What Causes Low Back Pain?
Pain may be the result of muscle strain, irritation and inflammation of the joints in the spine or pelvis, disc herniation or bulging discs, irritation of the nerves or trauma. Whatever the cause, chiropractic works to find the root of the problem and to correct that problem, not just its symptoms.
Muscle Strain, Muscle Tear, Pulled Muscle
A muscle strain, tear or pull is damage to the muscle tissue that causes pain and inflammation. The symptoms of a muscle strain can be swelling, redness, bruising, pain at rest or on using the affected muscle and/or muscle weakness.
Inflammation occurs when there is damage to the affected tissue. It is part of the healing process as the immune system attempts to repair the damage. The signs of inflammation are swelling, redness, heat and pain.
The discs are the cushions between the bones of the spine or vertebrae. Excessive pressure on the discs can cause them to bulge or herniate. Disc herniation causes intense pain either locally or radiating down the hip and leg, even so far as the foot. The pain is caused by the disc bulge pressing on nearby nerves.
There are a number of prescription and over the counter medications for pain relief. Most fall into one of two categories: analgesic (numbing) or anti-inflammatory. The most commonly used are anti-inflammatories or NSAID’s (non-steroidal anti-inflammatories).
Medications offer temporary, and often times necessary, relief, but they don’t address the root cause of the problem which means that when medications are stopped, the problem comes back.
NSAID’s also come with unwanted side effects: gastrointestinal irritation causing diarrhea, acid reflux and bleeding ulcers, erectile dysfunction (ED) and increased risk of cardiovascular diseases like heart attacks and strokes (with the exception of aspirin). Examples of NSAID’s include aspirin, ibuprofen, naproxen. Trademarked names: Advil, Motrin, Naproxen, Anaprox.
Corticosteroids are often administered by injection at the site of musculoskeletal injuries. They exert powerful anti-inflammatory effects but have a number of unwanted side effects including thinning of the skin and osteoporosis.
Acetaminophen (Tylenol) is referred to as an analgesic, which means that it increases the body’s pain threshold, but it has little effect on inflammation.
Most COX2 inhibitors were withdrawn from the market because of an increased risk of heart attack and stroke. Celebrex is still available.
Opioids, also known as narcotic analgesics, modify messages in the brain but come with a number of side effects: drowsiness, dizziness, respiratory depression, constipation, and urinary retention. They also can lead to addiction, contributing to the current opioid crisis.
Muscle relaxants relax tense muscle groups, most likely through sedative action in the central nervous system.
Anti-anxiety drugs work three ways: they reduce anxiety, they relax muscles, and they help patients cope with discomfort.
Some antidepressants, particularly the tricyclics, may reduce pain transmission through the spinal cord.
Some anticonvulsant drugs also relieve nerve pain or neuropathies, possibly by stabilizing nerve cells.
Alternatives to Medication
Acupuncture has been used for thousands of years to relieve pain. Hair-thin, sterile needles are inserted locally into your back and also at remote points to encourage the production of natural anti-inflammatories in your brain and direct your immune system to the area to speed healing.
Registered Massage Therapy
Muscle tension contributes to the factors that cause low back pain (herniation, muscle tear/strain/pull, poor posture, irritation of nearby nerves, poor biomechanics, etc.) Massage therapy relaxes muscles, increases circulation to the area, and helps to maintain the proper alignment of your back.
There are a number of effective herbal anti-inflammatories that do not come with the same associated risks as NSAID’s do.
By Dr. Pamela Frank, Naturopathic Doctor, updated Jan. 4, 2020