Everything You Should Know About Lower Back Pain

BY JARETT C. BIES, AVERA HEALTH

Lower back pain is the most common orthopedic problem in the world. The pain can sideline you from your life.

“The good news is for acute back pain: almost everyone recovers,” said Joshua Schwind, MD, Avera Orthopedics. Lower back pain is either acute (a sudden onset) or chronic (ongoing).

Basic health foundations can help your back:

• Plenty of moving, activity and exercise

• Healthy weight

• Quality sleep

• A diet that helps maintain an ideal weight

• Avoiding tobacco use

Healthy weight takes pressure off the muscle, nerves and bones that make up your back, and those parts only recover when you get good rest. Nutritious eating and regular exercise lead to a good weight and body mass index (BMI), while avoiding tobacco lets your body build and rebuild bones in its best way.

“You can help bulletproof your back against pain with these health steps,” Schwind said. “Yet for some, back pain may be inevitable.”

Where Back Pain Starts

We think we can shovel snow for two hours, or that we can move that heavy table from the dining room downstairs. Then the pain in your lower back begins

“When your back hasn’t done that sort of activity for a while, there’s an overload to the body. That can lead to injury or pain,” said Mark Ponstein, DPT, clinical physical therapist with Avera Therapy. “When the load of the activity exceeds our body’s ability, we can get injured. That’s why staying active and keeping muscles strong is so important.”

Red Flags of Back Pain that Show Serious Problems

When lower back pain comes with limited control of your bladder or bowels, it’s important to see a specialist. Or, if your mobility and quality of life are severely challenged by intense, unresolved pain.

“Those are red flags that can indicate a more serious problem,” said Schwind, who sees orthopedic patients for spinal needs related to trauma, deformities and degenerative conditions. It’s also of concern to have fever with lower back pain in patients younger than 15 or older than 65 as fever may indicate an infection that needs timely care.

When pain occurs, finding the cause of the pain is step one. When the pain is acute with a sudden onset, you may consider orthopedic urgent care. Or check with your primary care provider for the best next step.

Treatments to Overcome Lower Back Pain

Physical therapy is where many patients can start finding solutions for lower back pain and tailored education can help patients be part of the solution. Physical therapists realize that “packages of pain” are often lower-back related and your provider can help you figure out the root cause.

“Symptoms from the lower back can show up as pain and/or an abnormal sensation in the groin, buttocks, thigh, lower leg or foot,” Ponstein said.

Calming the pain is step one, but then it’s time to find long-term solutions. Physical therapy can introduce you to particular exercises and stretches that work best for your lower-back pain and help you keep it from coming back.

“We are puzzles, as people,” Schwind said. “One set of exercises might help Patient A, but movements in another direction are best for Patient B.”

“We can help people of any age get stronger, more flexible and to reach their goals,” Ponstein said.

In some cases, advanced imaging, such as MRI and CT, can help identify next steps which could include steroid injections or surgery.

“Some conditions of the spine are responsive to surgical intervention, if more conservative measures do not provide lasting relief,” said Schwind. “Disc herniations, crowding of the nerves – or stenosis – or malalignment of the spine, where one vertebra slips forward (spondylolisthesis) are well treated with surgery.”

Get help with your lower back pain at Avera. org/orthopedics.