Low Back Pain:
Low
back pain is a fairly common condition in general public. The lower back pain comes from multiple
sources including the muscles and the soft tissues. The lower back pain can also come from the
ligaments of the lower back and from the various joints and nerves supplying
the lower back. The pain can come from
the facet joints, which usually cause axial lower back pain. A person can also have lower back pain from
sacroiliac joints, which is occasionally referred to by the patients as hip
pain localized to the right or left lower back.
A person can also have pain from a lumbar degenerative/ herniated disc. Other causes of back pain include various
nerves such as the cluneal nerves or the superior gluteal nerves in the lower
back. The lumbar facet joints are also implicated in causing mostly lower back
pain in a significant number of patients. The other less common causes of lower
back pain can be assessed and treated by the doctor as noted from the patient’s
history & physical exam findings.

Primary Treatment of Lower Back Pain:
The
primary treatment consists of relative resting to ease the lower back
pain. Ice is usually beneficial in the
acute phase to decrease the inflammation but based on the general experience of
every patient, heat may be utilized if a person generally responds better to
the above. Anti-inflammatory medications
(if tolerated and not allergic to) can be tried such as ibuprofen or Aleve. These medications are generally taken at a
higher dose to exert sufficient anti-inflammatory and pain relieving
effects. Light massage may also be
helpful. After a day or two of resting
one can usually begin to mobilize more as tolerated and follow good postural
mechanics to prevent the pain from increasing again. A belt can be used to help support the lower
back area but while the support belts (the wide lumbar corsets) are useful in
acute lower back pain by decreasing the range of motion of the back, long term
use is not recommended because they tend to weaken up the back muscles and thus
make the back more prone to re-injury.
Muscle relaxants can also be utilized in the acute phase of
treatment. If the back pain does not
significantly improve with anti-inflammatory treatment or is just too severe,
opiate medications and short-term steroids can be utilized. If the above treatments are not useful in
that case further evaluation by a back specialist would be useful and an MRI
test may be ordered to further evaluate the reason for the pain or sciatica
based on the underlying suspect diagnosis.
The
links provided may act as a guide and giving further information about the
above conditions.