Don’t Back Down From Back Pain

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Carrying heavy shopping bags, sitting at a computer for several hours, slipping on the sidewalk on a rainy day… Back pain can come on suddenly from a variety of sources.

Your first instinct when you feel back pain may be to get plenty of rest.  Not so fast, says Jatinder Gill, MD, an anesthesiologist and back pain specialist at BIDMC’s William Arnold – Carol A. Warfield, MD Pain Center.

“Unless there are serious red flags – pain shooting down to your legs or incontinence – my first recommendation is to remain fully active,” Dr. Gill says. “The best thing you can do is try to move on. Too much resting and lying down is not good for your back.”

Low back pain is very common and has many causes, and we are at risk at every age. People often fear the worst when they feel back discomfort.

“A lot of times, it does get better on its own,” Dr. Gill says, explaining that it’s better to use your back than to restrict your movement when minor aches and pains arise.

“Through a process called neuroadaptation, the body can adjust to pain and the pain dissipates,” he says. “Remaining active despite some aches and pains is a very powerful tool in creating this neuroadaptation.”

Put your back into it.

Dr. Gill encourages regularly exercising your back to prevent injury. In addition to walking and stretching, eating healthy and refraining from smoking are important for maintaining overall body health.  And don’t forget about good posture.

“It takes ongoing effort to keep your spine straight, so maintaining good posture helps keep your back strong,” he says. “It is like a continuous exercise.”

He also recommends back extension exercises to help build lower back strength.  Think of these like a reverse sit-up – instead of lying on your back and sitting forward, lie flat on your stomach and arch your back upward to raise your chest off the floor. But as with any exercise, don’t take on too much too fast.

“Know who you are and build up your exercise intensity slowly, then maintain it,” he says.

Back pain increases as we age.

Over time, our bodies undergo many changes and pain is more common. Conditions such as spinal stenosis and arthritis are more likely in our later years, but advanced treatments are considered only when conservative measures have failed. Compression fractures in the spine can also occur as we age.  The risk is generally higher for women and something as simple a bumpy car ride or hard coughing can cause a fracture.

“For seniors, exercise is extremely important because only exercise can increase bone mass and strengthen bones and prevent these fractures,” Gill says.

A procedure called kyphoplasty is used when the fracture causes severe pain and disability. Specially trained physicians use a needle to fill the weakened area with a special cement to prevent further collapse of the bone. The procedure eliminates pain and helps patients return to normal activities.

“The main idea in treating back pain is to get people out of bed and keep them active,” Gill says.

Know when you need advanced care.

When conservative measures fail, a variety of treatments and procedures can help. Diagnostic nerve blocks are used to identify the source of pain.  Once the pain-causing nerves are located, a procedure called radiofrequency ablation can stop these nerves from sending pain signals, and thus eliminate pain for a longer period of time.

“This treatment can last from a few months to a few years,” Dr. Gill says.

For patients with complex pain who have nerve injuries or have had back surgeries, spinal cord stimulation holds great promise. This procedure involves a small implanted device that sends electrical pulses to reduce pain. “This treatment has been around for a long time, but recent advances have greatly increased its effects,” he says.

BIDMC’s Arnold-Warfield Pain Center offers a variety of advanced therapies techniques to treat back pain. For more information, visit bidmc.org/pain.