There are plenty of options for treatment of back pain

It has been a long winter for many people. Unless you live for winter sports, this time of year can be a challenge for many, especially with all the snow. One of the tasks we are burdened with here in the Northland is shoveling snow.

At least a few times every winter, snow shovelers come to the clinic with mechanical back pain, caused by injury to the muscles, discs, ligaments and tendons in the spinal area, often the result of overuse of the back, such as a long winter of shoveling. An overuse injury results from small repetitive micro traumas; one small event can cause the pain to suddenly appear.

Nearly everyone will experience an episode of mechanical back pain at some point in their life, and for many it can become recurrent.

There are certain signals of a more concerning problem with the back. If the pain is accompanied by fever, weight loss or loss of control of the bowel or urine, more aggressive and rapid medical work is required to determine if urgent intervention is needed.

Luckily, those cases are rare. The vast majority of back pain cases improve on their own.

After a back injury, the road to recovery can be slow. For some, it can be months or longer. For those who have not improved in six weeks, advanced imaging such as magnetic resonance imaging (MRI) can help determine if a surgical option should be considered.

Treatment of low back pain involves keeping the patient moving as much has possible. Studies show that prolonged rest makes the back worse and slows recovery.

Pain relief early in the course of treatment can provide comfort and allow for quicker return to activity. Ibuprofen and naproxen often can give good relief. Stronger pain medicines such as narcotics now play a very limited role in the management of back pain. They can help in the first few days, but beyond that they begin to cause harm and slow the return of function.

Physical therapy can be helpful early on in helping with pain and function, and is an opportunity to learn techniques to maintain good back health. Chiropractic manipulation can be helpful for people with acute or chronic back pain. Acupuncture has been shown to have a small benefit when added to other therapies. Massage may lead to good short-term outcomes for low back pain, and there is good evidence of yoga’s short- and long-term effectiveness on chronic low back pain.

Surgery can be considered for those having had disabling pain for many months. The outcomes for surgery are not significantly different for those treated with surgery vs. those treated conservatively two years out from surgery. It is important to have clear indications for surgery to ensure a good outcome.

Back pain is common, but there are good treatment options for acute and chronic back pain. The vast majority of episodes resolve without much intervention. There are many helpful things a person can do to help keep their back in good condition.

And it looks like we may be able to put our shovels away soon.

Dr. Ken Ripp is a family medicine physician at the Raiter Clinic in Cloquet.