Guide to Lower Back Pain
From Carol & Richard Eustice
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Part 1 of 10 - What Is Lower Back Pain? (Acute vs. Chronic Lower Back Pain)
Part 2 of 10 - What Structures Make Up The Lower Back? (Anatomy of the Back)
Part 3 of 10 - What Causes Lower Back Pain?
Part 4 of 10 - What Conditions Are Associated With Lower Back Pain?
Part 5 of 10 - How is Lower Back Pain Diagnosed?
Part 6 of 10 - How is Lower Back Pain Treated?
Part 7 of 10 - What Medications Are Used To Treat Lower Back Pain?
Part 8 of 10 - What Are Other Treatment Options For Lower Back Pain?
Part 9 of 10 - What Are The Surgical Procedures For Lower Back Pain?
Part 10 of 10 - Can Lower Back Pain Be Prevented?


Part 1 of 10 - What Is Lower Back Pain? (Acute vs. Chronic Lower Back Pain)

Lower Back Pain: A Common Problem

Back pain is a common neurological ailment. Men and women are equally affected. It occurs most often between ages 30 and 50, due in part to the aging process but also as a result of sedentary life style.

Job Disability

Lower back pain is a common cause of job-related disability and missed work. Most occurrences of lower back pain go away within a few days. Others take much longer to resolve or lead to more serious conditions.

Acute Lower Back Pain

Acute back pain generally lasts from a few days to a few weeks. Most acute back pain is mechanical in nature, the result of trauma to the lower back or a disorder such as arthritis.

Pain from trauma may be caused by:

sports injuries

work around the house

other stressors on the spine

 

Symptoms

Symptoms may range from muscle ache to shooting or stabbing pain, limited flexibility and/or range of motion, or an inability to stand straight.

 

Pain felt in one part of the body may radiate from a problem elsewhere in the body.

Some acute pain syndromes can become more serious if left untreated.

Lower back pain unrelated to injury or other known cause is unusual in pre-teen children, although, heavy backpacks can strain the back.

 

Chronic Lower Back Pain

Chronic back pain is measured by duration, pain that persists for more than 3 mo's is considered chronic

● It is often progressive and the cause can be difficult to determine.

Risks of lower back pain from disc disease or spinal degeneration increase with age

Part 2 of 10 - What Structures Make Up The Lower Back? (Anatomy of the Back)

The Back Is An Intricate Structure

Spinal Column

The centerpiece is the spinal column, which supports the upper body’s weight and houses and protects the spinal cord. Stacked on top of one another are more than 30 bones (the vertebrae) that form the spinal column or spine. Each of these bones contains a roundish hole that, when stacked in register with the others, creates a channel that surrounds the spinal cord.

Spinal Cord

The spinal cord descends from the base of the brain to just below the rib cage. Small nerves (roots) enter and emerge from the spinal cord through spaces between the vertebrae.

Cauda Equina

Because the bones of the spinal column continue growing after the spinal cord reaches its full length in early childhood, the nerve roots to the lower back and legs extend many inches down the spinal column before exiting.

This bundle of nerve roots is known as the cauda equina, or the "horse’s tail".

Other Structures Of The Back

Spaces between the vertebrae contain round, spongy pads of cartilage called intervertebral discs that allow for flexibility in the lower back. Bands of tissue known as ligaments and tendons hold the vertebrae in place and attach the muscles to the spinal column.

Four Regions

Starting at the top, the spine has 4 regions:

7 cervical (neck) vertebrae

12 thoracic (upper back) vertebrae

5 lumbar vertebrae

the sacrum and coccyx (tailbone)

The lumbar region of the back, where most back pain is felt, supports the weight of the upper body

Part 3 of 10 - What Causes Lower Back Pain?

 

Aging Process

As people age, bone strength and muscle elasticity and tone tend to decrease. The discs begin to lose fluid and flexibility, which decreases their ability to cushion the vertebrae.

Injury & Trauma

Pain can occur when, for example, someone lifts something too heavy or overstretches, causing a sprain, strain, or spasm in one of the muscles or ligaments in the back.

If the spine becomes overly strained or compressed, a disc may rupture or bulge outward. This rupture may put pressure on one of the more than 50 nerves rooted to the spinal cord that control body movements and transmit signals from the body to the brain.

  When these nerve roots become compressed or irritated, back pain results.

