Insights for back pain sufferers

Dear Spine-Health Member,

With the huge amount of information available on back pain, we thought you might appreciate a newsletter with information distilled down to a few useful insights. The following summarizes a number of little known facts about back pain causes, prevention and treatment options.

The amount of pain does not equal injury/damage

With acute pain, such as if you touch a hot iron, you will immediately feel a great deal of pain (the level of pain correlates to the level of damage). However, chronic pain (lasting greater than 6 weeks) is different, and the amount of back pain you feel does not typically correlate the amount of damage or degree of injury. See Common causes of back pain and neck pain.

Imaging tests do not equal a diagnosis

An anatomical abnormality that is seen on an imaging test (MRI, CT scan) is not necessarily a cause of your back pain. In fact, the vast majority of people who never have had an episode of back pain will have abnormalities (such as a herniated disc or degenerative disc) on an imaging test.

Disc degeneration is natural

Disc degeneration is a natural part of the aging process. With age, all people will exhibit changes in their discs consistent with degeneration. However, not all people will develop painful symptoms. While the disc degeneration is likely to get worse with age, the associated pain usually does not get worse and in fact usually gets better over time. See What's a herniated disc, pinched nerve, bulging disk, etc?

MRI scans are not always necessary

Most health professionals can develop a successful treatment approach based on a thorough medical history and physical examination. Only specific symptom patterns in a minority of cases indicate the need for MRI scans or other sophisticated tests. Typically, MRI scans are used when patients are not responding well to appropriate treatment. See Do I need an MRI scan?

Treatment tips for back pain sufferers:

Acetaminophen/NSAID's can help

Acetaminophen relieves back pain by blocking the brain’s perception of pain signals. It is generally considered a very effective non-prescription medication to treat back pain.

As most episodes of back pain have an inflammatory component, NSAID’s (such as ibuprofen, naproxen, and prescription COX-2 inhibitors) are also commonly used to treat back pain. It is more effective to build up an anti-inflammatory blood level, and the efficacy of NSAID’s is markedly lower if taken only when experiencing pain. Since NSAID’s and acetaminophen work differently, the two medications may be taken at the same time.

Apply ice and/or heat

Don't underestimate the impact of simply applying ice and/or heat to alleviate the acute pain. Use of passive modalities such as ice or heat can help reduce spasm and inflammation and enable you to start rehabilitation earlier. Some people get more pain relief from moist heat. For more information, see Ahh...Ice massage therapy for back pain relief.

Engage in activity and exercise

Following an episode of back pain, most people are naturally inclined to rest their back and not engage in exercise activity (walking, stretching, normal movement). But this is often the worst thing that you can do. The two main reasons bed rest may be recommended are to reduce pressure on the discs in the spine and to stop the mechanical stresses that are irritating pain receptors. However, in most instances, more than 1 or 2 days of rest can be detrimental to recovery, potentially leading to adverse results, including muscle atrophy which in turn causes more pain. See Back exercise and fitness for back pain relief.

Stay healthy

Anything you do that enhances your overall health will also help keep your back healthy. Quitting smoking helps the back heal and stay healthy. A regular vigorous walking or other aerobic exercise program is essential and should be done at least three times a week. Daily hamstring stretching helps relieve undo pressure/stress to the lower back. Proper nutrition and stress relief can also help keep the back healthy. See Exercise walking for better back health.

Engage your brain

Those who treat back pain now recognize that it is not merely a sensation, like vision or touch, but the perception of back pain is actually strongly influenced by the ways in which your brain processes the pain signals. And you have some degree of influence over this. For example, skills can be developed to use your mind to achieve deep muscle relaxation, which in turn can help alleviate the associated pain. Please see Effective coping strategies for chronic back pain and Chronic pain as a disease: Why does it still hurt?

We strongly believe that Information Therapy is a critical to successfully managing and seeking appropriate treatment for your back pain. Hopefully, Spine-Health is helping you with this important part of your recovery by providing you with information and resources to better understand prevent and seek appropriate treatment for back and neck pain.

Best regards,
Peter F. Ullrich, Jr., MD, Medical Director
Stephanie Burke, President
Spine-health.com

About the Spine-health.com Newsletter: Each issue of the Spine-health.com newsletter, SpineNews Update, is written by the founders of Spine-health.com - Peter F. Ullrich, Jr., M.D., Medical Director for Spine-health.com and Stephanie Burke, President of Spine-health.com. The content in the newsletters is not peer reviewed by Spine-health.com’s Medical Advisory Board. The articles to which the Spine-health.com newsletters link have been peer reviewed by members of the Medical Advisory Board.