Back Pain

Back Pain

Pain in the lower back is itself not a disorder. It can be a symptom of several different types of body conditions. It is usually due to a problem with the parts of the lower back, such as ligaments, nerves, and muscles, or the bony structures called vertebral bodies or vertebrae. The most common causes of back pain include ruptured discs, bulging discs, sciatica, arthritis, abnormal curvature of the spine, osteoporosis, or congenital disorders. It can also be secondary to a problem with nearby abdominal organs, such as the kidneys or the uterus.

Back pain is common, and in most cases, the pain gets better with rest, home remedies, and over the counter medications. Talk to your surgeon if you are experiencing back pain, especially if it’s not subsiding after self measures.

Symptoms

The primary symptom of back pain is the pain anywhere in the back, from lumbar vertebrae to sacral vertebrae. Sometimes, it may radiate all the way down to the buttocks, thighs, and legs. Besides pain, the common signs and symptoms may include;

  • Inflammation or swelling on the back
  • Persistent backache or discomfort, where resting or lying down does not help
  • Fever and weight loss
  • Urinary incontinence
  • Numbness or tingling sensations around the genitals, anus, or the buttocks
  • Faecal incontinence, or loss of control over bowel movements 

Treatment Options

Back pain usually gets better with rest and home remedies and other self-care measures, but sometimes seeking medical treatment is necessary.

Non-surgical options

Medication – Severe pain in the back often does not respond well to OTC pain medications and may require a prescription. Your doctor may prescribe codeine or hydrocodone, muscle relaxants, and antidepressants for short periods.

Physical therapy – Applying heat, ice, ultrasound, manual massage, and electrical stimulation to the back muscles and soft tissues may help relieve pain.

Cortisone injections – If other options (medications, exercise, etc.) are not effective, steroid injections may be injected into the epidural space. These are anti-inflammatory drugs that help reduce inflammation and swelling around the nerve roots.

Botox – Botox (botulism toxin) is thought to reduce pain by paralyzing strained/stiff muscles in spasm. These injections are effective in specific conditions and can be given for about 3 to 4 months.

Traction – The use of pulleys and weights to stretch the back is one of the traditional methods to relieve back pain. It is especially effective in relieving back pain secondary to a traumatic event.

Surgical options

Fusion – This procedure involves the joining of the two vertebrae together, with a bone graft inserted between them to fuse the bones. It may help relieve pain in certain conditions.

Artificial disk – A disk is inserted to replace the cushion between two vertebrae. It is effective in treating back pain due to poor posture.

Discectomy – A portion of a vertebral disc may be removed to relieve pressure against a nerve. Discectomy is often in cases where there is the growth of bony spurs due to any medical condition.

Partially removing a vertebra – This procedure involves removing a small section of a vertebra if it is pinching the nerves or the spinal cord.

Dr Ayman Eissa
MBBCh, MSc, MD, FRCA, FMFPRCA

Ayman is a Consultant in Anaesthesia and Pain Medicine at Sheffield Children’s Hospital and is also a specialist in the management of chronic pain in adults.

01709 464200

enquiries@kinvarahospital.co.uk 

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