Low back pain may also reflect:

 

nerve irritation

muscle problems

bone lesions

 

Other Causes

Most low back pain follows injury or trauma to the back, but pain may also be caused by:

 

osteoarthritis

osteoporosis or other bone diseases

viral infections

irritation to joints and discs

congenital abnormalities in the spine

scar tissue

 

Other Factors

Other factors that contribute to low back pain include:

 

obesity/weight gain

smoking

stress

poor physical condition/posture

poor sleeping position

 

Serious Problems

Low back pain may also indicate a more serious medical problem. People with back pain along with fever, loss of bowel or bladder control, pain when coughing, progressive weakness or pain radiating into the legs should contact a doctor immediately to help prevent permanent damage

 

Part 4 of 10 - What Conditions Are Associated With Lower Back Pain? Associated Conditions

Conditions that may cause low back pain and require treatment by a doctor or health specialist include:

Bulging discs (also called protruding, herniated, or ruptured discs) As discs degenerate and weaken, cartilage can bulge or be pushed into the space containing the spinal cord or a nerve root, causing pain.

 

Cauda equina syndrome occurs when disc material is pushed into the spinal canal and compresses the bundle of lumbar and sacral nerve roots. Permanent neurological damage may result if this syndrome is left untreated.

 

Sciatica a condition in which a herniated or ruptured disc presses on the sciatic nerve.

 

Spinal degeneration from disc wear and tear can lead to a narrowing of the spinal canal

 Those with spinal degeneration may experience back stiffness upon awakening or may feel pain after walking or standing for a long time.


●Spinal stenosis related to congenital narrowing of the bony canal predisposes some people to pain related to disc disease.


●Skeletal irregularities such as scoliosis, kyphosis, lordosis, back extension and flexion can produce strain on the vertebrae and supporting muscles, tendons, ligaments, and tissues.


Other Conditions

Other conditions associated with low back pain include:osteoporosis (a progressive bone disease)
fibromyalgia (a chronic disorder with widespread musculoskeletal pain)
ankylosing spondylitis (a chronic spine arthritis)
osteomyelitis (a bone infection)
sacroiliitis (inflamed sacroiliac joints)
 

Part 5 of 10 - How is Lower Back Pain Diagnosed?

 

Diagnosis

A thorough medical history and physical exam can usually identify any dangerous conditions or family history that may be associated with the pain. The patient describes:

 

the onset, site, and severity of the pain

duration of symptoms and any limitations in movement

history of previous episodes or any health conditions that might be related to the pain

 

The physician will examine the back and conduct neurologic tests to determine the cause of pain and appropriate treatment. Blood tests may also be ordered. Imaging tests may be necessary to diagnose tumors or other possible sources of the pain.

 

Diagnostic Methods

Diagnostic methods that may be used include:

 

X-rays (imaging methods that help diagnose the cause and site of back pain)

 

Discography (involves the injection of a contrast dye into a spinal disc thought to be causing low back pain)

 

Computerized Tomography (CT) (a quick and painless process used when disc rupture, spinal stenosis, or damage to vertebrae is suspected as a cause of low back pain)

 

Magnetic Resonance Imaging (MRI) (used to evaluate the lumbar region)

 

Electrodiagnostic Procedures (including electromyography (EMG), nerve conduction studies and evoked potential (EP) studies)

 

Bone Scans (used to diagnose and monitor infections, fractures, or disorders in the bone)

 

Thermography (uses infrared sensing devices to measure small temperature changes)

 

Ultrasound Imaging (uses high-frequency sound waves to obtain images inside the body)

Part 6 of 10 - How is Lower Back Pain Treated?

 

Treatment

Most low back pain can be treated without surgery. Treatment often involves:

medications

reducing inflammation

restoring proper function and strength

prevention

Most patients with back pain recover without residual functional loss. Patients should contact a doctor if there is no noticeable improvement after 72 hours of self-care.

Hot/Cold

Cold and hot packs for some, may help reduce pain and inflammation and allow greater mobility. Apply a cold compress to the tender spot several times a day for up to 20 minutes.

 

After a few days of cold treatment, apply heat for brief periods to relax muscles and increase blood flow. Warm baths may also help. Patients should avoid sleeping on a heating pad, which can cause burns and lead to additional tissue damage.


Rest

Bed rest? Experts suggest only 1 to 2 days at most. You should resume activities as soon as possible.

