Chronic low back pain is pain that persists for more than three months. Researchers have found that between 75-85% of all Americans experience some type of back pain during their lives. Low back pain is quite painful and debilitating, and 50% of patients who have an episode will have a recurrent episode within one year. The top back pain doctors at Arizona Pain offer exceptional treatment at eight Valley locations in metro Phoenix.
Anyone can have back pain, but there are some people at greater risk than others. Risk factors include:
Advancing age – Getting older is a risk factor. Most patients have the first episode of back pain between ages 30 and 40 years.
Poor physical fitness – Not being physically fit is a risk factor for back pain.
Heredity – Some people inherit ankylosing spondylitis, which is a type of arthritis that affects the spine and associated structures.
Being overweight – Too much weight puts stress on the back and causes pain.
Your job – Any job where you have to push, pull, lift or twist your spine can lead to spinal damage and back pain.
Many conditions can cause the back to hurt. However, common causes of back pain include bulging discs, herniated discs, spinal arthritis, lumbar spinal stenosis, spondylolisthesis, scoliosis, degenerative disc disease, and fibromyalgia.
The diagnosis of back pain is made based on your medical history, current symptoms, a physical examination, and the results of diagnostic tests and imaging scans. These tests include computed tomography (CT), magnetic resonance imaging (MRI), electromyography (EMG), myleogram, nerve conduction studies (NCS), discography, and x-rays (radiographs).
The treatment for back pain depends on the underlying cause. For chronic back pain, options include:
Hot or cold packs – To soothe sore muscles and stiff backs, hot/cold therapy is effective. Heat reduces muscle spasms, whereas cold reduces swelling.
Medications – Topical analgesics are ointments, creams, and gels rubbed over the site of pain on the skin. Nonsteroidal anti-inflammatory drugs (NSAIDs) reduce swelling and pain, such as ketoprofen and naproxen. Muscle relaxants and certain antidepressants are also used for pain. Opioids are reserved for severe pain that does not respond to strong medications.
Manipulation therapy – This involves physiotherapy, exercises, and chiropractor therapy that is used for muscle relaxation and strengthening. Massage is a means of pain control.
Radiofrequency ablation (RFA) – To destroy a portion of the nerve root, the doctor will insert a small needle and probe through the back and position it near the affected nerves. Once position is confirmed with x-ray guidance, the probe delivers a current.
Medial branch blocks – With this procedure, the doctor inserts small needles into the facet joints of the spine and injects a long-acting anesthetic. Based on research studies, this procedure has an 85% success rate, with participants reporting pain relief and improved mobility.
Transcutaneous electrical nerve stimulation (TENS) – A TENS unit is worn on the outside of the body. The unit delivers mild electrical current via electrodes to interfere with pain signals. According to a 2012 research study, this unit has an efficacy rate of 75-90%.
Epidural steroid injection (ESI) – This procedure is proven to have a 90% success rate, with injection of a long-acting corticosteroid, with or without an anesthetic, into the epidural space. This region lies at the outer region of the spinal cord and nerves.