Caring for a Bad Back

About 80 percent of people over 30 experience back pain at some point in their life, according to Christine Villoch, M.D., a spine and pain management specialist at the Baptist Hospital  Center for Spine Care, a division of Baptist Health Neuroscience Center.

“The majority of back complaints are resolved with conservative treatments,” she says.

Conservative treatments may include physical therapy, medications, and sometimes an epidural injection—a shot of steroids to reduce inflammation and pain in the spine.

But what happens when back pain remains your constant companion or if extreme pain keeps you horizontal for a few days? Here are a few things you should know about back pain.

When should you be concerned?

Chronic back pain is pain in the lower back that persists for three to six months or longer. Most back pain will resolve before then. Seek help based on the intensity and the duration of your pain, Dr. Villoch says.

If that nagging, low-grade ache persists for more than three weeks, make an appointment to see your doctor. However, if you are experiencing severe pain that affects your ability to function every day, call your doctor immediately or go to the emergency department, Dr. Villoch says.

What triggers back pain?

“People use poor body mechanics to do some of the basic tasks of life, including lifting, carrying, bending and sitting,” Dr. Villoch says.  For example, it’s important to tighten you stomach muscles, squat and use your leg muscles when lifting heavy objects, including a small child or a box of books, she says. Otherwise, you place added stress on your back.

Constant use of smart phones, computers and tablets may also aggravate back muscles, due to improper posture during use.

Which symptoms are red flags? 

If you are experiencing back pain, go see your doctor if your pain is accompanied by the following symptoms:

• Unexplained weight loss.
• Night sweats.
• Fevers.
• Severe pain at night.
• Bowel or bladder incontinence (seek immediate attention).
• Numbness/tingling or weakness in the legs.

The nerves are the communication wires that run from the spinal cord to muscles in your legs. A pinched nerve disrupts that communication system, which can lead to weakness, numbness and, in very severe instances, incontinence.

Why is weight important?

To protect your back, it’s important to maintain a healthy body mass index (BMI) — a measurement that uses your height and weight to measure your body fat.

“Excess weight puts more stress on the back,” Dr. Villoch says. “For example, if you are 50 pounds overweight, that’s like carrying a 50-pound weight around all day. That will fatigue your muscles and weaken your back.”

What are the treatment options?

Physical therapy will help you learn to use your muscles properly to avoid back pain. The physical therapist will teach you how inflexible muscles in your legs can add tension to your back.  The therapist will supervise your progress with flexibility stretches and core strengthening exercises.

In addition to your on-site therapy, your therapist will give you a home exercise program designed to maintain your core strength and flexibility.

Strong abdominal muscles provide a center of stability and support for your back muscles and function like a built-in corset.

To manage pain, your physician may prescribe anti-inflammatory medicine, painkillers, muscle relaxants, and possibly spinal injections — with important instructions about avoiding addiction and other side effects. Your physician may discuss surgical options if you’re in constant pain and other treatments fail to provide relief.

“Surgery is usually reserved for when all else fails,” Dr. Villoch says.

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A dose of prevention is the best medicine, she says. Good posture, correct body mechanics and a healthy lifestyle, including a good exercise program can prevent common back aches. But it’s important to know your body and to seek medical help when back pain persists.

“There’s no reason for you to be in constant pain,” she says. “The hope is to give you the tools and guidance to prevent future flare ups.”