Find answers, relief from your low back pain

Sunday, August 1, 2021

In this article:

Low back pain is a leading cause of missed work, school and activities.
There are many causes of back pain and treatments can vary from physical therapy to surgery.
Providence spine surgeon, Dr. Rafe Sales, weighs in on how you can get relief.

[5 MIN READ]

It’s happened to the best of us: A sore back. Maybe you’ve lifted something a little too heavy or you overdid it working in the yard on a nice, sunny Spring day. Or maybe you hurt your back from a fall or even in a car crash.

Low back pain is one of the biggest drivers of doctor’s appointments. Fortunately, with a little rest and recovery at home, low back pain can often clear up on its own. Even when it doesn’t, there are ways to treat your pain so you can get back to your normal activities.

Back pain for a couple of days is generally nothing too worrisome. However, if it isn’t improving after a couple of weeks of rest, it’s probably time to see your doctor.

“Everyone experiences back pain,” explains Rafe Sales, M.D., spine surgeon and co-medical director of Providence Oregon Spine Center. “Back pain for a couple of days is generally nothing too worrisome. However, if the back doesn’t feel stable or your pain isn’t improving after a couple of weeks of rest, it’s probably time to see your primary care doctor.”

Here, Dr. Sales shares his insight on common causes of low back pain and how it’s treated.

Common causes of low back pain

Dr. Sales sees a wide range of injuries and conditions that affect the low back. The most common include:

Herniated disc – Your spine includes rubbery discs between vertebrae that act as shock absorbers. These discs have a hard exterior and jelly-like center. When the disc becomes herniated, part of that jelly-like center pushes out of the disc. A herniated disc in the low back can cause extreme pain, immediate and sustained mobility issues and weakness or numbness in the leg or foot.
Scoliosis – This spinal condition refers to a sideways curvature of the spine. While it is typically diagnosed in childhood, it can be caused by age-related wear and tear, injuries to the back or complications from past surgeries. Kyphosis is another type of spine curvature, where the spine curves from front to back. It may cause poor posture that can lead to pain, digestive trouble and even breathing difficulties.
Spondylolisthesis – Another cause of low back pain, spondylolisthesis occurs when one of your vertebrae slips out of place onto the vertebra below it.
Pinched nerve – A pinched nerve can happen when an injury or condition in your low back causes a vertebra or disc to press against one of the many nerves along your spinal cord. The most common cause of a pinched nerve in the low back is a herniated disc.
Spinal stenosis – Your spine includes a small opening that allow nerves to run the length of the spine. These openings (foramina) can narrow over time, which can compress nerves and cause pain.

Treating low back pain

The best first step in relieving back pain is trying a few things at home. To start:

Rest and avoid activities that can stress or strain the back, like high-impact sports or lifting heavy objects.
Use a combination of heat to relax muscles and ice to reduce inflammation.
Try over-the-counter medicines, like Ibuprofen or Aleve to reduce inflammation and relieve pain.
Stretching can help loosen tight muscles and help relieve pain.
Get moving with low-impact activity, walking, biking or swimming to keep your body in motion and back muscles loose.

It’s also important to note that if you experience back pain with any of the following symptoms, you should see a doctor or emergency medical provider immediately:

Severe pain not improving with rest
Difficulty walking or standing
Inability to control bowels
Numbness or weakness in legs
Obvious changes in shape
Injury caused by impact, such as a fall or car wreck

If your pain isn’t severe, but persists and starts to interfere with daily activities, it may be time to see your doctor.

“An appointment with your primary care provider is a great place to start,” encourages Dr. Sales. “They can do an initial assessment and recommend other treatment, like physical therapy. They can also order an X-ray to make sure there aren’t any major issues in the spine.”

Getting started with physical therapy

Physical therapy is a great first line of defense against low back pain. A physical therapist will work with you to understand your back pain, including how you injured your back, symptoms and steps you’ve taken so far.

Your physical therapist will develop a treatment plan that includes stretching and strengthening key parts of your body that may contribute to low back pain.

Then, your physical therapist will develop a treatment plan that includes stretching and strengthening key parts of your body that may contribute to low back pain, like your core, hips, legs and (of course) back.

Knowing when it’s time to see a spine specialist

When at-home remedies and physical therapy aren’t helping relieve your back pain, it may be time to see a spine specialist.

Once we know where your pain is coming from, we can develop a treatment plan that will bring you relief.

“The first thing we’ll do is a complete work-up to pinpoint, precisely, the source of your back pain,” explains Dr. Sales. “Once we know where your pain is coming from, we can develop a treatment plan that will bring you relief.”

For some individuals, that plan may include spine surgery.

“I always look at risk/reward when it comes to surgery on my patients,” states Dr. Sales. “I’ll consider if they’ve done conservative treatments or how much pain is impacting their daily life. Then, I’ll compare it to how invasive surgery might be. It always has to be the right solution for my patient,” he finishes.

Advances in spine surgery

Spinal surgery has come a long way in the last 5-10 years. More and more procedures can be done with a minimally invasive approach. That means you’ll have a smaller incision, less pain and faster recovery.

Some of the biggest changes have been in herniated disc surgery, which is now an outpatient procedure with most patients going home the same day, and spinal fusion surgery.

Some of the biggest changes have been in herniated disc surgery, which is now an outpatient procedure with most patients going home the same day, and spinal fusion surgery.

“When I first started practicing 17 years ago, spinal fusion surgery meant 5 days in the hospital and a long recovery,” Dr. Sales says. “Now, we can do fusion surgery and patients go home the same day or spend just one night in the hospital.”

Dr. Sales credits those changes with helping clear up one of the biggest misconceptions in spine surgery.

“Some people have the idea that spine surgery doesn’t work, but it does,” shares Dr. Sales. “It works very well if the appropriate work-up is done and source of pain is identified.”

Emerging technology pushes care forward

Much like all areas of healthcare, new technology is improving care available to patients – and expanding what surgeons can offer. One Dr. Sales is excited about is spinal cord stimulation.

“It’s a really helpful procedure for patients who had a previous surgery or where surgery may be too invasive and difficult,” he explains. “We can put an implant on the spine that blocks pain signals that are sent to the brain from the low back or hip.”

Another exciting advancement is a new procedure that can help prevent repeat herniation. The procedure uses an implanted device to block holes in the disc from allowing the soft, jelly-like center from leaking out, causing pain or pinching a nearby nerve.

“This new technology to help prevent ongoing herniated discs is really a game-changer,” Dr. Sales states. “It will hopefully save people from repeat injuries that make them miss work and their favorite activities.”

Get started on your path to less pain

If you’re experiencing chronic or persistent back pain that’s not getting better with rest, talk to your primary care provider. They can start you on a path to finding answers and getting relief from whatever’s causing your pain.

Find a doctor

Schedule your appointment with one of our primary care providers or orthopedists today. Use our provider directory or search for one in your area.

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This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.