Chronic low back pain, that constant ache that ebbs and flows between being an excruciating pain that takes your breath away to that low grade constant ache that keeps you awake at night gradually wearing you down. Those who have not experienced this type of pain struggle to understand how much of your life it can change. Chronic low back pain can create large amounts of tension throughout the body as well as high levels of inflammation using huge amounts of energy. Add to this poor quality sleep and over time the sufferer struggles to find the reserves to get out of bed each day. This can gradually lead to more pain, a sense of hopelessness and a belief that this will never end leading to poor quality of life and in some cases clinical depression.
I’ve been in practice since 1995, starting out as a massage therapist and then becoming a Chinese medicine practitioner. One of my areas of special interest has always been pain management because over the years I have seen the devastating toll it can take on the suffers lives as well as the lives of their friends and loved ones.
What are some of the potential causes of chronic low back pain?
Sometimes an injury may result in a fracture that still enables movement and function. It doesn’t have to be the case where you have loss of function or feeling in your legs.
- Sprain or strain
Day to day activity creates wear and tear on the body that in some cases results in soft tissue or muscle damage that can result in acute low back pain initially but left untreated can turn to chronic low back pain.
- Disc bulge or herniation
In between the vertebrae of the spine are shock absorbers called discs. These are made of fibrous tissue and have a spongy gel inside allowing our vertebrae to be protected from damage. If parts of our spine sustain long periods of tension these discs can be pushed out of shape causing them to touch on the nerve that exits the spine. This is called a disc bulge. In severe cases the disc may split allowing the spongy gel to come out of the disc and touch on the nerve. This is called a herniated, prolapsed disc or previously a slipped disc. In both cases this can cause pain ranging from bad to excruciating. Helping to reduce the tension and inflammation associated with these situations can significantly improve the acute low back pain and reduce long term chronic low back pain in the process.
Excessive use of a part of our body can result in increased wear and tear leading to osteoarthritis. Left untreated this may lead to more long term and chronic pain. Rheumatoid arthritis is an autoimmune condition where the body’s immune system marks the cells related to our joints as foreign invaders. As a result the immune system attacks these cells creating pain, swelling, reduced function and deformation of joints.
- Curvature of the spine
Such as scoliosis, kyphosis or lordosis meaning the spine is not holding the correct curvature putting pressure on the wrong areas that can create pain, discomfort and reduced mobility.
A condition associated with high levels of pain throughout the body and in particular areas used frequently.
- Spinal stenosis
A condition where the hole through which the nerve runs narrows causing nerve impingement or a pinched nerve, which puts pressure on the nerve creating pain and loss of function or sensation.
How is chronic low back pain diagnosed?
As I’m sure you have worked out diagnosing back pain is not hard as it is pain and in your lower back. However diagnosing the cause can require a bit more investigation.
These are images that show alignment of bones and joints. They will also be able to pick up narrowing of joint spaces, fractures, spurs or bone degeneration.
- CT Scans/ MRI Scans
These are far more detailed scans that show muscle tissue damage, ligament damage or disc degeneration or damage.
- Blood tests
In some cases the cause of low back pain may very well be as a result of an infection. A blood test helps to be able to assess whether this is occurring.
- Bone scan
In some cases further investigation of the bones may be necessary to assess if there may be other issues occurring like tumours or compression fractures.
- Nerve conduction tests
This helps to be able to assess whether the reason for the pain or poor mobility could be caused by nerve damage.
What can you do for chronic low back pain?
There are a lot of different options that can be applied to assist in the improvement and reduction of chronic lower back pain and acute lower back pain.
In many cases back pain comes as a result of muscles that are tight. This can occur over long periods of time and so a long term stretching regime may assist improve pain frequency and intensity.
Whenever we have pain in the body it can indicate one area of tension as a result of another area of weakness. Adding the appropriate strengthening exercises to muscles that may have been underused for long periods of time may also assist in the management of chronic and acute low back pain.
- Muscle relaxants
The addition of compounds to help reduce systemic tension may assist in long term pain levels due to excess tension. Magnesium is one of a host of options that can be applied to assist with muscle function.
A review of 32 randomised control (1-5) trials has shown acupuncture has a positive effect in the treatment of chronic non specific low back pain in comparison to placebo and had a positive effect on function. In a review of 11 randomised control trials acupuncture was found to be superior to NSAIDS in effect when treating acute low back pain symptoms (2).
Looking for assistance in managing your health? At Evolve Natural Medicine we incorporate the use of acupuncture, Chinese herbal medicine, diet exercise and lifestyle advise to help you feel better and better. Where necessary we also work in conjunction with a wide range of health practitioners to ensure you get the outcome you deserve.
Author: Jeff Shearer, Evolve Natural Medicine
- Chou R, Deyo R, Friedly J, Skelly A, Hashimoto R, Weimer M, et al. AHRQ Comparative Effectiveness Reviews. Noninvasive Treatments for Low Back Pain. Rockville (MD): Agency for Healthcare Research and Quality (US); 2016.
- Lam M, Galvin R, Curry P. Effectiveness of acupuncture for nonspecific chronic low back pain: a systematic review and meta-analysis. Spine (Phila Pa 1976). 2013 Nov 15;38(24):2124-38.
- Lee JH, Choi TY, Lee MS, Lee H, Shin BC, Lee H. Acupuncture for acute low back pain: a systematic review. Clin J Pain. 2013 Feb;29(2):172-85.
- Wellington J. Noninvasive and alternative management of chronic low back pain (efficacy and outcomes). Neuromodulation. 2014 Oct;17 Suppl 2:24-30.
- Liu L, Skinner M, McDonough S, Mabire L, Baxter GD. Acupuncture for low back pain: an overview of systematic reviews. Evid Based Complement Alternat Med. 2015;2015:328196.
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