ACUTE BACK PAIN

An acute backache is typical. Up to 50% of people will have a back pain episode in any given year, and 80% of people will experience back pain at some point in their lives.

Key Points

EARLY RETURN TO ACTIVITY WITH GOOD PAIN CONTROL: IT WILL HURT YOU, BUT IT WON’T HARM IT
Any back pain that occurs between the buttock crease and the lower ribs is referred to as acute low back pain. Simply put, an episode that lasts less than six weeks qualifies as acute.

Both extreme pain and fear are possible. Thankfully, it usually gets better on its own. The two things that most patients want from their doctors are faster recovery and less likelihood of recurrence.

Acute back pain can manifest in several ways. Many people have mild to moderate back discomfort on occasion. That is, they manage well and move on with their lives, perhaps consuming a small amount of painkillers sometimes.

A severe acute episode is a common cause for concern. Some persons become “stuck” in one posture due to “spasms” or an acute locking. If this occurs, don’t worry—the back muscles will always “unlock.” How to “unlock” and regain your ability to work swiftly is the question. Resuming activities as soon as feasible and managing pain well appear to be essential components of an early and speedy recovery. 

The Back Book

‘The Back Book’ has been shown in a randomized controlled trial to assist in giving the right message at an early stage. Many Health Centers and Hospitals will have it, if not, it can be obtained from The Stationary Office by post.

Based on the available research conducted in the past ten years, it appears that taking a break could extend the healing period.

The key takeaway is that although your back will hurt, you won’t damage it.

Controlling pain is crucial. Numerous “over the counter” remedies provide a lot of potential benefits. Given their distinct mechanisms of action, the combination of two pills, paracetamol, and an anti-inflammatory is relatively safe. For the majority of people, ibuprofen 400 mg three times a day is safe and effective. The painkiller paracetamol acts on the brain’s central nervous system as well as the cause of peripheral pain. According to recent studies, it works very well for back discomfort. The public’s perception of it being weak since it can be found in supermarkets could be the reason for this; the efficacy of painkillers has been linked to this view. Ibuprofen is a good analgesic, or pain reliever, in addition to being an anti-inflammatory.

Sometimes the discomfort doesn’t go away, in which case harsher painkillers, such codeine, can be used briefly. Some of these can be purchased from a pharmacist or over-the-counter. If your doctor prescribes stronger medicines than these, you should follow up. If the more straightforward, conventional methods don’t seem to be helping, seeking the comfort and evaluation of a physician or other health care provider can hasten your recovery.

Patients frequently worry that by using painkillers to “mask” their discomfort, they could endanger their health even more. This is just untrue. The body has extremely strong defense mechanisms, which are not neutralized by over-the-counter painkillers. Moving after using basic pain relief measures won’t damage your back, in the same way that you can’t put your hand in hot water only after taking simple painkillers.

Thus, keep in mind to take 400 mg of Ibuprofen and one gram of Paracetamol quite regularly till the pain is much reduced.

Speak with a pharmacist if you have any reservations about taking this kind of medication.

The majority of acute back pain episodes resolve. Returning to regular activities as soon as possible is crucial as the discomfort starts to lessen.

Don’t put off going back to work or activities until you’re completely well. Acute episodes appear to be shorter and recover more quickly when movement occurs early.

The current suggestions are to avoid bed rest because it seems downright HARMFUL. This is supported by controlled scientific research that contrasted two days of bed rest with continuing with regular activities. You can see the whole scientific study, if you’d like, and a quick abstract by clicking the link below.

The Treatment of Low Back Pain

The effect of bed rest or keeping active is small. A comprehensive review is avalable at the link below.

http://content.nejm.org/cgi/content/abstract/332/6/351

The Cochrane Library

The reason why physiotherapy, chiropractic adjustments, and osteopathic therapies don’t seem to have much of an impact during the first four weeks of an acute bout of back pain is because it usually resolves on its own.

Health care providers’ primary responsibility is to assure patients that nothing grave is wrong while also conveying the “correct” message. It’s crucial to stay away from “mixed messages,” which can be extremely confusing, so be careful to seek trustworthy sources of information that are ideally not overly “commercial.”

Physicians have a series of “RED FLAGS” that occasionally indicate that more testing or evaluation may be prudent. Though not always, the red flags can be signs of a serious illness. Infrequent causes of back pain that doctors watch out for include cancer, infections, compression of the spinal cord, and compression of nerve roots.

Red Flags

  • A prior diagnosis of cancer or a history of cancer surgery
  • Unexpected weight reduction
  • Pain that worsens in spite of effective pain relievers
  • The recent use of high dose steroids or medications to decrease rejection may be risk factors for infection.
  • Additional risk factors include any conditions like
  • HIV/AIDS or drug use that lower immunity to infection.
  • A first-ever bout of excruciating back pain in someone over 55 a pain that keeps you awake at night and prevents you from falling back asleep.
  • or infection. Additional risk factors include any conditions like HIV/AIDS or drug use that lower immunity to infection.
  • A first-ever bout of excruciating back pain in someone over 55 a pain that keeps you awake at night and prevents you from falling back asleep.

Cauda Equina Syndrome

We handle this condition as an emergency. The two primary symptoms are altered bladder or bowel function and numbness surrounding the lower portion of the body. Often quite severe, the back pain may radiate down one or both legs.
You should get emergency medical attention as soon as possible if this occurs.

Yellow Flags

At times, these can be the barriers or challenges facing recuperation. Although most people are able to overcome problems, some require assistance. When back pain persists for more than four weeks, impairment may occasionally result. However, this can be avoided with early treatment.

Many of the warning signs are the common misconceptions and anxieties we have towards suffering. Some individuals develop future-related anxiety, such as worrying about using a wheelchair. Some patients will begin to exhibit what is known as “pain avoidance behavior,” in which they cease acting out of fear that their condition would worsen.

There are situations when sympathetic “friends” with scary anecdotes regarding back pain can exacerbate these concerns and assumptions. It’s now known that the beliefs held many years ago about back discomfort were incorrect. Through the use of modern research, we can now restore people’s ability to work and function far more quickly than in the past.

Keep in mind that “you won’t harm it, but it will hurt.”

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