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What can help back pain short of major surgery?

November 30, 2017 | Shalini S. Shah, MD
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People may not think about pain as a medical problem in and of itself, but one in three Americans will suffer from some sort of significant pain during their lifetime. It fact, pain is such a big problem that according to the Institute of Medicine in 2011 the cost of treating it is higher than the cost of treating heart disease, stroke and cancer combined.

Low-back pain is the most common pain Americans experience, and the one we most often treat here at the UC Irvine Health Center for Pain and Wellness.

Why your lower back hurts

Your spine is made up of 33 vertebrae, and the five vertebrae of the lumbar spine (lower back) tend to cause the most trouble. That’s because they bear the brunt of supporting the entire weight of the body in an upright position.

Standing, walking, exercising, bending, twisting, lifting — all these can put a strain on your lower back.

Most pain is caused by injury to the muscles, discs or nerves, and it typically goes away within six weeks.

We treat it with analgesic medications like aspirin and acetaminophen, such as Tylenol, and with nonsteroidal anti-inflammatory drugs (NSAIDS), such as Advil and Aleve. That seems to work for about 50 percent of the people with lower back pain.

Low back pain treatments

But when the pain either doesn’t go away or keeps coming back, we have a variety of options to work with, short of major spine surgery. Here are some of them:

  • Physical therapy. A physical therapy regimen to strengthen the body’s core muscles will take pressure off the back. It is especially helpful to develop stronger muscles to support diseased bones and discs.
  • Epidural steroid injections. We inject cortisone into the spine, carefully targeting it to go only to the site of the injury where it will relieve inflammatory pain. Limited doses are essential because excessive doses of cortisone can have serious side effects, causing such conditions as diabetes or Cushing syndrome.
  • Nerve blocks. We use radio waves to ablate or destroy the nerves that contribute to the pain, which allows us to block the nerves from sending pain signals to the brain. It’s a very effective technique that lasts for about year, and you can continually repeat the process.
  • Kyphoplasty. This is used for people whose painful backs are caused by osteoporosis, which is loss of bone density. With kyphoplasty, we inject a type of cement between the vertebrae that have been weakened by osteoporosis. It’s an effective, minimally invasive procedure that supports collapsed bones.
  • Spinal cord stimulation. This is an innovative, elegant technology where we insert a very thin electrode into the spine that sends non-perceptible vibrations to the nerve centers of the spine to relieve pain. The mechanism is placed under your skin and can be made permanent after a three-to-seven-day trial to make sure it works. 

How to prevent lower back problems 

While these are very helpful methods to control low-back pain without resorting to major surgery, the best thing is to prevent chronic pain in the first place. Naturally, age is a contributing factor. Beyond that there are three key things that can help, and they’re not rocket science.

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