Oh, My Aching Back! (Dr. Vee Contributed to AOL Health Article)

Photograph of Golfer by Elena Weber

Photograph of Woman Exercising on the Beach by Dusan Zidar

10 Questions About Lower Back Pain

By Deborah Huso (AOL Health Writer)

According to the American Academy of Physical Medicine and Rehabilitation, 80 percent of Americans will suffer from back pain at some point in their lives, and for most of us, that means lower back pain. While a fair number of people suffering from chronic lower back pain often end up taking the surgical route, more than half of those surgeries result in no change in pain and sometimes even increase pain.

The reason, according to Mitchell Yass, physical trainer and owner of PT2 Physical Therapy & Personal Training in Farmingdale, N.Y., is that most back pain is the result of muscle weakness or imbalance.

So if you’re suffering from persistent lower back pain and seek a doctor’s advice, here are 10 questions you should ask to help get yourself on the mend, hopefully without surgical intervention:

1. What is causing my lower back pain? It’s best to rule out simple causes first. Those might include muscle weakness or spasms, spinal stenosis or disc pain, all of which can be successfully treated without surgery. Ask your doctor to give you a full physical examination.

2. What are the signs my back pain is dangerous? If you’re experiencing loss of bladder or bowel control or numbness around the anus, you may have a more serious problem, and an MRI may be necessary to diagnose the cause.

3. Could stress be causing my lower back pain? New studies have shown that lower back pain is often linked to stress. This manifestation of stress as physical pain in the body is called tension myoneural syndrome.

Craig Antell, osteopathic physician and founder of New York Rehabilitation & Wellness, says he always recommends that patients with chronic back pain who have an obvious stress factor in their lives read “Healing Back Pain” by John E. Sarno, M.D., which helps patients discover and address the link between chronic pain and mental stress.

By addressing stress, one can often relieve the muscle tension in the back that causes pain.

4. Should I use heat or ice to treat back pain? Ice will help relieve pain in the case of muscle spasm or inflammation. With chronic back pain, heat can help. Neither will treat the pain, however, but they will relieve symptoms and make you more comfortable while you recover.

5. Should I be on bed rest? Vandana Bhide, M.D., who practices internal medicine in St. Augustine, Fla., says bed rest is the worst possible prescription and can actually slow recovery.

6. Should I perform exercises to relieve and address lower back pain? Bhide recommends stretching every day before getting out of bed. While your doctor or physical therapist can recommend exercises for your specific condition, one simple thing you can do before rising in the morning is to lie on your back and pull one leg to your chest and then the other, doing each side 10 times. Then perform the same movement with both legs. Once you get out of bed, perform a cat stretch (curling and flattening your back while on all fours) 10 times.

7. Is physical therapy helpful? Physical therapy is generally the primary and most effective treatment for lower back pain, as it involves hands-on manual exercise in which a therapist will teach you exercises to address your specific pain issue. To be effective, however, you must practice the back exercise regimen at home whenever you experience back pain or to prevent it from recurring.

8. Is any over-the-counter pain medication helpful or necessary? Avoid pain medications if at all possible because they do nothing to address healing. If you need temporary relief, try ibuprofen or naproxen. Your doctor may also prescribe a muscle relaxant or steroids.

9. Should I get an X-ray or MRI? An X-ray or MRI is only necessary if your doctor has ruled out muscle weakness or spasms, bulging disc, or spinal stenosis after a complete physical examination. An MRI is essential if you’ve experienced trauma, have night pain, and or loss of bowel or bladder function, any of which can point to a severe neurological disorder or even cancer.

10. At what point may surgery be necessary, and will it help? Surgery may be necessary if you are experiencing the above symptoms, and it will help in those cases. The reason so many people who have back surgery experience no relief of symptoms is because they have been misdiagnosed. “Always make sure your physician knows the objective cause of the back pain,” says Antell. “Just treating the pain won’t fix back pain for the long-term.”

Last Updated on May 9, 2010 by Dr. Vee