If you are suffering from low back pain, you have plenty of company. According to the CDC, 25 percent of the U.S. population reports experiencing acute or chronic back pain within the last 3 months. Studies show that back pain causes more disability worldwide than any other single condition. This means that millions of people are asking the same questions:
Why does my back hurt? and What can I do about it that doesn’t involve surgery?
Physiatrists are doctors who focus on this particular problem.
Causes of Lower Back Pain
It’s important to understand that there are four types of underlying causes of back pain:
congenital conditions, injury, disease, and the wear and tear of aging. These categories, although distinct, sometimes overlap. For example, an injury may be the result of a congenital or disease condition.
Congenital Conditions That Cause Lower Back Pain
Malformations of the spine or genetic disorders can result in lifelong back pain or permanent disability. Congenital conditions that result in back pain and restricted mobility include:
- Scoliosis, kyphosis, lordosis
- Spondylolisthesis*
- Ankylosing spondylitis
*This condition may be congenital or may develop later in life
Injuries That Cause Back Pain
Injuries that result in acute back pain can occur due to car accidents, slip and falls, during exercise or sports activities, doing chores, at work, or even as a result of a single awkward movement or a sneeze. Such accidents can cause damage to any of the many parts of the low back, including:
- Ligaments
- Tendons
- Muscles
- Nerve roots
- Vertebrae or the small facet joints that connect them
- Discs
- Sacroiliac joint (the joint between the spine and pelvis)
Such injuries not only result in immediate pain but continue to be troubling and require medical attention. Typical sprains and strains can be treated non-surgically.
Disease Conditions That Cause Back Pain
Although anyone can catch or develop a disease, some diseases are genetically linked. Disease conditions that cause back pain include:
- Rheumatoid arthritis
- Multiple sclerosis
- Post-polio syndrome
- Diabetes that causes neuropathy (nerve dysfunction)
- Osteomyelitis
- Bone cancer
While some of these disease conditions have many other serious symptoms, each has back pain as a troubling component.
How the Wear and Tear of Aging Causes Lower Back Pain
Though we all wish it were not so, aging involves a deterioration of the spine as well as other parts of the body. In some cases, wear and tear occur prematurely due to inherited conditions; in others, it is accelerated by serious injuries. Regardless, all but the luckiest among us will probably experience one or more of the following in our later years. Still, it’s heartening to remember that now we have many more effective treatments for back pain than our ancestors did.
The following conditions, though they can occur for various reasons earlier in life, are common in older individuals:
- Osteoarthritis — when the cartilage that cushions the bones erodes
- Disc herniation — when the gelatinous cushions between the vertebrae bulge and press on spinal nerves
- Spinal stenosis — when the spinal canal narrows, putting pressure on the spinal cord and/or nerve roots
- Pinched nerves (radiculopathy) that result in tingling and numbness, as well as pain
- Sciatica — pressure on the sciatic nerve that may also affect the hip, buttocks, and legs
- Osteoporosis as bones become thinner, more porous, and more brittle
- Sacroiliac (SI) joint pain due to inflammation of one or both joints between the spine and pelvis resulting in pain in the buttocks, lower back, or down the leg
- Compression fractures of the facet joints or vertebrae
- Neurogenic or vascular claudication, the former as a result of stenosis; the latter a result of impaired blood flow
As those suffering from low back pain know all too well, whatever its cause, relieving back pain is of utmost importance to increase mobility and improve quality of life.
Types of Treatment for Back Pain
As noted, there are multiple effective treatments for back pain. Your physiatrist will assist you in determining which will be best for you by taking into account your medical history, any pre-existing conditions, the nature and location of your pain, and whether your pain is acute or chronic.
Traditional Treatments for Back Pain
Conventional medicine has used the following treatments for back pain very successfully:
- Physical Therapy which your physiatrist will customize for your particular ailment, health conditions, and state of fitness
- Spinal epidural injections, which contain both a painkiller and a corticosteroid to reduce inflammation, are administered under fluoroscopic guidance to pinpoint the site
- Facet Injections to target the small joints between the vertebrae
- Radiofrequency Ablation deadens the facet nerve causing your pain
by using heat generated by radio waves
Complementary Treatments for Back Pain
It is no wonder physiatry has become a central feature of the healthcare landscape since, according to Pew Research Center, half of all Americans now use complementary treatments in conjunction with traditional ones, and are happy to find both available at their physiatrist’s office.
There are three types of complementary treatments: physical, psychological, and nutritional.
Physical complementary therapies are designed to use physical touch, technology, and guided movements to lessen back pain. Physical complementary therapies include:
- Acupuncture has been used for thousands of years as a way of relieving pain and accelerating healing by painlessly inserting tiny needles along charted meridians
to release endorphins that act as natural painkillers
- PEMF (pulsed electromagnetic field) technology decreases pain through the emission of varying frequencies of electromagnetic waves
- Yoga, Tai Chi, Qigong, and Dance Therapy are movement therapies designed to improve balance, ease mobility, and restore peace of mind as well as lessen pain
- Massage and Reiki use skilled practitioners who do hands-on work on the patient’s body to increase energy and calm as they lessen pain
Psychological complementary therapies are designed to channel mental energy and redirect the patient’s focus away from back pain. Psychological therapies include:
- Meditation
- Biofeedback
- Hypnosis
- Spirituality
- Art therapies (music, painting, sculpting, poetry)
- Individual counseling, group therapy, support groups
- Mindfulness
- Visual imaging
- Cognitive behavioral therapy (CBT)
All of these therapies empower the patient by showing how the body-mind connection can be used to lessen back pain.
Nutritional complementary therapies make use of natural substances to alleviate pain. Some of these may be part of your normal diet, like fatty fish, Brussels sprouts, blueberries, olive oil, dark chocolate, and lentil beans — all known to reduce inflammation. Others may be ingested as teas or supplements or rubbed on the area to reduce pain, such as chamomile, chondroitin & glucosamine, flaxseed, echinacea, cayenne, and St. John’s wort.
Why Physiatrists Are the Right Doctors to Treat Back Pain
Most back pain can be treated non-surgically. This is why so many patients with back pain
turn to physiatrists, doctors who specialize in pain management and restoration of function.
Because physiatrists are holistic practitioners, they use and recommend a broad range of treatments for back pain, including complementary therapies as well as traditional ones. They also frequently combine treatments to achieve optimal results as quickly as possible.
The Takeaway
There is every reason to feel hopeful if you are experiencing back pain since there are so many ways to successfully relieve it. Consulting with a well-respected physiatrist is a good first step because physiatrists are enthused about using complementary treatments in combination with more traditional treatments. More than that, they will consider your personal preferences and encourage you to play an active role in your healing.
