Back Pain Archive

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When to get help for low back pain

Image: Thinkstock

Pain from ruptured discs and arthritis doesn't have to flatten you. There are a variety of ways to ease lower back pain discomfort and reduce disability, often without drugs.

Spinal problems are the price we pay for walking upright. Wear and tear on our backbones and the constant pull of gravity on our vertebrae take their toll over time. Nearly every adult has had a stiff or sore back at some time.

A broken back without the fall

Don't ignore back pain, height loss, or osteoporosis. They could be signs of a compression fracture.

You didn't fall, and you didn't do anything strenuous. So it may come as a surprise when the bad back pain you've been experiencing turns out to be one or more broken bones in your back. "A common story is that someone bends down to put something in the dishwasher or steps off a curb a little hard and puts additional load on their spine. The weakened bone is not adequate to take that load, and it collapses," says Dr. Julia Charles, a rheumatologist and bone cell researcher at Harvard-affiliated Brigham and Women's Hospital.

What weakens the spine?

Your spine contains about 30 bones called vertebrae, stacked on top of each other like a roll of quarters. Each vertebra consists of an external bone surface (like plaster), and an inside filled with a honeycomb of support rods called trabeculae.

I’m in pain, so why is my doctor suggesting a psychologist?

The negative emotions that come from coping with chronic pain can lead to depression, and that very depression can lead to worse pain. Understanding the connection between pain and emotional health with the help of a psychologist can address these issues, and there are evidence-based therapies that can help as well.

Rubbing it in

Pain relief creams and ointments can get the medicine right to where it hurts, and the smell is often familiar and soothing. But do they work?

When something like a knee hurts, there's a natural tendency to rub it. And if it really hurts, most of us will think about popping a pain-relieving pill of some kind — acetaminophen (Tylenol) for starters, or perhaps one of the nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin, ibuprofen (Advil, Motrin), or naproxen (Aleve, Naprosyn).

By the way, doctor: What can I do about ischial bursitis?

 

Q. I have a pain in my right buttock, which my doctor says is ischial bursitis. Is there anything I can do for the pain or to make the condition go away?

A. Ischial bursitis, sometimes called ischiogluteal bursitis, is an inflammation of the fluid-filled sac, or bursa that lies between the ischial tuberosity (the lower part of the V-shaped bone that helps form the pelvis) and the tendon that attaches the hamstring muscle to the bone.  It helps to understand the location of the ischial bursa is by recognizing that it’s the part of your body that bears most of the pressure when sitting in a saddle.   Injury or overuse can cause the bursa to become inflamed, swollen, and painful — a condition called bursitis. Ischial bursitis can result from sitting for long periods on a hard surface, from direct trauma to the area, or from injury to the hamstring muscle or tendon through activities such as running or bicycling.

Early therapy helps people with low back pain avoid medication

In the journals

If you suffer from low back pain and want to avoid taking strong pain medication, you might want to consult a physical therapist first, suggests a recent study published online May 23, 2018, by Health Services Research.

Researchers reviewed insurance claims for approximately 150,000 adults, ages 18 to 64, who had been newly diagnosed with low back pain. They found that those who first consulted a physical therapist had an 89% lower probability of receiving an opioid prescription compared with those who saw another type of medical provider. They were also less likely to have an MRI or CT scan or to seek out emergency care for their pain.

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