Let's Talk Lower Back Pain and What It Could Mean v2

 Lower back pain may be one of the most common ailments, but its regular occurrence does not mean that it is any less painful or challenging to manage. An understanding of the factors that contribute to lower back pain may help in prevention or treatment it once it occurs.

Dr. Rachid Assina, Chief of Neurosurgery at Saint Clare’s Health, diligently works with his patients as they manage every aspect of lower back pain, from prevention to treatment through recovery.

One important way to understand lower back pain is to being by understanding the vocabulary surrounding it.

“Lower back pain is described as any activity intolerance due to back symptoms, which can include pain from the truncal area all the way to the low back or buttocks area, and even down from the back to the leg area.” Dr. Assina said. “Lumbago, a non-medical term, describes back pain in the truncal area. Sciatica is pain generating from the sciatic nerve, the longest nerve in the body, which travels from the lumbar spine down the back of your leg. Either way, the pain you experience comes from the interaction of the muscles, ligaments, bones, discs, joints and nerves in the area.”

There are several varieties of lower back pain. Acute pain can come from a sudden injury that could be a result of a sports injury, a car accident, or even from picking up a pen the wrong way from the ground, for example. “Acute pain also can be a result of any sudden phenomenon with no precipitating event,” Dr. Assina said.

“Sixty to ninety percent of adults will experience some level of back pain during their lifetime, and generally they are between the ages of 35 to 55 years old. Fortunately, about 90 percent who experience acute pain from injury and who are treated conservatively, will only take about four to six weeks for the pain to subside. Approximately twenty percent of adults who experience lower back pain will result in chronic pain and last a lifetime,” explains Dr. Assina

“The best treatment for many people, initially, should be conservative and based on common sense. This includes bed rest for a few days and taking some over-the-counter medications, such as Ibuprofen or Aleve. Soon after, people can usually resume their daily activities as the pain subsides,” Dr. Assina said. “If the pain does not subside within eight to twelve weeks, then people can consider seeking additional help from their primary care physicians- then they can begin a more advanced pharmacological treatment regimen, such as a muscle relaxants or stronger non-steroidal inflammatory medications. Physical therapy can then also be considered as an additional treatment.”

Before following this type of treatment plan, Dr. Assina warns that there are certain “red flags” people should be aware that indicate health issues that go beyond lower back pain.

“There are certain signs of illnesses when treating lower back pain that could reveal infections, cancer and other serious illnesses, for example,” Dr. Assina said. “Treatment must carefully consider if the patient is already immunocompromised. Patients could be immunocompromised for a range of reasons, including having a transplant, long-term medical steroid use, or HIV. Common infections, incontinence, loss of power or a foot drop, sudden weight loss, significant pain during the night, and muscle weakness are other factors that need to be considered as signs of more serious illnesses when proceeding with lower back treatment. These patients need to seek immediate assistance from their physicians,” stated Dr. Assina

After taking the conservative approach, such as pharmacological treatment and  physical therapy, and there are no ‘red flags,’ the next steps to take if the pain continues or worsens is for the primary care physician to initiate diagnostic imaging tests for further diagnosis. Magnetic resonance imaging (MRI) is the most effective modality to examine the physical sources of persistent lower back pain- it shows muscles, nerves that can be compressed, and other soft tissue. X-rays are effective in showing dislocations or fractures of the bone.  For example, “One common source of lower back pain is having a herniated disc, which pushes on the nerves. This causes local back pain, but also causes a lot of pain by putting pressure on nerve endings. This leads to numbness, weakness, and the wasting of muscles,” Dr. Assina said. “An MRI is very effective to see the source of the problem, such as a herniated disc, and then begin to effectively address it.”

There are certain preventive measures that can help avoid or minimize lower back pain. Exercise is critically important to strengthen core muscles and reduce back injury and pain. Cessation of smoking and weight loss are also very important.

“Posture is very important,” Dr. Assina said. “The curvature of your back when you are sitting or standing, whether you are working or not, affects your spine. Good posture, along with regular stretching and massages, can help the overall health of your spine and keep back pain at bay.”

“Saint Clare’s Health’s point of pride is its focus on providing individualized and compassionate care that patients have come to know and trust. When patients are experiencing lower back pain, whether acute or related to more serious long-term illnesses, they want the convenience of receiving exceptional care- all close to home,” Dr. Assina shares. “Additionally, Saint Clare’s Health has all of the advanced technology as the other larger medical institutions do, so patients can be assured that they are receiving the state-of-the-art care.” This makes Saint Clare’s Health a unique place; a hospital that is around the corner, and ahead of the curve.

“I don't consider Saint Clare’s Health to be a small community hospital when it comes to spinal issues. In fact, the hospital is very unique in that it provides any type of lower back pain treatments and operations necessary, whether it’s for deformities, tumors, acute pain, chronic pain, or anything else,” Dr. Assina said. “Our patients do well here. The doctors and staff give our patients not just a chance to survive lower back pain. It gives them a chance to thrive.” 

For more information, please call 973-625-6000 or visit www.saintclares.com.