Your back is an essential muscle, so don’t take it for granted. Carrying your body weight all day is a testament to its strength and flexibility, but if you don’t take care of it you may end up with temporary (acute) or chronic back pain. The spine, which runs from the base of your skull all the way down to your pelvis, is critical in protecting your back and how your nervous system functions.
Normal back pain happens and may be relieved with medication or hot patches, but what about chronic pain? To understand chronic pain, it’s important to know the structure of the back. Our upper body weight is supported by five vertebrae (L1-L5) in the lumbar region. Tiny shock absorbers cushion the spaces between the vertebrae. These are called intervertebral discs, and they’re rubbery and round and help the bones when your body moves. Vertebrae are held in place by ligaments, muscles link up with the spine by tendons, and the spine is connected to the brain by 31 pairs of nerves.
My Lower Back Hurts – Why?
Imagine you’re sitting at work, and you reach down and grab a piece of paper you dropped. Suddenly, intense pain erupts near your waist! Is it chronic, an old injury you just aggravated? Who knows?
Sudden back pain which lasts up to six weeks may result from heavy lifting or a fall. The pain may be referred to as chronic if it persists for longer than three months, but it’s less common than temporary pain. Conditions commonly linked to chronic back pain include:
- Ligament or muscle strain. This may happen when you lift an object using mostly your back and arms, and it weighed more than you thought. Or you turn awkwardly, straining spinal ligaments and back muscles. If you’re out of shape, continuous stress on your back can result in excruciating muscle spasms.
- Ruptured or bulging disks. Disks cushion the vertebrae (bones) in your spine. Pain may happen if the soft material in a disk ruptures or bulges and pushes on a nerve. But bulges or ruptures can happen without chronic back pain. Sometimes, disk disease is discovered if you have a spine x-ray for another procedure.
- Osteoarthritis is a cause of chronic back pain. If you have spinal arthritis it can lead to the spinal cord having less space around it, which is called spinal stenosis.
- Skeletal abnormalities. Chronic back pain may result if you have scoliosis, where your spine turns to the side, but this doesn’t happen until middle age.
- Osteoporosis. This happens if your bones become brittle and porous, and the vertebrae develop compression fractures.
The cause of chronic back pain can be mysterious, and the diagnosis often depends on tests or x-rays. Other conditions that may result in pain include tumors, infections, Sciatica, Abdominal aortic aneurysms, Cauda equina syndrome, kidney stones, Endometriosis, inflammatory diseases, or Fibromyalgia.
Is Chronic Back Pain Curable?
Your doctor can recommend a treatment plan after a physical exam and discussing your medical history. Depending on symptoms and causes, pain management might be possible through bed rest, exercise, and losing weight. What other treatment options are there?
- Medicine – Analgesics, nonsteroidal anti-inflammatory drugs, anticonvulsants, antidepressants, and counterirritants.
- Spinal manipulation and spinal mobilization.
- The use of traction or acupuncture.
- Biofeedback or nerve blocking therapies.
- Epidural steroid injections.
- Transcutaneous electrical nerve stimulation.
- Surgery – Vertebroplasty and Kyphoplasty, Spinal Laminectomy (also known as spinal decompression), Discectomy or Microdiscectomy, Foraminotomy, Intradiscal Electrothermal Therapy, Nucleoplasty (also called plasma disc decompression), Radiofrequency Denervation, Spinal Fusion, and Artificial Disc Replacement.
Clinical procedures and therapy are possible, doctors are now embracing the use of ketamine as an option to manage chronic back pain. If you’re someone who has suffered from chronic back pain and you haven’t found relief through other medication, or are planning on back surgery, then you may be a candidate for low-dose ketamine infusions.
“I think of ketamine as a very effective pain medicine for a small number of patients: In general, patients who have been taking opioids for pain and found them to be ineffective,” said Dr. Charles F. von Gunten, MD, PhD.
Risk Factors and Final Thoughts
Lifestyle choices can lead to long-term back pain if the symptoms aren’t treated. Other risk factors include illness, age, genetics, sleeping habits, lack of exercise. Luckily, most symptoms can be managed. Dr. Sunali Wadehra, MD, says ketamine “combats pain by acting against” specific receptors in the nervous system and has other clinical uses.
If you or a loved one is dealing with chronic pain we invite you to give us a call to learn more about ketamine.