Exercise

Exercise may be an effective way to speed recovery from low back pain and help strengthen muscles. This is particularly important for persons with skeletal irregularities.
Physical therapists can provide a list of gentle exercises that help keep muscles moving and speed the recovery process.
These may include:
●stretching exercises
●swimming
●walking
●tai chi or other movement therapy
●yoga

Mild discomfort felt at the start of these exercises should disappear as muscles become stronger. But if pain is more than mild and lasts more than 15 min. during exercise, patients should stop and contact a doctor.

 

Part 7 of 10 - What Medications Are Used To Treat Lower Back Pain?

 

Medications are often used to treat acute and chronic low back pain.

Effective pain relief may involve a combination of prescription drugs and over-the-counter remedies. Patients should always check with a doctor before taking any drugs for pain relief.

OTC Drugs

Over-the-counter NSAIDs are taken orally to reduce stiffness, swelling, and inflammation and to ease mild to moderate low back pain. These drugs include:

aspirin

naproxen

ibuprofen

 

Topicals

Topical counter-irritants applied to the skin as a cream or spray stimulate the nerve endings in the skin to provide feelings of warmth or cold and dull the sense of pain.

Many topical analgesics can also reduce inflammation and stimulate blood flow. The topical salicylates also contain salicylate, the same ingredient found in oral pain medications containing aspirin.


Anticonvulsants

Anticonvulsants may be useful in treating certain types of nerve pain and may also be prescribed with analgesics.

Antidepressants

Some antidepressants have been shown to relieve pain (independent of their effect on depression) and assist with sleep.
Antidepressants alter levels of brain chemicals to elevate mood and dull pain signals. Many newer antidepressants are also being studied for their effectiveness in pain relief.

Painkillers

Painkillers (opioids) are prescribed to treat severe acute and chronic back pain but should be used only for a short period of time and under a doctor’s supervision. These include:

codeine
oxycodone
hydrocodone
morphine

Part 8 of 10 - What Are Other Treatment Options For Lower Back Pain?

 

When back pain does not respond to more conventional approaches, patients may consider the following treatment options:

 

Spinal Manipulation

Spinal manipulation uses a hands-on approach in which licensed chiropractics use adjustments and a series of exercises to restore back mobility.

 

Acupuncture

Acupuncture involves the insertion of needles the width of a human hair along precise points throughout the body.

 

Biofeedback

Biofeedback is used to treat many acute pain problems. Using a special electronic machine, a patient may learn how to effect a change in response to pain.

 

Traction

Traction involves using weights to apply constant or intermittent force to gradually “pull” the skeletal structure into better alignment. Traction is not recommended for treating acute low back symptoms.

 

 

TENS Units

 

Transcutaneous electrical nerve stimulation (TENS) is given by a battery-powered device that sends mild electric pulses along nerve fibers to block pain signals to the brain. Small electrodes placed on the skin at or near the site of pain generate nerve impulses that block incoming pain signals from the peripheral nerves.

 

Other Treatments

 

 

Ultrasound Therapy (ultrasound is a noninvasive therapy used to warm the body’s internal tissues)

Vertebroplasty and Kyphoplasty (minimally invasive outpatient treatments to seal fractures of the vertebrae caused by osteoporosis)

Interventional Therapy (can ease chronic pain by blocking nerve conduction between specific areas of the body and the brain)

 

 

Part 9 of 10 - What Are The Surgical Procedures For Lower Back Pain?

Surgical Procedures

In the most serious cases, when the condition does not respond to other therapies, surgery may relieve pain caused by back problems or serious musculoskeletal injuries. Surgical procedures can include:

 

Discectomy

Foraminotomy

IntraDiscal Electrothermal Therapy (IDET)

Nucleoplasty

Radiofrequency Lesioning

Spinal Fusion

Spinal Laminectomy

 

Some surgical procedures may be performed in a doctor’s office under local anesthesia, while others require hospitalization.

It may be months following surgery before the patient is fully healed, and he or she may suffer permanent loss of flexibility.

Since invasive back surgery is not always successful, it should be performed only in patients with progressive neurologic disease or damage to the peripheral nerves.

