reflux, and it can also help keep your weight at a healthy level, which is better for your back.
• Talk to your doctor about nighttime pain medications that can help you sleep. Your physician will assess your best pain medication regimen, which might include muscle relaxants, over-the-counter pain relievers, such as aspirin, Tylenol (acetaminophen), or Advil or Motrin IB (ibuprofen) which can be effective for short-term use and might be available in a ‘PM’ formula that can help you sleep.  Naproxen sodium (Aleve) is long-lasting and may offer pain relief throughout the night. Use these medications only as directed and with a doctor’s care.
• Talk to your doctor about gentle exercises. Always consult with your doctor about recommended back pain-calming exercises. Never look online for ‘back pain exercises’ to do on your own, since your back might not be strong enough at this time for some exercises like planks or resistance band work. Your doctor will start you off slowly with a few exercises that can calm your back pain before bed, and then work with you to progress your back-improving movements over time.
• Practice a good bedtime routine. Turn off the television and computer, dim the lights in your room to ready your body for sleep, cool your bedroom with a fan to help you sleep better, and avoid reading or working in bed before sleep. Winding down can prepare your mind, as well as your body, for a deep, restful sleep that lets your body heal better, and after a good eight hours of healthy sleep can make your pain levels easier to tolerate in the daytime.

When to See a Doctor for Types of Severe Back Pain

 

Back painslows down millions of Americans each year, with symptoms ranging from nuisance soreness to back pain so severe and debilitating that a visit to the emergency room becomes the first step on a path leading to a spinal surgeon’s care. According to the American Association of Neurological Surgeons, back pain is the second most common reason that adults see a doctor.

Back pain can occur anywhere on the back, from the neck (cervical area) to the middle of your back (thoracic area) to the lower back (lumbar area) with the lower back often being the most common location of severe and lifestyle-limiting pain, since the lower back bears most of your weight. That weight can compress the cartilage cushion between your vertebrae. And, over time, you might experience a degeneration of that cushioning cartilage, causing your discs to compress or slide out of place.

Walking, bending, lifting, twisting, even sitting and standing can then become excruciating. Back pain flares up and then goes away on its own after a few days for some people. But for others, sharp pains and limited motion becomes a bigger, more longer-lasting problem requiring medical care.

Here are some of the more severe back pain conditions:

* Disc degeneration. Discs in the spine can deteriorate with age, and the deterioration of discs can lead to inflammation and irritation in the spine, which can cause great pain.

* Sciatica. While many people associate the term ‘sciatica’ with pain in the buttocks area, sciatica can be a painful condition in the back. Sciatica is caused when the sciatic nerve (a bundle of lumbar nerves) become irritated by a herniated disc. This condition is known as spinal stenosis. The sciatic nerve also can be irritated by an abnormality in a vertebra that puts pressure on it. Sciatic pain may be felt in the lower back or buttocks, and may also be felt in the calf and the foot. Sciatica pain can be mild with tingling, or it can become severe, growing worse at night. You might experience worse sciatica pain when you have long stretches of standing or sitting.

* Lumbar spinal stenosis. When spinal degeneration occurs the canal through which spinal nerves travel can narrow. As part of the aging process, discs can dry out and shrink. When these two conditions occur, you might experience painful pressure on a spinal nerve. This can happen with a minor injury, as a symptom of osteoarthritis of the spine, or simply as a symptom of aging. The resulting back pain can be severe.

* Osteoarthritis. Arthritis anywhere in the body can be painful, but when osteoarthritis occurs in the back, you may experience pain and muscle spasms. Osteoarthritis can affect the cartilage in the discs, the vertebrae or both anywhere along the spine, pinching the nerves and causing pain.

*Herniated disc. Also called a ‘slipped disc,’ this condition occurs when a damaged or bulging disc pinches or irritates a nerve root.

When severe back pain occurs, your physician will assess you for any or all of these conditions, and you will likely start on a back pain reduction plan that aims to reduce your discomfort, return your mobility, and manage your back pain flare-ups. Perhaps you and your doctor will decide that spinal surgery is the best solution to remedy the internal causes of your severe back pain, returning you to better quality of life.

The TOPS™ System is one such solution. The TOPS™ (Total Posterior Spine) System provides an alternative to spinal fusion for patients undergoing spinal decompression back surgery. Unlike spinal fusion, TOPS preserves the full range of the spine’s natural motion, and has been shown to provide better outcomes than fusion in clinical studies performed around the world.

How to Prepare for Spinal Stenosis Surgery, Part III

 

Spinal stenosis, an unnatural narrowing (or stenosis) of the spinal canal, is an all too common cause of back pain and restricted mobility, which results from pressure the narrowing column places on spinal nerves. For those who don’t respond to more conservative treatments, surgery may be recommended to correct spinal stenosis, and it’s important for such patients to prepare for the procedure properly. The preparations starts by ascertaining that back surgery is indeed called for.

Back Pain and Steroid Injections

Epidural injections of steroids have often been the treatment of choice for patients with a pinched nerve in the back whose symptoms did not respond to simple exercise, physical therapy, or other more conservative approaches. Steroid injections have also been offered to patients with spinal stenosis whose back pain was unrelieved by less invasive therapy. But the results of a new research study hint that injections of steroids for back pain may be less beneficial than believed. The study is small, but it still bears consideration, as the findings are statistically valid and underscore why healing is as much an art as a science.

The study of the efficacy of steroid injections for back pain examined more than 270 patients, aged 53 to 75 years old, culled from the ranks of a larger study of individuals with spinal health problems. The research subjects were followed for four years. Sixty-nine of these patients had epidural injections and 207 did not, but otherwise the patients’ symptoms were primarily the same in terms of severity, as measured by well-established scales used to measure pain in the leg and lower back. Using these scales, researchers found less improvement among those who had epidural injections than among patients who did not have injections.

Several caveats must be offered when considering the results of this research. First, as the authors readily acknowledge, factors that the researchers didn’t account for and couldn’t control may have affected or skewed the results. Nonetheless, we are seeing fresh thinking and new techniques improving outcomes for many spinal patients. For example, patients who elected to have spinal decompression surgery to relieve symptoms of pinched nerves typically opted for a spinal fusion back surgery in tandem, in order to stabilize the spine. Today, a growing number are opting for TOPS^TM – the Total Posterior Solution – System, instead of spinal fusion. The TOPS system, unlike spinal fusion, preserves complete independent motion of the individual vertebrae. This is one more way that fresh thinking, and new technologies and procedures are transforming the care and treatment of back problems.