The lower back pain is considered as chronic if it continues for more than three months. Lower back pain will arise if there is any injury or stress on any part of the body or through any disease. The pain might differ and can be experienced as nerve pain, bone pain or muscle pain.
The pain might also vary ranging from mild to severe. The source for pain is not clear most of the times and in fact the injury that has stimulated the pain might have got healed and not able to be detected later. But, the pain might still persist for longer period.
Causes Of Chronic Lower Back Pain
Injury To Bones, Muscles And Nerves
Chronic lower back pain is caused by various sources that might include stress, injury or a disease to the various structures like muscles, joints, bones, ligaments, spinal cord and nerves. The area that is affected will send the signals to the spinal cord via nerve endings and in turn to the brain. The brain will register the signals as pain.
Sensitized Signal Pathways
Chronic lower back pain is explained by several theories while it is not clear exactly what could be the real cause. The normal mechanism is not explained completely. The signal pathways in the nerves that carry the pain signals through the nerve endings into the spinal cord and into the brain will become sensitized. The pathways that are sensitized might enhance the pain that is perceived than the signal intensity that was generated by the source. Due to the sensitization of the pathways, even the triggers that are normally non-sensitive like touch of light also might result in sensation of pain. Therefore, even after the source of pain or injury has healed, the signals are continuously sent to the brain. These nerve signals are experienced as real and very severe compared to the pain due to the original disease or injury.
If the old television set is projected with the same image repeatedly, the image is burnt into the screen. If the screen is turned off, the screen will still display the image on it. In the similar way, the initial trigger for pain might have healed and the pain might still persist in the patients.
Treatment For Lower Back Pain
The chronic back pain can be treated based on the source and type of the back pain. If the source of pain can be treated then the process that is running the source has to be treated first. If the cause beneath the source of pain is not known exactly, then the symptoms are treated. The treatment goals include enhancing the quality of life, decreasing the pain and in improving the body functioning. The treatment for chronic pain involves medications, physical therapy, procedures, coping skills, and complementary medicine treatments. The health care practitioner will generate a program that involves the combination of all the above mentioned treatment options that can properly address the necessities of the patient.
The physical exercises include various strengthening and stretching exercises, patient education and manual therapies. The physical therapy also includes usage of modalities like ice, ultrasound, heat and electrical nerve stimulation which help in treating the pain.
Strengthening exercises are formulated to enhance the strength and stability of the structures present in the back that are experiencing stress. The strengthening exercises are known to energize the body from reduced activity. Based on the type of back pain, the exercises are designed that can address the specific abilities of the patient.
Basically two type of medications are used for chronic low back pain like non-narcotic and narcotic. The NSAIDs are useful to control pain and inflammation. Muscle relaxants, nerve stabilization drugs like anti-depressants and anti-seizure drugs are used for managing pain due to nerves. All these drugs have to be consumed after consulting the doctor.
Coping skills are very beneficial in managing the chronic back pain. These skills help the patient in dealing with the depression, anxiety, frustration and irritability. The psychiatrist or a specialist for pain management will treat the patient in this regard.