 

Surgical Procedures For Severe Chronic Pain

 

Other surgical procedures to relieve severe chronic pain include:

Rhizotomy (a procedure in which the nerve root close to where it enters the spinal cord is cut to block nerve transmission and all senses from the area of the body experiencing pain)

Cordotomy (where bundles of nerve fibers on one or both sides of the spinal cord are intentionally severed to stop the transmission of pain signals to the brain)

DREZ (dorsal root entry zone operation) (a procedure in which spinal neurons transmitting the patient’s pain are destroyed surgically)

 

Part 10 of 10 - Can Lower Back Pain Be Prevented?

 

Prevention

 

Recurring back pain resulting from improper body mechanics or other nontraumatic causes is often preventable. A combination of exercises that don't jolt or strain the back, maintaining correct posture, and lifting objects properly can help prevent injuries.

Many injuries are caused or aggravated by stressors such as:

 

heavy lifting
 

contact stress (repeated or constant contact between soft body tissue and a hard or sharp object)
 

vibration
 

repetitive motion
 

awkward posture

 

Ergonomics In The Home And Workplace

Applying ergonomic principles designing furniture and tools to protect the body from injury can greatly reduce the risk of back injury and help maintain a healthy back.

To reduce the risks of musculoskeletal injury and pain, more companies are promoting better ergonomically designed:

 

tools

products

workstations

living spaces

 

Back Belts

The use of wide elastic belts that can be tightened to pull in lumbar and abdominal muscles to prevent low back pain is controversial.

A study of the use of back support belts worn by persons who lift or move merchandise found no evidence that the belts reduce back injury or back pain.

Although there have been anecdotal case reports of injury reduction among workers using back belts, many companies that have back belt programs also have training and ergonomic awareness programs. Injury reduction may be related to a combination of these or other factors.

Source: NIH Publication No. 03-5161
 

Lower Back Pain Relief Made Simple

Learn All About The Different Lower Back Pain Relief Choices You Have

Source: http://www.womens-health-fitness.com/lower-back-pain-relief.html

Lower back pain relief can be accomplished in many different ways. But exactly what can you can do to prevent lower back pain and injuries and, if you do sustain them, what can be done to promote the healing process?

Though the lower back pain relief here is focused on what can be done on an individual basis, it must always be remembered that there is no replacement for consultation with a qualified physician.

80 percent of the adult population suffers from lower back pain at some point in their lives, so, whether it's you of somebody you care for, it is useful to have some lower back pain relief techniques at hand for treating it.

The good news about lower back pain is that is usually goes away on its own over time. The vast majority of it comes from simply straining muscles and joints at levels they are not designed to withstand, which leads into the first lower back pain relief recommendation: Slow Down.

In most cases a few days worth of reducing the normal load you put on your back in enough. A strained back muscle may cramp or "freeze," which causes acute discomfort.

Given time to mend, however, the muscle will began to relax and the body's natural lower back pain relief healing processes will commence.

Over-The-Counter-Medications. In response to an injury a body part may become inflamed, which you will know by the signs of swelling, pain, warmth, and redness.

To achieve a measure of lower back pain relief and assist the healing process you can buy over-the-counter anti-inflammatory medications like ibuprofen. Acetominophen is another alternative. Though not an anti-inflammatory drug, it does offer effective lower back pain relief and is easier on the stomach.

Ice and Heat. During the first 48 hours after a back injury ice slows down the swelling process and acts as lower back pain relief.

After 48 hours, however, it loses these abilities. This is when your switch to heat, as in the form of a heating pad. This increases the blood flow to recovering tissue and relaxes the muscles.

Massage. Be it done by a friend or family member with a nice touch or a professional, a massage can relax strained muscles and, just as importantly, a strained psyche that is causing back muscles to tense up.

Keep Moving. When we are hurt instinct tells us to lay low and keep movement to a minimum. Indeed, the traditional approach to lower back pain relief used to tell us exactly that.

More recent studies, however, have shown that careful movement does a better job of promoting recovery and lower back pain relief than remaining still. Much can be accomplished with simple lower back pain exercise - provided you have consulted with a specialist who can dispense advice and instructions on what is best for you.

Change Your Routine. Though movement can help in lower back pain relief, it is also important during this period to avoid things that result in putting too much stress, be it physical or psychological, on your healing back.

Whether it is in improving your posture in a chair, not lifting heavy objects, or avoiding things that cause you aggravation, adapt your daily routine to the requirements of your recovering back.

