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Chronic back pain: What can you do about it?

"Of pain you could only wish for one thing: that is should stop," wrote George Orwell in his famed novel 1984.

For people struggling with chronic lower-back issues, however, those wishes are not always granted. For many people, the pain doesn't stop.

How do you know when back pain has become chronic and what are the options for addressing it?

Determining the degree and duration of pain

Lower back pain is a very common condition. About 4 of every 5 adults experiences it to a degree during their lives. The intensity of the pain can vary widely, from a continuous, low-grade dull ache to a piercing, practically incapacitating sensation.

Fortunately, usually back pain gradually gets better within a few weeks, often assisted by anti-inflammatory medication or physical therapy. If pain lasts over three months, however, it is considered chronic pain.

What are the main options for treatment?

The place to start in treating back pain is with anti-inflammatory medication and physical therapy.

Anti-inflammatory meds such as aspirin, naproxen, or ibuprofen, can be purchased over the counter and taken at home. But if prescription drugs are needed for pain management, seeing a doctor will be necessary to get a prescription.

If the drugs prescribed by the doctor are opioids, such as Oxycontin, a potential concern is the drugs becoming addictive. In recent years, overuse of opioids has become a full-blown public health crisis, with thousands of accidental deaths caused by overdoses every year. We discussed this in a post on overdoses earlier this year.

If you use prescription meds to manage pain, it is important to proceed with caution.

It's also good to know the role physical therapy (PT) can play in helping the body heal from back pain. PT involves doing a set of specified exercises under the guidance of a physical therapist. These exercises facilitate the flexibility and strength needed to allow the components of the back (spine, discs, nerves, muscle, etc.) to regain their cohesion.

If you have not tried acupuncture, that is another possibility to consider for seeking relief from back pain. Acupuncture involves the insertion of thin needles into the skins at precise points, following the principles of ancient Chinese medicine. The idea is to use the natural energy flow of the body to allow the body to heal itself.

What if more serious intervention is needed?

Physical therapy and anti-inflammatory meds are the place to start, but they aren't the only options for addressing serious back problems.

Sometimes, epidural injections may be called for. These injections involved the insertion of pain relievers directly into a space in the spinal canal. This is done by inserting a catheter (long, thin tube) in between vertebrae in the back.

If complications from a particular back condition become severe, surgical intervention for back pain is another possibility. This may be necessary, for example, when nerve roots in the spinal cord have been compressed by a ruptured disc or when the space in your spinal canal has narrowed (a condition called spinal stenosis).

Easing your pain and anxiety

Many reasons can contribute to serious back pain. From injuries sustained in car crashes to debilitating conditions such as sciatica that occur over time, the place to start is by understanding your unique circumstances.

If your pain isn't getting better, talk to your doctor. No matter what comes next, we hope this post has helped you to better understand how to stop - or at least ease - your pain.

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