You know you are getting older when weight is harder to keep off and your back starts to ache.
Most people experience low back pain during their lifetime starting as early as age 20, with about half experiencing recurrent pain. In fact, this is usually the reason people first seek medical care as an adult. Medical expenditures and costs related to this condition have increased dramatically.
Despite its frequency, back pain can be vague without a direct cause 80% of the time. There are limited treatment options, making it frustrating for patients and physicians.
When back pain does occur, it is important to exclude serious causes that can lead to long term nerve damage such as infection or significant trauma.
The good news is that new onset back pain resolves on its own the majority of the time. Medical research has proven that when back pain does occur it is important to try to continue your daily activities as much as possible. This will help decrease the severity and length of time that symptoms occur. What you should not do is stay in bed or avoid activities because this can actually increase the time needed to recover.
Medications such as Ibuprofen have been shown to be helpful for a short time and may have a role in controlling chronic pain due to their anti-inflammatory effect. Muscle relaxers may also have place in controlling symptoms, but no more so than Ibuprofen and at greater risk of sedation. Opioids such as Percocet and Norco have gained recent publicity due to the addiction epidemic. They work by blocking the sensation of pain; but at great risk of dependency, abuse and other complications. Because of these risks, medical sources usually recommend avoiding using these medications and in the end, they are no more effective than the medications discussed above.
Other options include physical therapy and manipulation or hands-on techniques. Physical therapy guided by trained professionals has evidence for treatment and prevention of short-lived back pain so is often the first treatment choice. In addition, these treatments and continued exercise can prevent recurrence. Osteopathic manipulation has proven effective for acute and chronic low back pain. Sometimes when patients come to the doctor with pain that has been persistent, they want a scan. However, imaging in the acute setting has not been shown to improve outcomes and can be unnecessary.
Low back pain is a common problem that is happening more frequently across the globe. Struggling with this issue can be incredibly difficult but it is important to commit to trying the options recommended by medical professionals and keep an open mind about results.
Ultimately, you and your primary care physician should come to a shared decision before using any chronic medication or treatments. Physicians have a long way to go to master this issue in the changing world, so open communication and understanding will be vital moving forward.
Dr. Jimmie Stewart is a family medicine physician with WesleyCare Family Medicine Residency.