Otherwise, there is a pronounced risk of re-injury, a longer than necessary recovery period, or an injury that does not heal properly and is vulnerable to further damage.

Pain Management. An encouraging thing about back pain is that so much of it can be avoided by simple cautionary measures, usually, in fact, by making slight modifications to things we do every day.

When standing upright, your chest should be forward, your head up, shoulders straight, and your weight even distributed between your feet with your hips tucked in. If you have to remain standing for long periods, avoid remaining in the same position for the entire time.

Be sure to move around and change positions regularly. Another good idea is to rest one foot on a stool, curb, etc. then switch to the other foot after a few minutes.

If your work requires you to perform tasks on a platform or desk make sure to adjust it to a height that is comfortable for you. Spending day after day hunched over while on your feet is almost a sure recipe for back problems.

In today's work world many of us have jobs that involve spending most of our time in a seated position. The rule of thumb here is to sit for as little as possible, and even then for only short periods of time.

Since this is not always possible, be sure to get up and walk around frequently. Even a short stroll across a room will add lower back pain relief.

When in a seated position for long periods, sit with a support positioned in the curve of your back. Nothing fancy, even a firm pillow or a rolled up towel will do the trick. At the same time, keep your hips and knees at right angles.

If your chair is too high for this, either replace the chair or get a stool to rest your feet on. Otherwise keep both feet on the floor and do not cross your legs.

The chair you use should be firm and have a high back and arm rests. The problems with soft chairs or couches in that the curve in your back is not supported and it can come to be in a rounded position, which causes the kind of muscle and joint stress that leads to problems in need of lower back pain relief.

When seated in a chair in front of a desk, make sure the different pieces of furniture complement each other so that you can sit up straight as you work, with your elbows and arms on your chair or desk and your shoulders relaxed. Hunching or leaning over should be avoided.

Finally, when getting out of a chair after sitting for a period of time, be sure to stand up by straightening your legs, not bending at the waist. Once in a standing position stretch your back by doing a series of simple back bends.

Much of the same applies when driving in a seated position. Support the curve of your back and be sure your seat is positioned close enough to the wheel so that your knees can bend and your feet reach the pedals without having to stretch for them.

The simplest lower back pain relief is avoid lifting heavy objects, or those whose size or shape make them awkward to move. Since lifting cannot always be avoided, be sure not to lift with your back.

When grasping a object to be lifted have it close to your body with your feet spread shoulder width apart and planted firmly on the ground. Use your leg muscles to do the actual lifting, with the simplest means of doing this being to start with your legs bent so that you merely need to straighten your knees.

Once you have lifted the object, keep it in front of you and move with small, slow steps. Instead of twisting, change direction with your entire body coordinated together for the move.

When the object is set down, once again keep it close to your body and let your legs do the work. Remember, the muscles in your legs are a lot bigger and stronger than those in the lower back.

Many a back injury can be prevented by following a lower back pain exercise program that keeps the muscles strong and flexible. When designing your own, do so with the aid of your physician, physical therapist, or a qualified trainer.

Invest in a firm mattress and box spring that supports your body without sagging. It is best to sleep in a position where the curve in your back can be supported. Lying on one's stomach on a soft mattress is exactly the wrong thing to do for your back.

The sleeping lower back pain relief method recommended by many experts in on your back with three sources of support for your body: one below your lower back that is fitted to the curve there, one below your knees that supports them enough to take strain off the lower back, and a pillow below your neck that, like the lower back support, conforms to the natural curve found there and provides support.

Here are some other helpful lower back pain relief strategies and tips for lower back pain relief. Try one or more to see how they work in with your lifestyle.

Control your breathing slow and steady for a few minutes. Focus on rhythmic, controlled breathing, holding inhaled breaths in for about three seconds, then exhale and repeat to help redirect focus from back pain and allow the body to naturally respond on its own.

Repeat as needed throughout the say to help the body relax.

Some helpful lower back pain relief suggestions are: Choose a comfortable position that takes the strain off your back and is least painful for you.

 

• On your back with your knees up, rest your lower legs over the coach or a chair.

   

• Lie in a fetal position on your side and place a pillow between your knees.

When possible for lower back pain relief, rest for a couple of days. Find a couple of your most comfortable breathing positions above and alternatively use them throughout the day.

