Chronic Back Pain

Back pain can range from muscle aches to serious pain radiating to other parts of the body. It is one of the most common reasons to see a healthcare provider. Chronic back pain is pain that persists for 12 weeks or longer. The pain may remain even after an initial injury, or after an underlying cause of acute back pain has been treated. The pain may also leave you incapacitated. It can worsen with movement or be present at rest.

Recovery and normal use of the back may take a few weeks to years. Self-care, physical therapy and medical treatment are often required for recovery.

Signs and symptoms of back pain can include:

• Muscle ache
• Shooting or stabbing pain.
• Pain that radiates down your leg.
• Pain that worsens with bending, lifting, standing or walking.
• Pain that improves with reclining.

An underlying disease or injury often causes chronic back pain:

• Spine related problems.
• Inflammation of the spine.
• Degenerative spinal disc disease.
• Physical injury or trauma from an accident.

Anyone can develop back pain, even children and teens. These factors may put you at greater risk of developing back pain:

• Having had acute back pain before.
• Back pain is more common as you get older, starting around age 30 or 40.
• Lack of exercise leading to weak, unused muscles in your back and abdomen.
• Being overweight puts extra stress on your back.
• Improper lifting whereby you use your back instead of your legs to carry the weight can lead to back pain.
• People who suffer from depression and anxiety appear to have a greater risk of back pain.
• Smoking can reduce the blood flow to the lower spine, which keeps your body from delivering enough nutrients to the discs in your back. Smoking also slows healing.
• Some types of arthritis and cancer can contribute to back pain.

Seek immediate medical care if your back pain:

• Causes you to have a strong urge to poo or pee or if you cannot control your bowels or bladder properly.
• Is accompanied by fever (a body temperature of over 38° Celsius).
• Follows a fall, blow to your back or another injury.
• Is severe and doesn't improve with rest.
• Spreads down one or both legs, especially if the pain extends below the knee.
• Causes weakness, numbness or tingling in one or both legs.
• Is accompanied by unexplained weight loss.

You may avoid back pain or prevent its recurrence by improving your physical condition in the following ways:

• Exercise: regular low-impact aerobics activities — those that don't strain or jolt your back — can increase strength and endurance in your back and allow your muscles to function better, such as walking and swimming. You can choose to walk home rather than take a motorbike from the bus stop.
• Build muscle strength and flexibility: abdominal and back muscle exercises, which strengthen your core, help condition these muscles so that they work together like a natural corset for your back.
• Maintain a healthy weight: being overweight strains your back muscles. If you're overweight, losing enough weight to reach a healthier weight can relieve back pain or prevent debilitating pain.
• Quit smoking: your healthcare provider can help you quit.
• Always hold a good posture: stand upright, don't slouch. Good posture can reduce the stress on your back muscles.
• Choose a seat with good lower back support, armrests and a swivel base. Placing a pillow or rolled towel in the small of your back can maintain its normal curve. Keep your knees and hips level. Change your position frequently, at least every half-hour.
• Lift smart: avoid heavy lifting, if possible, but if you must lift something heavy, let your legs do the work. Keep your back straight — no twisting — and bend only at the knees.

Most acute back pain gets better with a few weeks of home treatment. However, everyone is different, and back pain is a complex condition. For many, the pain doesn't go away for a long period, but only a few have persistent, severe pain.

Over-the-counter pain relievers and massage with hot water bottles (not directly on the skin) might be all you need for acute back pain. Bed rest isn't recommended.

Continue your activities as much as you can tolerate. Try light activities, such as walking and daily activities. Stop the activity that increases pain, but don't avoid activity out of fear of pain. If home treatments aren't working after several weeks, your doctor might suggest stronger medications or other therapies.

Medical Treatment:

Treatment aims to relieve your pain and improve your ability to function.

• You can use Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or paracetamol, which may help relieve back pain. These can be used as required but must not be overused to prevent serious side effects. Stronger pain relievers will be prescribed for chronic back pain if these do not give sustained, round-the-clock relief.
• Your healthcare provider may also prescribe a muscle relaxant in most mild to moderately severe chronic back pain. Muscle relaxants can make you dizzy and sleepy, do not drive or operate machines when taking them.
• Pain relievers that are applied to the skin containing diclofenac, ibuprofen, menthol or other pain relievers are useful for muscular pain. They deliver pain-relieving substances through your skin as creams, patches, ointments or gels.
• Opioid pain relievers are important when pain is moderate to severe. Drugs containing opioids, such as codeine, tramadol, oxycodone or hydrocodone, may be used for pain flare-ups.
• Antidepressants like amitriptyline have been shown to relieve chronic back pain independent of their effect on depression.
• Surgery may be recommended if this combination of medicines and self-care does not help you.

Physical therapy and supports

• Physical therapy can help to ease back pain. Your therapist will advise on exercises such as stretching, stabilization and core strength exercises.
• Aids like heat pads to warm up the muscles or ice packs to soothe sore muscles after active therapy sessions or exercise can help to relieve pain.
• Back braces can improve mobility and reduce the perception of pain.

Chronic back pain is often a source of significant discomfort for many adults. Posture c0rrection and paying attention to workplace health and safety is an important way to protect yourself.

At the earliest sign of recurring or chronic back pain, you should see a healthcare professional for early diagnosis and care. Early diagnosis and treatment can slow the disease, prevent complications and ensure better outcomes.