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Each year, one health condition causes more than 83 million lost workdays in the United States. Commonly called lumbago, lumbar strain or an aching sacroiliac, low back pain (LBP) afflicts most American adults at least once in their lifetime. It ranks as one of the leading reasons for medical consultations, costing the U.S. healthcare system $130 billion annually — $20 billion more than diabetes.
LBP is primarily caused by improper lifting or repeated stooping or bending, which strains lumbar muscles and tendons. Most of the time the discomfort is temporary, lasting days to weeks. The pain may vary from sharp and shooting to dull and achy, sometimes radiating into the buttocks or leg (sciatica). It can interfere with walking, sleeping or daily activities.
People over the age of 50 are prone to LBP due to years of lumbar wear and tear. Other risk factors include obesity, arthritis, or physical jobs such as construction or farming. Emotional stress can cause LBP, too: anxiety tightens back muscles, making them susceptible to injury.
LBP usually responds to moist heat and a few days’ rest. It’s important to return to normal activities (except heavy labor) as soon as possible — too much sitting or lying down can stiffen and weaken back muscles. Acupuncture may help; so can massage or a home Transcutaneous Electrical Nerve Stimulation (TENS) unit (skin-applied electrical current that interrupts pain signals). Over-the-counter, non-steroidal anti-inflammatory drugs (NSAIDs) like generic Advil manage pain, and generic Tylenol can be effective.
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If your back pain persists more than two weeks, consult your health care professional. They may suggest that you be sent for spinal X-rays or an MRI to check for bulging discs, muscle tears and bony abnormalities. Physical therapy or hands-on manipulation by a chiropractor or osteopath are often recommended. You may be prescribed a long-acting NSAID, like generic Celebrex or Voltaren, or a non habit-forming muscle relaxer, like generic Flexeril. Opioids are rarely used for LBP as they are not only extremely addictive but also don’t work as well as NSAIDs.
Epidural injections, a mix of steroids and numbing medicine infused around the spinal cord, can help some sufferers. Surgery is considered a last resort.
Contact your medical provider immediately if your pain is extreme (especially after a fall or blow to the back); if you have persistent weakness, tingling or numbness in your buttocks or legs; or if you experience new bowel or bladder symptoms, like incontinence. These symptoms suggest severe nerve compression and require urgent attention.
Good self-care is the best way to prevent LBP. Support your lower back by maintaining a healthy weight and strengthening your abdominal muscles. When hoisting heavy objects, bend your knees then lift with your legs. Hold heavy items close to your body and when possible, use a backpack. Carry lighter weights symmetrically — one grocery bag in each hand.
Prolonged sitting at work or home is hard on your back: Try a lumbar roll for support and get up to gently stretch every 45 minutes. Consider a standing desk. Take breaks when driving, too, stopping for 15 minutes every two hours. Stress management can also help to relax back muscles. Consider taking regular walks, signing up for tai chi or meditation (free at our local libraries), or having coffee with a friend. Get to bed at the same time every night. If you’re a side sleeper, put a pillow between your knees—under them if you sleep on your back—to ease lumbar pressure.
More information on LBP and its prevention can be found here.
Dr. Mary Jenkins, a contributor to the Herald and member of its board of directors, retired after nearly 40 years as a family practice physician in New York state.