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Orthopedics

Low Back Pain Facts, Treatments,Cost,Exercises,Recovery

  • April 6, 2022
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Low Back Pain

low back pain has become one of the greatest public health problems worldwide. The author based on the current international standards summarizes the knowledge necessary for every day treatment of low back pain.

In acute low back pain, the author underlines the necessity of the rapid, accurate diagnosis and separation for specific and non-specific low back pain. In specific acute low back pain, the treatment should focus on to eliminate the main cause.

In non-specific cases pain killing treatment and early active mobilization is the choice for the healing acceleration. The utmost priority in any case is to hinder transforming the pain into a chronic issue. Standard goal of treatment in chronic low back pain includes pain reduction, maintenance of physical activity, with decimal disability, and restoration of working ability.

Analgesics, non-steroid anti-inflammatory drugs, and muscle relaxants reduce pain, while multidisciplinary management programs, personalized and guided physiotherapy, cognitive behavioral therapy, as well as short training programs will help to restore function. Surgical treatment is only indicated in degenerative cases and only after the failure of conservative therapy.

Low Back Pain Causes:

  • Muscle or ligament strain. Repeated heavy lifting or a sudden awkward movement can strain back muscles and spinal ligaments.
  • Bulging or ruptured disks. Disks act as cushions between the bones (vertebrae) in your spine.
  • Arthritis
  • Osteoporosis
  • Trauma
  • Heavy Lifting
  • Poor sitting posture
  • Humpback while using a mobile phone or laptop
Low Back Pain Causes

low back pain treatment

1 - House hold treatment

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

Stop your normal physical activities for a few days and apply ice to your lower back. Doctors usually recommend using ice for the first 48 to 72 hours, then switching to heat.

Alternate ice and heat to relax muscles. The RICE protocol – Rest, Ice, Compression, and Elevation – is recommended during the first 48 hours.

Take over-the-counter pain medication, such as ibuprofen (Advil, Motrin IB), or acetaminophen (Tylenol) to relieve pain.

Sometimes lie on your back causes more discomfort. If so, try lying on your side with your knees bending and a pillow between your legs. If you can comfortably lie on your back, place a pillow or rolled-up towel beneath your thighs to reduce the pressure on the lower back.

A hot bath or a massage can often relax stiff and knotted muscles in the back.

2 - Medical treatment

.Over-the-counter (OTC) pain relievers

Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve), may help relieve back pain. Take these medications only as directed by your doctor. Overuse can cause serious side effects. If OTC pain relievers don’t relieve your pain, your doctor might suggest prescription NSAIDs.

.Muscle relaxants

If mild to moderate back pain doesn’t improve with OTC pain relievers, your doctor might also prescribe a muscle relaxant. Muscle relaxants can make you dizzy and sleepy.

.Topical pain relievers

These products deliver pain relieving substances through your skin via creams, salves, ointments or patches.

.Narcotics

Drugs containing opioids, such as oxycodone or hydrocodone, may be used for a short time with close supervision by your doctor. Opioids don’t work well for chronic pain, so your prescription will usually provide less than a week’s worth of pills.

.Antidepressants

Some types of antidepressants — particularly duloxetine (Cymbalta) and tricyclic antidepressants, such as amitriptyline — have been shown to relieve chronic back pain independent of their effect on depression.

low back pain treatment

3 - Surgical Treatment

For severe cases, surgery may be necessary. 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.

  • Discectomy(Laminectomy)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.
  • 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.
  • Annuloplasty 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 makes the spine stronger and cuts down on painful motion. 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.

The risks of the most common types of low back pain surgery’s

1. Spinal fusion:

Spinal fusion is generally a safe procedure. But as with any surgery, spinal fusion carries the potential risk of complications.

Potential complications include:

  • Infection
  • Poor wound healing
  • Bleeding
  • Blood clots
  • Injury to blood vessels or nerves in and around the spine
  • Pain at the site from which the bone graft is taken

2. spinal laminectomy:

Laminectomy is generally a safe procedure. But as with any surgery, complications may occur. Potential complications include:

  • Bleeding
  • Infection
  • Blood clots
  • Nerve injury
  • Spinal fluid leak

Low back pain surgery Cost

  1. Cost of One to two levels laminectomy in Iran it’s about 1200$ to 1500$
  2. Cost of two level Spinal fusion in Iran it’s about 2500$

Preparing for Low back pain surgery

Depending on your age and general medical fitness, your surgeon may ask you to have a checkup appointment with your family doctor and any other doctor with whom you schedule regular visits, such as your cardiologist (heart doctor).

Preparing for surgery
Preparing for surgery2

Spinal Surgery Recovery:

After surgery, you’re transferred to the recovery room where the health care team watches for complications of the surgery and anesthesia. You may also be asked to move your arms and legs. Your doctor may prescribe medication to relieve pain at the incision site.

You might go home the same day as the surgery, although some people may need a short hospital stay. Your doctor may recommend physical therapy after a laminectomy to improve your strength and flexibility.

Depending on the amount of lifting, walking and sitting your job involves, you may be able to return to work within a few weeks. If you also have spinal fusion, your recovery time will be longer.

You can also read more about postoperative recovery in table below:

Spinal Surgery Recovery

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