Chronic back pain is one of the most prevalent conditions experienced by individuals of all ages. Lower back pain specifically can be attributed to factors including poor posture, anxiety, and stress. In many cases, the discomfort of lower back pain is specifically related to misalignment of the spine, or tension in the connecting muscles. Depending upon the cause of the pain, a number of long-term treatment plans can be viable options for relief.
Postural Issues of the Spine
Lower back pain that is the result of problems with the spinal muscles can also be attributed to systemic tension as well as tightness in the hamstrings. These factors may the result of sitting or standing for long periods of time, since these practices reduce flexibility in the hip flexors, legs, and even the rotator cuff of the shoulders.
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If the basis for chronic lower back pain is the result of posture or tension, then physical therapy or stretching exercises can provide relief. These practices may be employed in the home or in the office, and can allow the spine to realign while also strengthening the connecting muscles and tendons. Some basic exercises that can be used include:
- Forward bends – these help to stretch the spine through gravitational traction and also are effective for lengthening the hamstrings.
- Backbend over an exercise ball – this position will apply gravitational traction to the spine in a relaxed manner, since the weight of the body is supported by the ball.
- Down facing dog – this pose opens the shoulders and the hamstrings, while working core muscles to provide greater support to the spine.
Muscle Tension and Chronic Back Pain
Problems with the spinal muscles can greatly contribute to the severity of pain that is experienced. In most cases, it is this constant flexion of the muscles that results in the feelings of discomfort, and relaxing the muscles will provide considerable relief. Further concerns with muscle tension can include the fact that prolonged time periods of constant flexion can also pull the bones of the spine out of alignment. For this reason, it can be important to alleviate the cause of the pain not only for comfort, but also to avoid future problems.
Heat is one of the most common methods for alleviating chronic back pain that is caused by muscle tension. This can be administered through a number of means:
- Heating pads – including hot water bottles or electric mats that are placed directly on the area of discomfort.
- Medicated patches – these induce the sensation of heat through the use of camphor, menthol, or capsaicin, which increases circulation and relaxation to the affected areas.
- Hot baths – these can be highly effective for relieving muscle tension and pain in the lower back, but also for relaxing connecting muscles which may be exacerbating the pain.
Along with heat, manual manipulation can also be effective for reducing lower back pain. This can include massages that are administered by clinical professionals, or by electronic devices. Physical therapists and pain management physicians will often use electrical stimulation, known as TENS, in order to relax the back muscles. This method will also stimulate nerve roots and increase the production of endorphins, to alter the manner in which pain is perceived.
While TENS is an effective method for both inducing relaxation and reducing pain, it should be noted that this non-pharmaceutical approach is not applicable for all individuals. Other conditions can exclude people from using this treatment and the following comorbid conditions are considered prohibitive:
- History of seizures
- Some heart conditions, including arrhythmias
- The presence of a pacemaker
- History of migraines
Lower Back Pain From a Herniated Disc
Herniated and bulging discs can be the result of an injury, but can also be present in cases where there is a chronic degeneration of the spine. This cause of lower back pain happens when the cushioning discs between the vertebrae move out of alignment and become pinched between the bones. In some cases, people can find relief from the pain with the help of a chiropractor, who physically manipulates the bones, discs or tendons in order to put the spine back in balance.
Physical therapy can also be effective for moving a herniated disc back into place in a less drastic manner. Exercises that strengthen the muscles around the spine will also help to pull the vertebrae and discs back into alignment. These methods can further offer a protective element, as toning the muscles can prevent future injuries and slippage as well.
In some cases, a herniated disc may cause pinching or injury of nerve roots. This will often result in chronic lower back pain as well as impairment of the limbs. Frequently, this will affect manual dexterity or the ability to walk, although this will depend upon where in the spine the nerve roots are pinched. Physical therapy may still be used as a means of pain management, although many of these cases can require surgery in order to completely reduce the pain.
Progressive Chronic Back Pain
Other causes for chronic lower back pain can be the result of progressive conditions that may develop in mid to late life. These can include:
- Degenerative Disc Disease – which is a genetic condition that can manifest as early as the mid twenties, and results in the progressive deterioration of the cushioning between the vertebrae.
- Spondyliosis – this condition is a continual disintegration of the vertebrae and can cause severe lower back pain from pinched nerves and muscle tension.
- Parsonage Turner Syndrome – another genetic condition that affects both the upper and lower back through a breakdown of the shoulder and hip joints.
Pain Medications for Chronic Back Problems
Chronic back pain that is the result of a progressive illness or other causes may necessitate the use of pain medications. The most common class of pharmaceuticals that are utilized are NSAIDS, which may be prescribed or accessed as over the counter drugs. These pain medications reduce the inflammation that can generate the discomfort, and may increase circulation to the area, which can speed the healing process.
In severe cases, the use of opiate or opiate derivatives may be used as pain medications. These controlled substances have a direct effect on the nerve roots, by blocking the pain receptors and thus reducing the intensity of the sensations.