From time to time, every hour to couple hours or so, include these into your routine:

 

• Get up and move around a little, walking and arching your back a little.
• Add some light stretching activities like gently pulling knees, one at a time, to your chest.
• Light water / pool activity or aquatherapy
• Light stationary bike riding or sitting in a comfortable chair for brief periods.

Check with your local drug store pharmacist to see which lower back pain relief medications are available over-the-counter (OTC). Popular to use are aspirin for overall lower back pain relief, ibuprofin for a combination anti-inflammatory and lower back pain relief response like in the Advil, and acetaminophen products like Tylenol.

When selecting the type of lower back pain relief medication, keep in mind that liquid gel types absorb fasted into your system. However, regardless of your choice, do follow the directions on the labels, unless otherwise directed by your physician, and follow the recommended dosage guidelines.

Check with your local pharmacist and health store to see which lower back pain relief liniments and ointments are available. Some popular lower back pain relief items on the market are BENGAY, Tiger Balm and Sportscreme; generally products with a form of rubbing alcohol listed in the ingredients.

Ask about the availability of other lower back pain relief remedies including herbal treatments. Some health food stores stock packaged herbal tablets, teas and other products.

Be aware, though, that most often these lower back pain relief alternative products are not thoroughly tested as OTC products are, nor can the contents be assured for safety, quality and potency.

 

If you have any questions about lower back pain relief please use the form at the bottom of this page to contact our experts.

 

 

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Relief For Chronic Neck And Back Muscle Pain
 

Is Chronic Pain on the Rise?

Reviewed By Charlotte Mathis, MD

By R. Morgan Griffin
WebMD Feature

Source: http://www.webmd.com/solutions/chronic-back-pain/rise-of-pain?page=1

 

As the first baby boomers hit their 60s, many are finding life hurts a bit more than it once did. Whether playing tennis, lifting a basket of laundry, or just getting out of bed, pain -- for some, chronic pain -- is a new companion.

"We have an aging population," says Robert Bonakdar, MD, director of pain management at the Scripps Center for Integrative Medicine in La Jolla, Calif. "As the baby boomers get older, we're going to have more and more people with chronic back pain, osteoarthritis" and other painful conditions.

But while previous generations may have been more willing to accept pain as an inevitable consequence of aging, experts say many baby boomers won't stand for it.

"I think that baby boomers are less likely to accept the status quo," says Steven P. Cohen, MD, an anesthesiologist in the division of pain medicine at Johns Hopkins School of Medicine. "They have a sense of entitlement. Living the rest of their lives in chronic pain is just unacceptable."

The good news is that they're right. Just because some painful illnesses become more common as you get older doesn't mean you're doomed to suffer. You should not accept living in chronic pain -- not when plenty of treatments offer pain relief.

Chronic Pain: Why Are We Hurting?

The causes of pain aren't so surprising. As people age, their sins catch up with them. A lifetime of minor injuries -- a stress fracture from jogging in your 30s, a bad back from lifting a couch in your 40s -- can add up to serious pain.

"You see a lot of back pain, neck pain, knee pain, joint pain, and pain from falls, and tears and other injuries in baby boomers," says Christopher L. Edwards, PhD, assistant professor of psychiatry and medical director of the Biofeedback Laboratory at Duke University School of Medicine.

The boomer generation can be stubborn about fitness, says Edwards. "Some baby boomers have the same exercise regimen at age 60 that they had thirty years before," Edwards tells WebMD. "Their bodies can't keep up with them."

And while keeping active is important at every age, unfortunately bones weaken and muscles atrophy over time. These are facts of life. If you push yourself too hard, you can get hurt. Sometimes, that injury becomes a source of chronic pain.

Disease can play a hand, too. Pain can stem from arthritis, diabetes, and cancer. Pain after surgery can become chronic. Painful syndromes, like fibromyalgia and irritable bowel syndrome (IBS), also cause suffering.

"With almost every medical condition, the incidence of pain increases with age," says Cohen.

 

Is Chronic Pain More Common Now?

As baby boomers age, the number of people with painful conditions like osteoarthritis will rise. Current estimates of those living with chronic pain range from 50-65 million. But is the average person more likely to be in pain than he or she used to be? Experts aren't sure.

"If I had to guess, I'd say that the incidence of pain is probably about the same as it's always been," says Edwards. "What has changed is our way of talking about it."

