Back pain is the #1 cause of disability in the United States. Up to half of all Americans live with some degree of chronic back pain and over 80% will experience back pain at some point during their lifetime. It is estimated that approximately $300 billion is lost each year as a result of lost productivity due to chronic back pain. Back pain is the second most frequent reason to visit your doctor (behind respiratory infections) yet understanding about the causes and treatment of back pain is still poorly understood by many.
“Opioids are not recommended for chronic back pain.”
- Most acute back pain, regardless of treatment will improve within about 2 weeks with or without any treatment. Sometimes treatment with pain relievers is necessary in the short term if symptoms are severe, but it does not change the course of the disease.
- If back pain lasts longer than 2 weeks, treatment with physical therapy or medication may be indicated.
- Imaging, either with x-ray or MRI is not indicated unless symptoms persist for more than several weeks or there is an acute neurological deficit, such as loss of bowel or bladder control or severe weakness.
- Pain is not a reason to do imaging. Often findings on MRI are noted that may have nothing to do with the causes of the pain. For example, a patient who strains their back lifting a heavy object but has no symptoms other than back pain does not need a MRI. Even if a disc bulge or rupture is noted, it may have nothing to do with the pain.
- Try to avoid surgery unless there are distinct neurologic symptoms, such as weakness or numbness. Surgery for pain symptoms alone has a lower success rate for the reasons listed in #4, the abnormality seen on MRI may not be causing the pain.
- Medications such as muscle relaxants and pain relievers do not change the course of the disease. Other options, such as acupuncture, physical therapy, amino acid based therapies have proven effective but without the side effects such as sleepiness and addiction.
- If you hurt your back, bed rest is usually not recommended. In fact, lying in bed for more than a few days can lead to weakness of the spinal muscle and can worsen the problem.
- Exercise, if done correctly, can help reduce back pain by increasing flexibility, improving strength, including in your abdominal muscles, which can take pressure off of your back.
If you suffer from back pain here are some easy to use resources that can be helpful.