Low back pain can be managed with rest while more severe cases may need a treatment regime. Dr Tan Kian Hian, Head ＆ Senior Consultant from the Department of Anaesthesiology at Singapore General Hospital, explains.
Acute low back pain is pain felt in the lower back that lasts for less than three months.
"Most people experience
low back pain at certain stages of their lives. In most cases, it will get better in several weeks even without treatment. However, this varies from person to person. Such a pain may happen again over time and may progress to chronic low back pain, which is back pain that persists for more than three months," says Dr Tan Kian Hian, Head ＆ Senior Consultant from the Department of Anaesthesiology at Singapore General Hospital (SGH), a member of the
SingHealth group.
What to do if you have low back pain
If your low back pain bothers you, it is important to see your doctor, and work with him or her to manage your pain. Medical history and physical examination are needed to check for any serious medical condition that may be associated with your low back pain, although this is rare. Additional investigations such as x-rays and blood tests are not needed in the majority of cases of acute low back pain. Such tests do not help with your pain or your ability to move your back.
It is normal to worry about the cause of your low back pain and the impact it may have on you. Talking to your doctor or specialist about your concerns can be helpful. You will usually find that there is no serious cause and that there are ways to relieve your symptoms.
The goal of the consultation is to help you find ways to manage your low back pain and return to your usual activities.
Most people find that the pain eases off over a short period of time as healing occurs. Pain-relieving measures can help you cope with your symptoms while nature takes its course. For example, your doctor can prescribe you medications like paracetamol, anti-inflammatory medicine, and muscle relaxants.
Staying active helps to prevent long-term problems. Your low back pain may make it difficult for you to carry out your usual activities, and you may even want to rest completely. However,
it is important to resume normal activities as soon as possible.
How to avoid aggravating low back pain
Low back pain can be prevented and managed through lifestyle modifications such as:
Adopt a good posture.
Avoid staying in the same position for long periods of time. Frequently take breaks by standing and stretching. This helps reduce stress on the back from building up to critical levels.
Maintain a healthy weight.
Try to modify activities so that they are less likely to strain the lower back.
Lift objects properly and avoid bending at the waist.
Adjust your workspace to reduce strain on the back
Exercise regularly to strengthen and increase the flexibility of back muscles. e.g. swimming, brisk walking, cycling. Also, exercise programmes must be balanced to exercise all parts of the body.
Sleep on a firm mattress.
When to see a pain specialist for low back pain
You should see a pain specialist if:
The low back pain persists, lasting more than three months.
The pain is associated with nerve root pain that is characterised by:
The specialist will perform a complete initial assessment that typically includes a medical history and physical examination. He or she may ask you certain questions as well as conduct strength and movement tests on you to check for serious underlying conditions, such as fractures, tumours, infection and severe nerve damage. Sometimes, other investigations may be needed to arrive at a diagnosis.
Symptoms of low back pain
In severe cases, you may have the following symptoms. Seek medical help early.
Constant pain with no significant relief at rest
Aggravated by bending in all directions
Localisable severe pain to a single spot on the back
Progressively severe pain over days/weeks
Persistent nerve pains, pain or sensation of numbness, pins & needles aching in one or both legs
Weakness of legs, difficulty in walking, unsteady walking
Bladder/bowel problems associated with back pain (difficulty in passing urine - incontinence)
General symptoms of poor health, loss of appetite, weight loss, lethargy, fever and chills
History of cancer
Common causes of low back pain
Most of the time low back pain is due to muscle strain. It is rare for the pain to be caused by a serious medical problem. In about 95 per cent of the cases, the pain can be managed effectively even when the specific cause is unknown. In fact, 90 per cent of patients recover within six weeks.
Treatments for low back pain
A multi-pronged approach will be needed to manage chronic low back pain.
Medication
Physiotherapy
Interventional therapy
This is used to diagnose and treat the cause of the pain arising from different spinal conditions. It mainly involves injections administered in a procedure suite using guidance from x-rays.
Such a procedure lasts for about 30 minutes and is performed under local anaesthesia with mild sedation. You will be fit to go home within two hours after observation.
If required, you will be referred to an orthopaedic surgeon for a surgical assessment.
Ref: Q15
Check out other articles on back pain:
10 Tips for a Healthy Back
What is a Slipped Disc?
Sciatica: Back Pain that Extends Down to the Feet
Ankylosing Spondylitis (Spine Inflammation): Causes, Symptoms, Treatment
How Nerve Pain Can Cause Chronic Pain
