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About Back Pain

Most back pain, especially lower back pain, is caused by simple muscle strains.

Most back pain is caused by simple strains and the main focus of this site is how to prevent recurring back pain by strengthening the muscles that support the spine with back exercises, along with correcting posture, using proper lifting techniques, and understanding the physical limitations of the back. There is also information on a wide range of back pain treatments, including complementary treatments, for the relief of both acute and chronic back pain.

Back Pain, especially in the lower back (lumbar spine), is a problem that most people experience at some time in their lives. The muscles that support the spine are in constant use; even while simply sitting, the muscles are in use to keep one from falling over. The spine also bends, straightens and twists. This constant stress on the back can result in back strain and pain.

The lower back supports most of the weight of the body and is subject to the most mechanical stress. As a result, the lower back is commonly injured. Lower back pain caused by strained muscles or ligaments is the most common type of back pain (sometimes referred to as lumbago).

Though most back pain is caused by muscle or ligament strain, there are other causes such as damage or injury to spinal nerves, bones, or discs. Sciatica, which is not a disease in itself but radiating pain and other symptoms caused by inflammation or compression of the sciatic nerve, can be caused by many conditions. Osteoarthritis of the spine is a common cause of back pain in people over 65 years of age. The incidence of some other back conditions also increases with age. Back pain is sometimes caused by a problem with the kidneys.

If back pain persists for over 3 months, it is considered chronic back pain. That doesn’t mean wait 3 months to see a doctor – an aching back can be a symptom of something that requires immediate attention such as a kidney infection. Back pain that lasts several days should be diagnosed and treated by a physician. It the pain is severe or is accompanied by numbness or pain down the leg, a doctor should be seen immediately.

The severity of back pain does not always correlate with the severity of the injury or damage.

In many cases the cause of back pain is hard to pin down. A simple muscle strain often causes more pain that a herniated disc. Herniated discs can produce intense back pain but often do not produce any symptoms at all. Even in those with damaged discs and spinal joints, the source of the pain may be strained back muscles.

If a doctor recommends surgery to relieve back pain, a second opinion should be sought. If one has a herniated disc, for example, but the herniated disc is not actually the source of the pain, surgery will not help relieve it. (Most herniated discs improve without surgery)

Stress, anxiety, and depression are often linked to back pain. Stress causes muscles to contract, which reduces blood flow to the tissues and often leads to pain. Stress hormones also heighten the perception of pain. There are many ways to relieve stress, from exercising to learning relaxation techniques. For some people, relieving stress is the most effective way to reduce pain.

Back pain can occur suddenly, but more often develops gradually.

For example, when the muscles supporting the back are held in one position (contracted) too long, the back muscles get fatigued and strained. Byproducts of muscular activity (such as lactic acid) build up in the back muscles. High levels of these acidic waste products in the muscles cause muscle irritation and pain.

Recurring back pain is frequently the result of inadequate muscle strength, shortened muscles; poor posture, being overweight, poor bending and lifting techniques. These are all factors that can be controlled .

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Epidural Injection

Epidural injections are a common treatment option for many forms of low back pain and leg pain. They have been used for low back problems since 1952 and are still an integral part of the non-surgical management of sciatica and low back pain. The goal of the injection is pain relief; at times the injection alone is sufficient to provide relief, but commonly an epidural injection is used in combination with a comprehensive rehabilitation program to provide additional benefit.

Most practitioners will agree that, while the effects of the injection tend to be temporary – providing relief from pain for one week up to one year – an epidural can be very beneficial for a patient during an acute episode of back and/or leg pain. Importantly, an injection can provide sufficient pain relief to allow a patient to progress with a rehabilitative stretching and exercise program.

Lower Back Pain Treatment

Lower Back Pain

How Epidural Injection Work?

An epidural injection delivers medicine directly into the epidural space in the spine. Sometimes additional fluid (local anesthetic and/or a normal saline solution) is used to help ‘flush out’ inflammatory mediators from around the area that may be a source of pain.

The epidural space encircles the dural sac and is filled with fat and small blood vessels. The dural sac surrounds the spinal cord, nerve roots, and cerebrospinal fluid (the fluid that the nerve roots are bathed in).

Several common conditions that cause severe acute or chronic low back pain and/or leg pain (sciatica) from nerve irritation can be treated by injections. These conditions include:

  • A lumbar disc herniation, where the nucleus of the disc pushes through the outer ring (the annulus) and into the spinal canal where it pressures the spinal cord and nerves. Read Lumbar Herniated Disc for more information on diagnosis and treatments.
  • Degenerative disc disease, where the collapse of the disc space may impinge on nerves in the lower back.
  • Lumbar spinal stenosis, a narrowing of the spinal canal that literally chokes off nerves and the spinal cord, causing significant pain.
  • Compression fractures in a vertebra.
  • Cysts which are in the facet joint or the nerve root and can expand to squeeze spine structures.

The epidural injection procedure takes place in a surgery center, hospital, or a physician’s clinic.

Epidural Injection Pain Relief Success Rate

Patients will find that the benefits of an epidural steroid injection include a reduction in pain, primarily in leg pain (also called sciatica or radicular pain). Patients seem to have a better response when the epidural injections are coupled with an organized therapeutic exercise program.

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