Cohen argues that this new perspective on pain has had a big effect. He says that 40 years ago, pain after a mastectomy was reported to be about 5%. Now, some studies show it to be as high as 50%. Obviously, surgery wasn't less painful forty years ago. But where people in the past may have simply struggled through potentially debilitating pain, now we ask for help.

"As health care has improved, the whole medical profession has focused more on quality of life rather than just life," says Cohen. Chronic pain relief has become an important goal in its own right.

And people gain that relief differently, often taking one -- or several -- approaches, including:

• Prescription drugs
• Over-the-counter medicines
• Complementary medicine (also called alternative or integrative medicine)

Prescription Drugs and Chronic Pain Relief

Narcotic painkillers like OxyContin, Percocet, and Vicodin are widely associated with chronic pain relief -- and with addiction. However, experts generally say the dangers of abuse are overstated.

"The fact that there is a potential for abuse of these drugs doesn't diminish their value in treating pain," says Edwards. "There just needs to be a balance." Every medication has drawbacks, and deciding to use one is always a matter of weighing the benefits and risks.

And with some medications there are potentially grave risks. Painkillers called Cox-2 inhibitors -- like Bextra, Celebrex, and Vioxx -- were heralded as wonder drugs a few years ago. Then research showed that for some they posed a risk of heart attacks and strokes. (Bextra also posed a risk of serious skin reactions).

Of these drugs, only Celebrex is still available, and the FDA requires it to carry a strong risk warning.

Surgery or implanted devices -- like pain pumps -- are sometimes helpful for severe chronic pain, though of course surgery has its own risks. If you feel you need a new approach to managing your chronic pain, talk to your doctor

Over-the-Counter Drugs: Do-It-Yourself Pain Management?

Many people prefer finding pain relief with over-the-counter drugs rather than seeing a doctor. "We're a do-it-yourself culture," says Penney Cowan, executive director of the American Chronic Pain Association. "And it's obviously a lot easier and cheaper to buy a bottle of painkillers than it is to see a doctor."

That's usually OK, so long as you're only using over-the-counter drugs occasionally and as directed on the label.

But pain is sneaky. It can worsen so gradually you don't notice. It starts with an occasional ache you treat with a couple of painkillers. But over a few years it can become relentless. And your "occasional" use of a nonprescription painkiller has turned into a daily ritual of downing a handful of pills. That's a cause for concern.

"People severely underestimate the dangers of over-the-counter painkillers," says Cowan.

Some of the most problematic are NSAIDs (nonsteroidal anti-inflammatory drugs) like aspirin, Advil, Aleve, and Motrin. Taken regularly, they can result in serious gastrointestinal bleeding and may also raise the risk of cardiovascular problems. What's worse, the older you are, the more likely you are to have complications from these drugs, says Cohen.

A Holistic Approach to Chronic Pain Relief

But drugs and other medical treatments aren't the only solution. Some baby boomers are turning to unorthodox new techniques -- or very old ones for chronic pain relief.

Complementary medicine is designed to work alongside conventional medical treatment and includes options like:

• Acupuncture
• Massage
• Biofeedback
• Focused relaxation
• Meditation
• Exercise, and other techniques

Bonakdar says baby boomers are more open to these approaches to pain relief than previous generations. And some approaches, like acupuncture, biofeedback, and massage have been shown to help ease pain in scientific studies.

And while other approaches may not have the same evidence backing them up, your doctor might still encourage you to try them if they have no risks.

However, supplements -- like vitamins, herbs, and botanicals -- can have serious side effects and interact with other drugs. Make sure your doctor knows about all the ones you use.

Taking Control of Your Health -- and Chronic Pain Management

Getting older is inevitable. And as your body ages, the likelihood of illness increases. But that doesn't mean you have to accept chronic pain passively.

Baby boomers have a reputation for being demanding about their health care. Yet plenty of people in their late 50s and early 60s are in pain but aren't getting relief. If you're one of them, speak up. You deserve to have your pain managed, says Cowan.

"There's a saying that while pain is inevitable, suffering is not," says Cowan. "We do not have to suffer." No matter your age, you never need to settle for living with chronic pain.

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Published Nov. 6, 2006.

Preventing Back Pain

Source: http://www.emaxhealth.com/45/4453.html

We don't think very much about our backs: that is, until they start to hurt. Many of us are hurting as back pain is now one of the most common medical complaints in the U.S. The good news is that, in many cases, back pain can be prevented. Here are ACE's Top 10 ways to maintain a healthy back.

