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  • Richard R. Fay, DC

Lower Back Pain

Updated: Aug 25


If you have had lower back pain, you are not alone. Back pain is one of most common reasons people see a doctor or miss days at work. Even school-age children can have back pain.

Back pain can range in intensity from a dull, constant ache to a sudden, sharp or shooting pain. It can begin suddenly as a result of an accident or by lifting something heavy, or it can develop over time as we age. Getting too little exercise followed by a strenuous workout also can cause back pain.

There are two types of back pain:

  • Acute, or short-term back pain lasts a few days to a few weeks. Most low back pain is acute. It tends to resolve on its own within a few days with self-care and there is no residual loss of function. In some cases a few months are required for the symptoms to disappear.

  • Chronic back pain is defined as pain that continues for 12 weeks or longer, even after an initial injury or underlying cause of acute low back pain has been treated. About 20 percent of people affected by acute low back pain develop chronic low back pain with persistent symptoms at one year. Even if pain persists, it does not always mean there is a medically serious underlying cause or one that can be easily identified and treated. In some cases, treatment successfully relieves chronic low back pain, but in other cases pain continues despite medical and surgical treatment.


What Can Cause Lower Back Pain?


Most acute low back pain is mechanical in nature, meaning that there is a disruption in the way the components of the back (the spine, muscle, inter vertebral discs, and nerves) fit together and move.


Some examples of mechanical causes of low back pain include:


Injuries

  • Sprains (overstretched or torn ligaments), strains (tears in tendons or muscle), and spasms (sudden contraction of a muscle or group of muscles)

  • Traumatic Injury such as from playing sports, car accidents, or a fall that can injure tendons, ligaments, or muscle causing the pain, as well as compress the spine and cause discs to rupture or herniate.


Degenerative problems

  • Intervertebral disc degeneration which occurs when the usually rubbery discs wear down as a normal process of aging and lose their cushioning ability.

Nerve and spinal cord problems

  • Spinal nerve compression, inflammation and/or injury

  • Sciatica (also called radiculopathy), caused by something pressing on the sciatic nerve that travels through the buttocks and extends down the back of the leg. People with sciatica may feel shock-like or burning low back pain combined with pain through the buttocks and down one leg.

  • Spinal stenosis, the narrowing of the spinal column that puts pressure on the spinal cord and nerves

There are many different causes of back pain, as Dr. Fay says, " Everyone is entitled to more than one problem."


How Is Back Pain Diagnosed?


A complete medical history and physical exam can usually identify any serious conditions that may be causing the pain. Neurological tests can help determine the cause of pain and appropriate treatment. Imaging tests are not needed in most cases but may be ordered to rule out specific causes of pain, including tumors and spinal stenosis. Occasionally the cause of chronic lower back pain is difficult to determine even after a thorough examination. Dr. Fay is highly experienced and will suggest the correct testing needed to properly diagnose your condition.


Some of the tests Dr. Fay could refer you for are:


Diagnostic imaging tests allow specialists to see into the body without having to perform exploratory surgery. Imaging includes:

  • Computerized tomography (CT) can show soft tissue structures that cannot be seen on conventional x-rays, such as disc rupture, spinal stenosis, or tumors.

  • Magnetic resonance imaging (MRI) creates a computer-generated image of bony structures and soft tissues such as muscles, ligaments, tendons, and blood vessels. An MRI may be ordered if a problem such as infection, tumor, inflammation, disc herniation or rupture, or pressure on a nerve is suspected

  • X-ray imaging can show broken bones or an injured or misaligned vertebra.



How Does DuPage Health and Physical Therapy Treat Back Pain?


Depending on your diagnoses some of the treatments Dr. Fay will suggest are:


Acupuncture is moderately effective for chronic low back pain. It involves inserting thin needles into precise points throughout the body and stimulating them (by twisting or passing a low-voltage electrical current through them), which may cause the body to release naturally occurring painkilling chemicals such as endorphins, serotonin, and acetylcholine.


Transcutaneous electrical nerve stimulation(TENS) involves wearing a battery-powered device which places electrodes on the skin over the painful area that generate electrical impulses designed to block or modify the perception of pain    


Physical therapy programs to strengthen core muscle groups that support the low back, improve mobility and flexibility, and promote proper positioning and posture are often used in combination with other interventions  


Spinal manipulation and spinal mobilization are approaches in which doctors of chiropractic care use their hands to mobilize, adjust, massage, or stimulate the spine and the surrounding tissues. Manipulation involves a rapid movement over which the individual has no control; mobilization involves slower adjustment movements. The techniques may provide small to moderate short-term benefits in people with chronic low back pain but neither technique is appropriate when a person has an underlying medical cause for the back pain such as osteoporosis, spinal cord compression, or arthritis.


These are just some of the many treatments available at DuPage Health and Physical Therapy. If you are experience any back pain, please feel free to give us a call, we will do our best to provide you with an excellent plan of care right away.





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