Relief for Back Pain

If there were an Oscar for sites in the body most likely to be painful, the back would likely win. According to a 2021 national survey,  39% of American adults have back pain, and those over age 65 are more likely than younger adults to have it. Back pain “outranked” upper and lower limb pain, head pain, abdominal, pelvic, genital and tooth pain.

Handling Back Pain

As distressing as that sounds, relief is possible from back pain, experts say. Here’s how.

“People need to get involved in their own care and understand what is causing the pain and their options,” says Alan D. Kaye, MD, PhD, pain fellowship director and professor of anesthesiology at Louisiana State University Health Science Center, Shreveport.

Experts classify back pain as acute pain—you lifted something that was too heavy and now you hurt—or chronic pain—generally defined as pain that persists for 3 months or longer.

Acute back pain ‘’tends to get better quickly,” says Roger Chou, MD, professor of medicine and director of the Pacific Northwest Evidence Based Practice Center at Oregon Health and Science University, Portland. He means within a few days or a week. It may sound counterintuitive, but staying active is one of the best things you can do to speed recovery from acute back pain. “We think it’s better to try to maintain whatever activity levels you are comfortable with,” Chou says. He’s not talking about a high impact jog or exercise class, just staying in motion, rather than pulling the covers over your head.

Chronic back pain, as the name suggests, is more difficult to treat—but also has more options for relief than in the past. Chronic pain can originate from many areas in the back, including the sacroiliac joint linking the pelvis and lower spine, the facet joints, which Kaye calls the stabilizers of the spine, or the discs, the spine’s ‘’shock absorbers.”

Certain occupations, such as those requiring much lifting, or twisting and bending, can increase the risk of back issues. Many forms of arthritis can lead to back pain. And, good news for sloppy housekeepers, obsessive cleaning, as in OCD style, can increase the risk of an aching back. “Every hour in our clinic, we get someone who is an OCD cleaner,” Kaye says.

Potential Back Pain Solutions

For inflammation in the sacroiliac joint, a short course of physical therapy might help, Kaye says, as well as an injection of a corticosteroid.

An option for facet joint problems is radiofrequency ablation, a procedure to ‘’degenerate” the nerves. The procedure can give relief, although nerves can grow back, Kaye says. Others say it can produce more long-term relief.

For disc problems, an epidural can provide some relief, Kaye says. And a procedure called a percutaneous discectomy, in which part of the herniated disk irritating the nerve  is removed, can relieve pain, too, some research has found.

The FDA has expanded approval of spinal cord stimulation devices for back pain, but two recent analyses conclude that the costly technique may not be any better than placebo.

Better Management

Beyond procedures for back pain, there are many other avenues to relief. Physical therapy can help, with the ideal PT program individualized based on the kind and extent of pain, Chou says.

“Some patients will use cognitive behavioral therapy to help understand the pain, and then set goals in terms of what they can do,” he says. For instance, someone might aim to be able to sit for a specified time so they could attend an event, then decide what it would take to accomplish that.

A unique approach to behavioral therapy, called cognitive functional therapy or CFT, involves targeting unhelpful pain-related behaviors and emotions in order to meet goals such as attending important events. In this study of CFT, it gave better results than usual care for chronic back pain.

Don’t gobble up non-steroidal anti-inflammatories for pain relief

What Else To Know?

Don’t gobble up non-steroidal anti-inflammatories for pain relief, Kaye warns. As opioid prescriptions have declined greatly in the wake of the opioid epidemic, many people turn to daily NSAIDS and think they are safe at any level, Kaye says. Not so, and he warns people of the GI bleeding risk with their use.

Look at surgery as a last resort, after trying the other avenues to relief, Chou says. “We think surgery should be reserved for people who aren’t improving or are severely impaired despite trying non-surgical [treatments].”

Your turn: Have you overcome an aching back problem? Share your best tips, please.

Kathleen Doheny is a Los Angeles-based independent journalist, specializing in health, behavior, fitness and lifestyle stories. Besides writing for Senior Planet, she reports for WebMD, Medscape, Psycom.net,  Practical Pain Management, and other sites.  She is a mom, mother-in-law and proud and happy Mimi who likes to hike, jog and shop.

Doheny photo: Shaun Newton

This article offered by Senior Planet and Older Adults Technology Services is for informational purposes only and is not intended to substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding any medical condition. If you think you may have a medical emergency call 911 immediately.