OVER VIEW OF LOW BACK PAIN

At least 80 percent of Americans will experience low back pain in their lifetime.

Most low back pain is the result of an injury, such as muscle sprains or strains due to sudden movements or poor body mechanics while lifting heavy objects.

According to the National Institute of Neurological Disorders and Stroke (NINDS), low back pain is the most common cause of job-related disability. Low back pain can also be the result of certain diseases, such as:

    •    A ruptured or herniated disc 

    •    sciatica

    •    arthritis

    •    kidney infections

    •    infections of the spine

  • Cancer

  • Muscle sprain or Strain

  • Trauma such as Car accident

Acute back pain is categorized when pain last anywhere from a few days to a few weeks, while chronic back pain is pain that lasts longer than three months.

Low back pain affects individuals between the ages of 30 and 50. This is partly due to the changes that occur in the body with aging. As you grow older, there’s a reduction in the fluid content between the vertebrae in the spine.

This means discs in the spine experience irritation more easily. You also lose some muscle tone, which makes the back more prone to injury. This is why strengthening your core muscles specially using good body mechanics in daily activities, having good ergonomics while at work are helpful ways in preventing low back pain.

When it comes to any Musculoskeletal pain, having a good team of practitioners by your side can make a big difference. Our Newport Beach pain relief Chiropractor Dr.Gilak is a great resource, please feel free to give us a call or visit us for a appointment.

The most common Causes of Back pain that patient seek Our Chiropractor in Newport Beach are:

Disc Herniation: The discs in the back are prone to injury. This risk increases with age. The outside of the disc can tear or herniate.

A herniated disc, which is also known as a slipped or ruptured disc, occurs when the cartilage surrounding the disc pushes against the spinal cord or nerve roots. The cushion that sits between the spinal vertebrae extends outside its normal position.

This can result in compression of the nerve root also know as nerve impingement as disc exits from the spinal cord and through the vertebral bones. Disc injury usually occurs suddenly after lifting something or twisting the back. Usually it is the flexion and rotation movement. Unlike a back strain, pain from a disc injury usually lasts for more than 72 hours and recovery takes up to 6 to eight weeks.

Spine Stenosis: 

Spinal stenosis is most commonly due to degeneration of the discs between the vertebrae. Most of the time has a genetic component to it, it causes the spinal column to narrow which puts extra pressure on the spinal cord and the nerves. The result is compression of the nerve roots or spinal cord. Sometimes bony spurs or soft tissues, such as discs add more pressure to the spinal cord.

Pressure on the spinal nerves causes symptoms such as:

    •    numbness

    •    cramping

    •    weakness

You might feel these symptoms anywhere in the body. Many people with spinal stenosis notice their symptoms worsen when standing or walking. Flexion or bending forward usually alleviate the symptoms. These cases are only managed by our Newport Beach Chiropractor, there are not reversible and our goal is help patients with their Activities of daily living, making them understand their condition and how to cope with it.and by alleviating the symptoms using proper postural stretches and strengthen technqiues.

Muscle Sprain/Strain: The muscles and ligaments in the back can stretch or tear due to excess activity. Symptoms include pain and stiffness in the lower back, as well as muscle spasms. Rest and Ice at home in combination of Chiropractic Spine Manipulation  in addition to physiotherapy modalities are common remedies for these symptoms at our Chiropractic office in Newport Beach

Low back Pain due to pregnancy results from pelvic changes and alterations in weight loading. Back symptoms almost always resolve postpartum.

Sciatica: Sciatia usually occur with a herniated disc if the disc presses on the sciatic nerve. The sciatic nerve is the nerve that supplies the leg, As a result, sciatica can cause pain in the Gluteal area, legs and feet. This pain usually feels like burning, or pins and needles. There are other causes besides herniated Disc for Sciatica symptoms and on your visit Dr Gilak will evaluate and runs orthopedic tests and other test to determine the cause.

Abnormal spine curvatures

Scoliosis, kyphosis, and lordosis are all conditions that cause abnormal curvatures in the spine.

These are congenital conditions that are usually first diagnosed during childhood or adolescence. The abnormal curvature causes pain and poor posture because it places pressure on:

    •    muscles

    •    tendons

    •    ligaments

    •    vertebrae

Other conditions

There are a number of other conditions that cause lower back pain. These conditions include:

    •    Arthritis is an inflammation of the joints.

    •    Fibromyalgia causes  long-term pain and tenderness in the joints, muscles, and tendons.

    •    Spondylitis is inflammation of the joints between the spinal bones.

    •    Spondylosis is a degenerative disorder that may cause loss of normal spinal structure and function. Although aging is the primary cause of the condition, the location and rate of degeneration is specific to the individual.

How is low back pain diagnosed?

Your doctor will likely begin by requesting a complete medical history and conducting a thorough physical examination to determine where you’re feeling the pain. A physical exam can also determine if pain is affecting your range of motion.

Your doctor may also check your reflexes and your responses to certain sensations. This determines if your low back pain is affecting your nerves.

