Low Back Pain is one of the most common reasons people go to see their doctor. The video above is a “must see” video for all!

 

Acute back pain causes:

• nonspecific lumbosacral pain/strain

• radicular pain or sciatica

• emergent pathologies.

 

5 emergent pathologies are:

1. infection such as osteomyelitis, or spinal epidural abscess,

2. fracture (trauma or pathologic)

3. disk herniation & cord compression

4. cancer in spine causing cord compression

5. vascular – leaking/ruptured AAA, retroperitoneal bleed, and spinal epidural hematoma.

 

Red flags for Low Back Pain - Emergencies:

1. Age 60

2. Constitutional Symptoms (fevers, weight loss, night sweats, reduced appetite) or history of cancer

3. Immunodeficiency (including diabetes, IVDU), previous spinal interventions, or recent infections

4. Pain not resolved by analgesia

5. History of trauma or coagulopathy

6. Cauda equina/cord compression symptoms (bowel incontinence, bladder retention or erectile dysfunction, saddle paresthesia - loss of sensation around anus, progressive bilateral leg weakness)

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Home Exercises depending on your type of back pain

Healthy Back Pattern 1

Healthy Back Pattern 2

Healthy Back Pattern 3

Healthy Back Pattern 4

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Medications:

Depending on the type of back pain you have, your doctor might recommend the following:

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• Over-the-counter (OTC) pain relievers. 

  • Analgesics - Acetaminophen (Tylenol)

  • Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve), might relieve acute back pain. Take these medications only as directed by your doctor. Overuse can cause serious side effects. If OTC pain relievers don't relieve your pain, your doctor might suggest prescription NSAIDs.

• Muscle relaxants. 

  • If mild to moderate back pain doesn't improve with OTC pain relievers, your doctor might also prescribe a muscle relaxant. Muscle relaxants can make you dizzy and sleepy.

• Topical pain relievers. 

  • These are creams, salves or ointments you rub into your skin at the site of your pain.

• Narcotics. 

  • Drugs containing opioids, such as oxycodone or hydrocodone, may be used for a short time with close supervision by your doctor. Opioids don't work well for chronic pain, so your prescription will usually provide less than a week's worth of pills.

• Antidepressants. 

  • Low doses of certain types of antidepressants - selective norephinephrine reuptake inhibitors (duloxetine) and tricyclic antidepressants (amitriptyline) - have been shown to relieve some types of chronic back pain independent of their effect on depression.

• Injections. 

  • If other measures don't relieve your pain, and if your pain radiates down your leg, your doctor may inject cortisone — an anti-inflammatory medication — or numbing medication into the space around your spinal cord (epidural space). A cortisone injection helps decrease inflammation around the nerve roots, but the pain relief usually lasts less than a few months.