May 25, 2020 by Peter B. Laird
Preventing and Treating Back Pain
According to the National Institute of Neurological Disorders and Stroke, 80 percent of adults living in the United States will experience back pain during their lifetimes. With such a high prevalence of back pain and equally high costs associated with lost or diminished worker productivity, it’s important to prevent back injury and understand the most effective ways to treat it.
Melissa Guanche, M.D., a Baptist Health Neuroscience Center physiatrist who develops treatment plans to restore patients’ function and quality of life following a debilitating injury or condition, says it’s important to understand the underlying injury before treatment starts.
“Not all back pain or injuries are the same,” she said. “And treatment varies based on what is causing your pain or restricting your movement and how long you’ve experienced pain or disability as a result.”
For common back injuries, often caused by muscular strains resulting from poor posture, improper lifting or overuse of back muscles, Dr. Guanche recommends seeking medical attention within days of feeling pain to prevent further injury.
Periods of Back Pain
Dr. Guanche categorizes back pain into three types – acute, sub-acute and chronic – based on how long a person has experienced his or her pain.
During the acute phase – when the injury first occurs, up to about four weeks – Dr. Guanche says back pain from muscle strain often resolves with rest and over-the-counter pain medicines or nonsteroidal anti-inflammatory drugs (NSAIDs), such as naproxen. In fact, a study published in JAMA in 2015 concluded that these medications were as effective in controlling back pain as opioids, without the threat of dependence or addiction.
If pain persists past the four-week mark, it is considered sub-acute. Dr. Guanche recommends seeing a doctor if you have not yet been medically evaluated, as further injury that may increase the pain can occur.
“Once someone has endured pain for three months, we classify them as having ‘chronic pain,’” Dr. Guanche said. In this category, more aggressive treatment may be necessary.
Treating Back Pain
After rest and over-the-counter medication to control pain – allowing the back to heal on its own, Dr. Guanche may prescribe physical therapy to reduce pain and restore function.
“Physical therapy is key,” she said. “It is integral to the rehabilitation process to have long-lasting pain relief and prevent a recurrence of your back injury or pain.” She adds that it’s important to have a physical therapist who has experience with your injury, which is why a medical evaluation is recommended to determine the location, cause and degree of injury.
Physical therapy targets and builds core strength and improves flexibility in the hip flexors and hamstrings, which support the core, including back muscles. Often physical therapists will recommend an at-home exercise program to keep the muscles strong after therapy concludes.
“Lasting relief is rarely found without the involvement of physical therapy in the treatment plan,” Dr. Guanche said.
Prescription-strength anti-inflammatories or muscle relaxers may be prescribed as well to alleviate symptoms in some cases. For chronic back pain, epidurals or facet blocks may be required to improve patients’ quality of life.
Preventing Back Pain
Like for the treatment of back pain, exercise is key to preventing back pain, Dr. Guanche says. Research published in JAMA Internal Medicine indicates that the most effective ways to prevent future back injury and pain is education about spine anatomy, posture and proper lifting, along with regular exercise aimed at strengthening the core muscles of the abdomen and back. Dr. Guanche agrees. But, she warns, it’s important to follow the advice of a physical therapist or doctor, to avoid exercises that could aggravate or re-injure the back.
With regular exercise, major risk factors of back pain and injury, including a sedentary lifestyle and obesity, are greatly reduced. “So much prevention lies in exercise that we can’t ignore the benefits,” Dr. Guanche said. “To keep your back healthy and your risk for disability minimized, be sure exercises that strengthen your core are part of your daily routine.”