"This back pain has started again... I can't sit or stand up..." This is a story that is very familiar to many people in our country. Back pain is a very annoying thing. What makes it even more annoying is when it doesn't get any better despite trying every type of medicine and treatment. If you are also suffering from this problem, this article will be very important for you.
Why don't some treatments work? New discoveries tell the story
A recent large study found something very surprising. That is, out of the ten most common noninvasive treatments we use for back pain, only one is actually effective. Imagine how low that percentage is!
According to these researchers, although some treatments provide some relief, it is often temporary and very minimal. In fact, if you measure pain on a scale of 100, these supposedly successful treatments only reduce pain by a small amount, like 4 to 8 points.
See the table below for some of the treatments that work, and some that don't.
| Nature of pain | Somewhat successful treatment | Treatments that are not very successful |
|---|---|---|
| Acute Back Pain (lasting less than 12 weeks) | NSAIDs (Nonsteroidal Anti-inflammatory Drugs) type painkillers. For example: Ibuprofen, Diclofenac. | Exercise, Glucocorticoid (Cortisone) injections, Acetaminophen (Paracetamol). |
| Chronic Back Pain (lasting more than 12 weeks) | Exercise, spinal manipulative therapy, taping, some antidepressants, capsaicin plasters. | Antibiotics and anesthetics such as Lidocaine. |
Why is back pain so common and difficult to treat?
Back pain is a leading cause of disability worldwide. This is because back pain can have many causes and persist. If the treatment you receive does not target the underlying cause of your pain, the pain may persist or return over time.
Simply put, there are two main types of back pain:
1. Specific back pain: This is caused by a clearly identifiable change in the body, such as a spinal fracture or spinal stenosis .
2. Nonspecific Back Pain: Surprisingly, 85-95 out of 100 cases fall into this category. This means that there is no single specific cause for back pain. Many interrelated factors can contribute to it.
This is the most important thing: first meet with your doctor to determine what type of back pain you have. Then, together, the two of you can decide what treatment is best for you.
So what do we do? What is the right way?
If you have 'non-specific' back pain, here's a good place to start:
What to do at first
First, talk to your doctor and if he recommends it, you can take an NSAID pain reliever for a short period of time. But this is very important:
Warning: NSAIDs (e.g., Ibuprofen, Diclofenac) are not suitable for everyone. If you have a history of intestinal bleeding, gastritis, heart disease, kidney disease, or high blood pressure, you should definitely tell your doctor before taking this medication.
Painkillers are only a temporary solution. At the same time, it is essential to make a plan to gradually resume your normal activities, walks, social activities, etc.
If the pain persists...
If the pain has been there for weeks or months, we need to think differently. Painkillers only suppress the pain, they don't cure the underlying problem.
"The best thing we can do for any patient in pain is to find the cause of the pain and treat that cause."
For example, think of someone who sits in the same position all day. When they do this, there is a lot of pressure on the sacroiliac joints, which connect the spine and hip bones. This can lead to back pain. In times like these, simple exercises that can help bring those joints back into alignment can provide great relief.
If simple treatments like these don't relieve the pain, your doctor may consider more complex, invasive treatments.
- Radiofrequency Ablation: Heating and inactivating the nerves that carry pain.
- Spinal Cord Stimulator: A small device that is implanted into the spine and blocks pain signals.
- Surgery: To correct structural problems in the discs or bones of the spine.
Choosing the best treatment for you
From all of this, we understand that a "one-size-fits-all" approach to back pain does not work. The best thing to do is to choose the best treatment that is specific to the patient and suits them.
Things like MRI scans can be very helpful in this regard. An MRI can identify even subtle problems with the discs, nerves, and spine.
Think about someone like this:
There is a 40-year-old man. He has degenerative disk disease, is a bit overweight, and has psychological trauma from something that happened to him in the past.
A single treatment is not enough for someone like this. The doctor may consider all these factors and recommend a combination of treatments.
- Physical Therapy: To strengthen muscles and increase flexibility.
- Counseling: To manage the relationship between trauma and pain.
- Losing weight: To reduce pressure on the back.
- If necessary, specific injections or other treatments targeting the spinal discs.
In this way, the most effective way is to take everything related to your condition together and create a treatment plan that works for you.
Take-Home Message
- Back pain is a complex problem. There is no one-size-fits-all treatment.
- Most commonly used treatments provide only temporary and minimal relief.
- The first thing to do is to see a qualified doctor and identify the root cause of your pain and its nature (specific or nonspecific).
- Don't rely solely on painkillers. Exercise, physical therapy, and lifestyle changes are very important.
- Inform your doctor about your other medical conditions before taking any medication, especially NSAID painkillers.
- A treatment plan that is tailored specifically to you, combining several treatment methods, is often the most successful. Talk openly with your doctor about this.
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