Back to Basics: Preventing and Treating Lower Back Pain

What emergency room doctors and primary care physicians have been seeing over the years, science has validated: More people are seeking medical attention for bouts of lower back pain.

In fact, using the Global Burden of Disease Study in 2010, researchers have noted that the incidence of lower back pain worldwide increased by 43 percent – from 58.2 million to 83 million – between 1990 and 2010. And, in the United States, lower back pain accounts for more than 3 percent of ER visits, according to a study published in The Spine Journal. Furthermore, research published in The Journal of the American Medical Association (JAMA) shows that back pain and headaches often are cited as the No. 1 causes for missed days of work.

Hanif Williams, M.D., a Baptist Health Medical Group physician with Baptist Health Primary Care and chair of the Department of Family Medicine at Baptist Hospital, says the majority of his patients who seek medical attention for their lower back pain suffer from muscular strains caused by overdoing physical activity.

“What we’re seeing with the younger population is that people are trying to get in shape, but they don’t have enough time during the week,” he said. “So, they pack it all in on the weekend and end up injuring themselves. Injuries also occur when people take on physical tasks that they usually do not perform themselves and are unaware of the proper body mechanics involved in doing those tasks.”

Effective Treatment and Prevention of Lower Back Pain

A new batch of research suggests that following the simplest steps may be the best way to treat and prevent future injuries or bouts of lower back pain. A recent article in JAMA Internal Medicine examined the most effective ways to prevent lower back pain. It found that regular exercise, along with education about spine anatomy, proper lifting techniques and posture, were the most effective ways to prevent lower back pain. Additionally, a study published in JAMA last year concluded that pain relievers, such as acetaminophen, and anti-inflammatory medications, such as naproxen, were more effective in treating lower back pain than opioid drugs, which can be highly addictive.

Exercise

Dr. Williams agrees with these findings. He begins treatment of lower back pain caused by muscle strain by recommending an exercise program geared toward strengthening the body’s core, including back muscles. He says these exercises, combined with a mild pain reliever or anti-inflammatory medication and icing the area two to three times a day, often helps take care of the immediate injury. The exercise program also has the added benefit of preventing future injuries, as the muscles strengthen. In more severe cases, Dr. Williams will send patients to physical therapy to help restore function along with a focus on strengthening the core muscles.

Opioids

Rarely does Dr. Williams prescribe opioid treatment when trauma to the back or debilitating pain is not present. This is consistent with the U.S. Centers for Disease Control and Prevention’s guidelines for prescribing opioids for chronic pain.

“Opioids don’t treat the underlying problem,” Dr. Williams said. “Our focus is to get the patient functioning again, while avoiding the dependence that quickly develops from opioid use and the tolerance that’s just around the corner.”

With trends of sedentary lifestyles, overweight and obese populations, and “weekend warriors” trying to make up for lost exercise time, lower back pain is sure to continue to threaten the well-being and productivity of Americans. But, armed with the knowledge that the simplest steps help, we can prevent lower back pain and injuries by getting back to the basics.