<>Low back pain is one of the most common complaints on the planet. And you may wonder where to turn when you start experiencing some of those aches or twinges in the lower part of your back. Take heart. "In most cases, you won't need a specialist," says Dr. Robert Shmerling, a rheumatologist at Harvard-affiliated Beth Israel Deaconess Medical Center. >
<>The McKenzie method45 uses clinical examination to separate patients with low back pain into subgroups (postural, dysfunction, and derangement) to determine appropriate treatment. The goal is symptom relief through individualized treatment by the patient at home. The McKenzie method is not exclusively extension exercises; it emphasizes patient education to decrease pain quickly, restore function, minimize the number of visits to the clinic, and prevent recurrences.45 Two systemic reviews have compared the McKenzie method with different conclusions.11,43 Clare et al11 concluded that McKenzie therapy resulted in decreased short-term (less than 3 months) pain and disability when compared with NSAIDs, educational booklet, back massage with back care advice, strength training with therapist supervision, and spinal mobilization. Machado et al43 concluded that the McKenzie method does not produce clinically worthwhile changes in pain and disability when compared with passive therapy and advice to stay active for acute LBP. >
<>Today, the most common conventional treatments for lower back pain relief are medications, including NSAIDS like aspirin and Tylenol, along with more potent prescription painkillers, such analgesics. These drugs can potentially cause adverse side effects in some patients and commonly don’t solve the underlying causes of lower back pain (such as poor posture, obesity or exercise-related strains). Some medications for back pains have even been tied to complications, such as liver damage or intestinal bleeding, when taken for long periods of time or in high doses. >
<>Bony encroachment: Any condition that results in movement or growth of the vertebrae of the lumbar spine can limit the space (encroachment) for the adjacent spinal cord and nerves. Causes of bony encroachment of the spinal nerves include foraminal narrowing (narrowing of the portal through which the spinal nerve passes from the spinal column, out of the spinal canal to the body, commonly as a result of arthritis), spondylolisthesis (slippage of one vertebra relative to another), and spinal stenosis (compression of the nerve roots or spinal cord by bony spurs or other soft tissues in the spinal canal). Spinal-nerve compression in these conditions can lead to sciatica pain that radiates down the lower extremities. Spinal stenosis can cause lower-extremity pains that worsen with walking and are relieved by resting (mimicking the pains of poor circulation). Treatment of these afflictions varies, depending on their severity, and ranges from rest and exercises to epidural cortisone injections and surgical decompression by removing the bone that is compressing the nervous tissue. >
<>Some people may need prescription-strength NSAIDs or opioid medications to help with pain. It is important to talk to your doctor or pharmacist if you are taking any other medications -- including over-the-counter medicines -- to avoid overdosing on certain active ingredients. Your doctor may also prescribe muscle relaxants to help ease painful muscle spasms. >
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