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Understanding lower back pain

By John Riggin

If aches and pains bother your lower back, you're not alone. Lower back pain is one of the most common complaints that people make to their primary care doctors. It can impact people of any age and be caused by any number of issues. While it may be common, lower back pain isn't usually a cause for major concern, and treatment options are always improving.

Common causes

A complex combination of spinal bones and discs, nerves and muscles work together in the lower back, and a wide variety of issues can trigger pain. Add to that an aging population and growing incidence of obesity, and it's not difficult to see why lower-back pain is so common. As we age, it's more likely that we may suffer from degenerative issues, like arthritis and long-term wear of the spine.

"While degenerative diseases or conditions are the most common cause of lower back pain, for some it could just be a mechanical problem," says Dr. Jeffrey Mimbs, a board-certified neurological surgeon with Enloe Medical Center's Neurosurgery & Spine Program.

   
Jeffrey S. Mimbs, DO; Larry A. Wainschel, MD; Bill Whitlatch, MD
   
Jeffrey M. Lobosky, MD; Bruce L. Burke, MD

These mechanical problems, such as a muscle sprain or spasm, are usually caused by physical overexertion and create pain that will subside shortly. Something like a tear could be more serious, but also more unlikely. Sedentary lifestyles lacking a variety of movement and improper posture can make it easier to hurt one's back.

When you should see a doctor

Most back pain subsides within or after a month, says Dr. Mimbs, who recommends that people start treating their pain with the basics — over-the-counter analgesics, or painkillers, and hot-and-cold packs. If these stand-by remedies aren't cutting it, a medical professional might recommend some tests to find the root of the problem.

The National Institutes of Health defines chronic pain as lasting three or more months. So if your pain is suddenly more severe or feels different than usual, it may be time to schedule an appointment. At that point, your primary care doctor may recommend you talk with a neurosurgeon or another specialist.

If, in addition to pain, a person's general mindset is markedly different or if they suffer from a loss of motion, motor skills or grip, this might indicate an affliction of the nervous system and should be examined by a doctor, says Dr. Larry Wainschel, another board-certified neurological surgeon affiliated with Enloe's Neurosurgery & Spine Program.

"Look out for any type of neurological deficit," he says. "Or a difference in character."

Dr. Mimbs describes another red flag: "If the pain wakes you up from a dead sleep, get it checked out."

This is different than pain that interferes with falling asleep. Pain so intense that it awakens a person from a deep sleep is not typical and can be a sign of something more serious; a person experiencing this should consult their doctor immediately.

Diagnosis and treatment

Lower back pain got you down?
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Join us Thursday, July 31, for a special event.

If you experience aches and pains from lower back pain that prevent you from fully enjoying your life, join Enloe Medical Center as we bring together a panel of local neurosurgeons to discuss lower back pain.
  • Learn about symptoms and causes of lower back pain.
  • Explore treatment options.
  • Ask questions of the physician panel.
  • Visit exhibits and more!

Register for this FREE event today! Online registration or call 1-877-365-6363.

There are a variety of causes of lower back pain, so it makes sense that there are also a variety of solutions. That can make diagnosis something akin to detective work.

"One thing that really helps is for the patient to tell me a really good story about what is behind the pain," Dr. Mimbs says, "about how, when and where it started, if it was after an event or if it has been ongoing, what makes it better or what makes it worse, whether it's typical or atypical."

An X-ray, CT scan or MRI may be ordered to assist with the diagnosis of a problem. Both of the neurosurgeons said they do not recommend surgery for most of their patients. They know that 86 percent of patients get better without surgery.

"Maybe one out of 10 patients is a surgical candidate," according to Dr. Mimbs.

Pain management through physical therapy, medication or other treatments like steroid injections and epidurals can delay the need for surgery for years. This is good because surgical treatments are evolving rapidly — countless new options have become available in the past decade, and many are less or minimally invasive.

Additionally, the doctors generally recommend that people keep moving and stretching. "We don't believe in bed rest," Dr. Mimbs says. "Stay as active as you can. We want you up and about."

A healthy lifestyle can help

An active lifestyle is the best way to keep your spine healthy. Regular exercise improves muscle strength and flexibility, which benefits spine health. Aerobic exercise and core-strengthening like swimming, yoga and Pilates are perfect for increasing full-body movement.

High-impact sports like power lifting, football and wrestling can cause damage, as can activities like Cross Fit. Sports like baseball, basketball, tennis and golf may expose a back problem, but are not likely to cause one. Knowing your limits and maintaining your ideal body weight are both healthy behaviors.

Finding relief

There can be several paths to finding relief for lower back pain. First, speak to your general practitioner or family doctor. Your doctor can determine whether simple home remedies and over-the-counter medications may help or if you might benefit from a referral to a physical therapist or a specialist such as a neurosurgeon.

Looking for a doctor? Visit Enloe's Find A Doctor directory at www.enloe.org/doctor or call 1-877-Enloe-MD.

Introducing the Enloe Neurosurgery & Spine Program

Enloe's new Neurosurgery & Spine Program is dedicated to restoring patients' function and mobility, minimizing pain, and helping them return to a normal lifestyle. Neurological surgeons, nurses, physical therapists, neurosurgery and spine liaison nurses, and case managers work together to provide comprehensive care with a personalized and comfortable experience for patients having neurosurgery and spine surgery. The surgeons offer a range of brain and spine procedures, including minimally invasive options. The program team also offers a class before surgery as well as follow-up upon returning home. The Enloe Neurosugery & Spine Program is a Blue Distinction Center+ in Spine Surgery.

For more information about the Enloe Neurosurgery & Spine Program, call 530-332-5448 or visit www.enloe.org/spine.


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