Maintain a healthy weight. Excess weight tends to creep up slowly, so we may not be aware of how it affects us. But try carrying a 20-pound pack on your back all day and you will have a better idea of how extra weight takes a toll on the whole body.

Strengthen the abdominal and back muscles. You have heard it before, but strengthening the abdominals really does help protect the back. In fact, a strong core, which includes all the muscles of the trunk, is important for avoiding injury, whether you are cleaning your house, playing tennis or sitting at a desk all day.

Lift items properly. Protect your back when lifting anything by standing close to the object with your feet apart to give you a stable base. Squat down while keeping the spine in proper alignment and contract your abdominals as you lift using your legs.

Strengthen the leg muscles. Along with the core muscles, the leg muscles play a vital role in helping you maintain good posture and body mechanics. And strong leg muscles can take much of the burden off the back when you are lifting heavy items (see above).

Stay flexible. Inflexibility in the form of tight hamstrings and a limited range of motion in the trunk can increase your risk of injury or make existing back pain worse. Some forms of exercise, such as yoga, Pilates and tai chi, may help relieve or prevent back pain by increasing flexibility and reducing tension. These exercises should not be done, however, if they are uncomfortable or place a strain on the back.

Maintain good posture. Correct posture and body mechanics play a vital role in preventing back pain because pressure on the discs and strain of the muscles, ligaments and back joints is aggravated by incorrect posture and body mechanics. When your posture is good and you move your body correctly, you reduce the strain on your back.

Buy a comfortable mattress. Most of us spend a good deal of time in bed, which is why a good mattress is such a wise investment. Do some research, test the mattress out at the store and ask for recommendations. Remember: what works for one person may not work for you so take the time to find the mattress that suits your needs.

Reduce stress. Stress increases tension in all your muscles including your back. Reduce or better manage your stress and you may literally feel as if the weight has been lifted from your shoulders.

Warm up before activity. Beginning any activity with cold muscles and joints puts you at risk for injury. Jumping right into intense activity increases your risk of injury, so take the time to get your muscles and joints warm and limber first.

Support the lower back when sitting. Use a rolled towel, small pillow or specially designed seat support available at medical supply stores. Remove the support every half hour for five minutes to give your lower back a change of position. After sitting for a prolonged period, straighten your back to an upright position and, if possible, stand and walk around to give your back a break.

Back Pain Treatment

Home Remedies

Back Pain Relief - First Aid
Low back pain is a common symptom that is not generally associated with an illness or a specific injury. Even if the pain is severe, it can go away as quickly on its own as it does after medical treatment, sometimes more quickly. Most episodes of back pain that last more than 1 week diminish by themselves in about 1 month. To get low back pain relief, consider these options:

• Take nonprescription back pain relief medication, such as aspirin, acetaminophen, or ibuprofen, at the first onset of pain in the lower back hip and/or leg.
• Apply a cold pack (or a bag of ice wrapped in a towel) to the painful area for 5–10 minutes at a time, during the first 24–48 hours of discomfort for back pain relief.
• If the pain is not better within a few days, use a heating pad on the painful area.
• Keep moving, but protect your back. Avoid sudden turning or bending motions, which could hinder back pain relief. As much as you can, avoid bed rest. Go on with your usual activities as much as possible.
• Get help for back pain relief. If the pain is still intense or troublesome after 1 week or so, make an appointment for spinal manipulation with a licensed physical therapist, chiropractor, or osteopathic physician for back pain relief.
• If the pain has not decreased to a tolerable level after 4–6 weeks, make an appointment with your healthcare professional for back pain relief.

Low Back Pain Treatment Source: Back Pain Center Exercising With Back Pain Exercising when you have low back pain can help you feel better faster and prevent more back pain. A gradual return to normal activities, including exercise, is recommended. Even if you have mild to moderate low back pain, you can do the following without putting much stress on your back:

• Walk short distances
• Stretch and do flexibility exercises
• Use a stationary bicycle
• Swim

It is important to start slowly and to gradually build up the speed and the length of time that you do the exercise. At first, your low back pain symptoms may get a little worse when you exercise or become more active. Usually, this worsening of low back pain is not a concern. However, if your low back pain becomes severe, contact your healthcare professional. Once you can return comfortably to normal activities, your healthcare professional may recommend additional aerobic and low back exercises.