Advertisements

Back Pain Therapy for Muscle Strains

Back Pain Therapy for Muscle Strains

By Raul Cardenas, MD

If you develop progressive weakness, urinary or bowel incontinence, or if you have numbness in your groin or anal region, you should seek treatment.

If the pain is recalcitrant to conservative management, a thorough evaluation by a neurosurgeon is imperative. Your neurosurgeon may require further testing, such as more imaging (MRI or dynamic X-rays), epidural steroid injections (or nerve blocks), and/or nerve conduction tests to aid in the diagnosis.

Dr. Raul Cardenas is a neurosurgeon with Semmes Murphey Clinic. For more information please visit their website at semmes-murphey.com or call (901) 522-7700.

The updated Bureau of Economic Analysis data shows that from 2000-2012 treatment for musculoskeletal disorders (which include back problems) was the second-largest contributor to overall growth in health services spending. This amounted to about $188 billion. It should come as no surprise to know that lower back pain is the fifth most common reason for all physician visits in the United States, and it will affect about 80-85% of the population. In other words four out of five people will suffer from back problems at one time or another. The majority of these episodes are self-limited and respond well to conservative management.

The guidelines for back care were published in the Annals of Internal Medicine back in 2007. This was a very useful scientific paper that established seven recommendations for the treatment of these back episodes. They reviewed a total of 131 meta-analyses, randomized controlled trials, and divided back pain in two very broad categories: non-specific low back pain and specific low back pain. We learned that most of the non-specific back pain (85% of back pain episodes) is caused by muscle strain, and no immediate surgical intervention is recommended.

Knowledge of these facts provides some degree of laxity in regards to the prescribed management. Different neurosurgeons have different routines. I usually recommend 2-5 days of rest from exercise (not bed rest) and non-steroidal anti-inflammatory drugs (NSAIDS), which would include ibuprofen and naproxen, followed by gradual return to activities. Medications, such as muscle relaxants, may be needed to reduce muscle spasms. Physical therapy is often prescribed

so the patient can learn how to follow proper body mechanics, such as good posture and lifting correctly, and to improve strength and flexibility in the spine, abdomen, and legs.

Following proper body mechanics, keeping a healthy weight and having a strong core is the best method for preventing any future back pain episodes. If there is significant pain that persists beyond a week, I recommend an evaluation by a healthcare professional. If you have been diagnosed with nonspecific back pain and the pain changes in intensity or quality, I also recommend making an appointment with your primary care provider. This is particularly important if the pain travels down the legs below the knee (suggesting pressure on the nerves as they leave the spinal cord), or if there is weakness or numbness in a leg. If you develop progressive weakness, urinary or bowel incontinence, or if you have numbness in your groin or anal region, you should seek treatment.

If the pain is recalcitrant to conservative management, a thorough evaluation by a neurosurgeon is imperative. Your neurosurgeon may require further testing, such as more imaging (MRI or dynamic X-rays), epidural steroid injections (or nerve blocks), and/or nerve conduction tests to aid in the diagnosis.

Dr. Raul Cardenas is a neurosurgeon with Semmes Murphey Clinic. For more information please visit their website at semmes-murphey.com or call (901) 522-7700.

Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

%d bloggers like this: