Low Back Pain

Jennine Brogan, APRN

Almost everyone has experienced back pain at some point in their lives. Back pain can range from the very mild to quite severe. Depending on the type and severity it can radiate into the hips or buttocks, down the legs and to the feet. Low back pain can last anywhere from minutes to days, weeks, years, and even decades. Acute back pain is short lived and resolves in less than a month. Chronic back pain persists over time. It may be continuous and essentially unchanged or intermittent in type and presenting with episodic exacerbations.

When it comes to back pain there is certainly a great deal of variation in symptoms, presentation, and progression of the problem. Causes vary widely and may be related to a genetic predisposition and environmental factors such as work history and accidental injury. This article will only attempt to describe the basic and common symptoms.

Most mild back pain involves at least one of the following symptoms, an uncomfortable muscle ache, stiffness with movement, and back spasms. It is usually relieved with rest, light stretching, topical heat or ice, topical rubs, and a little time. Mild back pain may be brought on by a day of working in the garden, house cleaning, a long drive in the car, or any other activity which is slightly more strenuous than you are accustomed too. Even a persistent cough, untimely sneeze, or awkward twisting motion may be enough to stress or strain the muscles in your back. The good news is most mild back pain is temporary and resolves with limited disruption of your life and activities.

Moderate back pain is a bit more painful and longer in duration. Moderate back pain is associated with similar symptoms but a greater intensity. The back muscles may spasm and tighten resulting in a sharp and gripping pain. Pain can radiate to the hips, buttocks, and legs. Symptoms may last several days to several weeks before you are able to completely resume your normal activities. Moderate back pain is often associated with previous episodes of back pain or past injury. The symptoms may require the addition of common over the counter anti-inflammatory medication such as ibuprofen or naproxen for a day or two. Muscle relaxants may be prescribed by your provider for a short time.

Severe back pain presents as much more intense. Most activities come to a screeching halt. It can be acute or chronic. Examples of acute injuries include things like a bad fall, a car accident, or lifting a heavy piano. Chronic symptoms persist and may be the result of an acute injury or simmer over time without a specific cause. Chronic mild or moderate back pain can progress with time and evolve into something more severe. Even severe symptoms can resolve or require medical intervention. Treatment is based on the underlying cause.

When to seek medical advice or treatment is a question a lot of people have and while we cannot address every circumstance or scenario, here are a few guidelines. First, if you lose bowel or bladder function you should be seen right away as this can be a sign of a medical emergency and requires immediate workup in the emergency department. Always use common sense and if you aren't sure about something ask your provider. If you feel something isn't right, seek medical advice. You should be seen and evaluated if you are having weakness in your back or legs, have a loss of function, or cannot sit or stand. You should be seen if your symptoms are severe or worsening and have not responded to time and rest. Start with your primary care provider who may refer you for further work up or recommend medication or physical therapy.

We have all heard the saying; an ounce of prevention is worth a pound of cure. Well prevention is always the preferred treatment and a lot of back pain and injuries can be avoided. Some of the things you can do to help include maintaining a healthy body weight. When we carry extra weight around our midsection the result is an exaggerated curve in the lower back which affects the joints, nerves, and muscles. Daily stretching helps with flexibility and core strengthening. Both are important for balance, movement, and muscle strength. You are less likely to fall if you have good core strength and flexibility. Yoga and walking are both great for everyone from the beginner to the advanced. Just start from where you are.

Join us at Marcus Daly Memorial Hospital for a free Cholesterol Screening and Health Fair on Saturday, May 9, 2015 from 7:00am to Noon. For more information visit www.mdmh.org.

Questions and or comments regarding this week's health column please contact Jennine Brogan, APRN at Rocky Mountain Neurosurgery Center, 1190 Westwood Drive, Hamilton, MT 59840. Working together to build a healthier community!

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