I’m not a back guy, but I know back pain. This last episode that
laid me horizontal in bed was probably from lifting my 14-year-old Golden
Retriever, helping her up and down the steps. Once she’s on flat
ground, she putters out like any other nonagenarian. However, when she
gets to the stair landing, she looks back at me as if to say, “Listen,
when you’re 99, you tell me how easy it is to go up and down these
stairs. It’s not happening, so you better pick me up, fella.”
According to the National Institute of Neurological Disorders and Stroke,
about 80 percent of adults experience low back pain at some point in their
lifetimes. This pain can vary from mild to severe, short-lived or long-lasting.
When it happens, back pain can make many everyday activities difficult.
There are many causes of low back pain. Regardless of the mechanism, age
is a confounding factor. As we age, our spine ages with us. Aging causes
degenerative changes in the spine beginning as early as 30 years old,
making us prone to back pain. But besides age, overactivity is probably
the most common cause of low back pain that I see and experience. This
type of back pain is characterized by muscle soreness and tightness. It
is usually preceded by too much yard work, an outside activity or a weekend
project. In my practice, I also see low back pain in patients who have
started a new exercise regimen, and they’ve ramped it up too fast.
The symptoms of low back pain vary. It may be sharp or stabbing or feel
like a “charley horse” type of cramp. Mine always begins after
bad lifting mechanics or prolonged bending, and I feel as if I have tweaked
my back. It then progressively becomes more sore as my lumbar muscles
tighten up. Here are some other symptoms:
- Back pain may be worse with bending and lifting.
- Sitting may worsen the pain.
- Standing and walking may worsen the pain.
- Back pain comes and goes, often following an up and down course of good
days and bad days.
- Pain may extend from the back into the buttock but not down the leg.
- Sciatica, pain radiating down the leg, is common with a herniated disk.
This includes buttock and leg pain with tingling and numbness that goes
down to the foot.
Prolonged pain, radiating pain down the leg, loss of sensation, weakness,
or bowel or bladder issues should be promptly evaluated by a physician
who frequently treats backs.
Treatment for low back pain secondary to lumbar strain from over activity
consists of time, medication and modalities.
- A short course of over the counter anti-inflammatories or acetaminophen
can help relieve the pain.
- Strict bed rest is not recommended. However, limit activity to prevent
exacerbation of low back pain.
- Passive modalities such as heat, ice, massage, ultrasound, and electrical
stimulation can be very beneficial in the acute phase. The application
of heat can loosen tight muscles whereas ice is beneficial at the end
of the day.
- Balms and salves such as Blue-Emu (I just like saying emu), Bengay and
IcyHot can help with symptomatic pain. I have an IcyHot patch on my lower
back because Shaq says it helps him, so why not give it a try.
- Physical therapy can be beneficial to initiate a stretching and strengthening program.
- Traction is often used and can be beneficial though there is not much evidence
as to its effectiveness.
Normally, an episode of low back pain will last for a few days to around
a week or so. If you are not having any luck with the above recommendations
or symptoms become worse, I recommend seeing a physician who may recommend
imaging of the back and possibly a short course of steroids.
Prevention of future episodes of back pain start with healthy lifestyle
habits. We cannot avoid the normal wear and tear on our spines that goes
along with aging, but we can lessen the chance of a flare-up.
- A weekly exercise program that combines low impact aerobic exercise like
walking or swimming with specific exercises to keep the muscles in your
abdomen and back strong and flexible.
- Proper lifting mechanics. Do not bend over to pick something up. Keep your
back straight and bend at your knees.
- Maintain a healthy weight. Increased weight puts added stress on your lower back.
- Avoid smoking. Smoking has been shown to cause your spine to age faster,
heal more slowly and lead to greater episodes of back pain.
- Proper posture. Especially in this day of computer screens, we are all
guilty of hunching over a keyboard.
For all of my readers, I hope you never have an episode of low back pain.
If you do, I hope my recommendations help. I’d love to type a few
more lines, but my nonagenarian Golden Retriever needs to go out. She
gets grumpy if she has to wait.