Unless you have concerning or debilitating symptoms or neurologic loss, your doctor will probably monitor your condition for a few weeks before sending you for testing. This is because most low back pain resolves using simple self-care treatments.

Certain symptoms require more testing, including:

    •    lack of bowel control

    •    weakness

    •    fever

    •    weight loss( recent and unwated)

 

Make sure to seek proper medical attention immediately if you experience any of these symptoms in addition to low back pain.

 

Imaging tests such as X-rays, CT scans, ultrasounds, and MRIs are be necessary to properly diagnosed the condition, the doctor usually determine which test are necessary:

    •    bone problems

    •    disc problems

    •    Electromyography (EMG) or nerve conduction tests can help identify any problems with your nerves.

 

 

What are the treatment options for low back pain?

Home care

Self-care methods are helpful for the first 72 hours after the pain begins. If the pain doesn’t improve after 72 hours of home treatment, you should call your doctor.

Stop your normal physical activities for a couple of days and apply ice to your lower back. Doctors generally recommend using ice for the first 48 to 72 hours, then switching to heat. However as a Chiropractor I recommend seeing your Chiropractor right away can make a big difference in your diagnosis, treatment outcome and the duration of your pain, followed by recommendation of your doctor.

 

Alternate ice and heat to relax muscles. The common practice of RICE — rest, ice, compression, and elevation is usually recommend.

Take over-the-counter  NSIADS pain medication.can help. However as an alternative to drugs, use of over the counter natural and topical muscle relaxant such as Biofreez or Arnica can help.

 

Sleeping position: If lying on your back causes more discomfort. Consider lying your side or putting a pillow behind your knees, keeping supported at 90 degree of flexion release Psoas muscles spasm which can alleviate the pain.Low back

There are a number of possible medical treatments including:

 

    •    Chiropractic Manipulation

  •   Physiotherapy Modalities

    •    Medication: muscle relaxants

    •    nonsteroidal anti-inflammatory drugs (NSAIDs)

    •    narcotic drugs such as codeine for pain relief

    •    steroids to reduce inflammation

    •    Therapeutic Massage

    •    stretching

    •    strengthening exercises

    •    back and spinal manipulation

 

When Surgery is necessary?

For severe cases, surgery may be necessary. Newport Beach based Chiropractor Dr Gilak works with many great surgeon in Newport Beach and she will make an appropriate referral.

Surgery is usually only an option when all other treatments fail. However, if there’s loss of bowel or bladder control, or a progressive neurological loss, surgery becomes an emergency option.

For disc herniation cases a discectomy is a common surgery to relieves pressure from a nerve root pressed on by a bulging disc or bone spur. The surgeon will remove a small piece of the lamina, a bony part of the spinal canal.

A foraminotomy is a surgical procedure that opens up the foramen, the bony hole in the spinal canal where the nerve root exits.

Intradiscal electrothermal therapy (IDET) involves inserting a needle through a catheter into the disc and heating it up for 20 minutes. This makes the disc wall thicker and cuts down on the inner disc’s bulging and irritation of the nerve.

A nucleoplasty uses a wand-like device inserted through a needle into the disc. It can then remove inner disc material. The device then uses radio waves to heat and shrink the tissue.

Radiofrequency lesioning or ablation is a way to use radio waves to interrupt the way the nerves communicate with each other. A surgeon inserts a special needle into the nerves and heats it, which destroys the nerves.

Spinal fusion is an another surgery option commonly performed to stabilize the spine. The procedure removes discs between two or more of the vertebrae. The surgeon then fuses the vertebrae next to each other with bone grafts or special metal screws.

A spinal laminectomy, also known as spinal decompression, removes the lamina to make the size of the spinal canal bigger. This relieves pressure on the spinal cord and nerves.

Prevention Method: 

As your Alternative Medicine practitioner, we are all about prevention.Practicing prevention techniques may also help lessen the severity of your symptoms if you already have a lower back injury. Newport Beach pain relief Chiropractor Dr. Gilak highly recommends the following suggestions: 

 

    •    Core strengthening

    •    losing weight if you’re overweight

    •    Practice proper lifting techniques

    •    constantly work on proper ergonomics

           Quite smoking

         Consider changing your mattress

    •    Use supportive chairs

References: 

    •    Back conditions: Procedures. (n.d.).
nyspinemedicine.com/procedures

    •    Back pain? (2016).
niams.nih.gov/Health_Info/Back_Pain/back_pain_ff.asp

    •    Low back pain. (2013).
orthoinfo.aaos.org/topic.cfm?topic=a00311

    •    Low back pain fact sheet. (2019).
ninds.nih.gov/disorders/backpain/detail_backpain.htm

    •    Radiofrequency ablation. (n.d.).
my.clevelandclinic.org/health/treatments/17411-radiofrequency-ablation

    •    Spondylosis. (n.d.).
utswmed.org/conditions-treatments/spondylosis/

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