In order to determine the correct therapeutic interventions needed for the management of individuals with lower back pain, it is advisable to consult with an appropriately trained back specialist to incorporate the specific needs of the patients and to take into account their condition and medical history.

 

The main objectives for managing lower back pain include:

 

• To provide adequate pain relief so that the patient can actively participate in their physical therapy and rehabilitation.
• To be able to prevent further stress to the spine and thus prolonged injury by improving their posture and ergonomics.
• To be able to maintain the ability to function well enough at work and at home.

 

Causes of Lower Back Pain

 

The most common cause of lower back pain is a muscle strain or spasm as well as other soft tissue injuries around the lower back. These are usually not serious in nature with most of them being able to resolve with conservative measures, but they can be painful.

 

Other causes may include:

 

• A herniated lumbar disc which can irritate a nearby nerve root.
• Stenosis of the lumbar region of the spinal canal which causes pressure to be applied to the spinal cord.

 

Non-Surgical Therapies

 

There are numerous non-surgical therapeutic options available for the management of lower back pain and these will depend on the mentioned needs and circumstances of the affected individual.

 

The most common of these therapies include the following:

 

• A short period of rest – a couple to a few days of rest can help to prevent further injury to the affected area of the lower back. The usual suggestion is to reduce strenuous physical activities and not incorporate too much bed rest into this regime as this can cause further stiffening of the muscles.
• Pain medications – the most commonly used pain medications (analgesics) to manage lower back pain include acetaminophen, non-steroidal anti-inflammatory agents (ibuprofen, naproxen), muscle relaxants (orphenadrine), narcotics (codeine), oral corticosteroids (prednisone), antidepressants (duloxetine), and anticonvulsants (gabapentin). Each of these medications has their own indications, strengths, side effect profiles, and limitations in managing lower back pain and their use will depend on the cause of the lower back pain.
• Applying heat and/or cold packs – applying heat to the affected area of the lower back is known to promote blood flow which facilitates the healing process. The application of cold packs helps to reduce swelling in situations where an acute injury has occurred. In some cases, alternating between the two therapies has helped affected individuals.
• Physical therapy – patients with lower back pain are referred to physical therapists where they are taught back exercises, such as low-impact aerobics, to strengthen the supportive muscles around the lower back. These therapists can also help to relieve any spasms and tension in the mentioned muscles of the lower back by performing appropriate stretching techniques.
• Massage therapy – massage therapy has been clinically proven to help reduce the pain experienced by patients with lower back issues. This therapy has been shown to improve blood flow to the muscles of the lower back and this helps to reduce stress and tension in the anatomy, thus reducing pain.
• Epidural injections – injectable steroids can be administered via the epidural space (the area between the spinal cord membranes) which helps to reduce any inflammation that may be present in this area of the lower back.
• Lifestyle modifications – reducing one’s weight through dietary changes and increasing physical exertion, and quitting smoking can help to reduce lower back pain.

 

If these therapies have proven to be unsuccessful, then patients may be consulted for possible surgery.