In approximately 90% of cases the pain is temporary, in the rest it can be chronic.
Attention and intensive care are needed for those affected by back pain that lasts more than a month and a halfas they are at greater risk of back pain turning into chronic condition.
A recent review of studies found that people with acute and subacute low back pain experienced improvement in pain and difficulty within the first 6 weeks.
According to researchers, low back pain is considered an acute problem when it lasts less than 6 weeks. When back pain lasts 6 to 12 weeks it is considered a subacute condition. And when it exceeds 12 (reaching up to 52) it is persistent/chronic.
The review published in the Canadian Medical Association Journal. As the researchers report, there is a percentage of patients with subacute low back pain who recover very slowly. Since their symptoms are very likely to become chronic and not improve significantly over time, it is essential to identify them and intensify treatment to prevent this progression.
Back pain is a very common symptom. It is estimated that more than 600 million people worldwide experience it every year. The pain can originate in any structure of the lumbar spine, such as:
- Bone
- Joints
- Muscle
- Tendons
- Connections
- Nerves
Back pain can occur in people of any age. But it is more common between the ages of 30 and 50, especially in those who do not exercise regularly. And this is because in this case the muscles are not strong enough to be able to adequately support the spine.
The risk factors
As spine surgeon Dr. Konstantinos Starantzis, director of the Department of Spine and Scoliosis at the Athens Medical Center, explains, the most common causes of lower back pain are:
- Increased body weight
- Repeated lifting of heavy objects
- Bad posture
- Smoking (reduces blood flow to the intervertebral discs)
Genetics also plays an important role, explaining the onset of certain conditions, such as ankylosing spondylitis, he adds.
Sometimes, the pain is caused by a specific reason, such as an injury or condition (herniated disc, stenosis, osteoporosis, etc.). In most cases, however, it is non-specific, meaning the cause has not been clarified. It is often the result of simple effort.
The onset of low back pain varies from person to person and from case to case in the same patient. It can appear suddenly, after bad movement or poor posture or weight lifting, or gradually. Sometimes it is mild and tolerable, sometimes unbearable, says Dr. Starantzis.
Its regression also has a large temporal variation, from a few days to weeks, or much longer. Most patients recover within a few weeks. In about 90% of cases the pain is temporary. But 50% of people who suffer from low back pain will have a recurrence within a year.
Understanding the clinical course of low back pain is essential to identifying patients who are at risk of perpetuating pain so that they receive the correct treatment and advice.
Persistent/chronic back pain
The new review was based on 95 previous studies involving thousands of people with acute, subacute or persistent/chronic low back pain.
As the review showed, patients with persistent/chronic low back pain had high levels of pain and disability that improved little over time.
Most other patients began to improve within the first 6 weeks. However, a significant number of subjects with subacute low back pain had persistent pain and physical difficulties.
Identifying them and receiving more treatment is the goal of the study, in order to speed up their recovery and prevent low back pain from becoming a chronic problem.
How is it treated?
Nonspecific low back pain can be treated with conservative and invasive techniques. TO conservative treatment are included medicinesfor example:
- Nonsteroidal anti-inflammatory drugs taken orally
- Muscle relaxants and/or
- Local analgesics
Other methods of conservative treatment are rest (not immobility but limited activity) eh Heat. OR physical therapy it is useful both for recovering from an episode and for preventing relapses, because:
- Strengthens the back and abdominal muscles
- Improve flexibility
- Train the patient to stand and sit by aligning the body correctly so that the back is not subjected to strain
For pain that does not improve with conservative methods, they exist invasive techniques. They could happen spinal drug injections (intraforaminal, perineural, epidural). The injections aim to reduce swelling and inflammation of the spinal nerves, explains Dr. Starantzis.
Infusions are performed on an outpatient basis, without anesthesia, under radiological guidance. The duration of the procedure does not exceed 10 minutes in total. Repeating these injections is allowed for people who cannot undergo surgery, regardless of the reason. But there is a limit to the annual number.
In which patients is surgery recommended?
Patients with specific pain (i.e. when the cause is known) are treated in similar ways, but also have one other final option: surgery. This provides a permanent solution to the pain and daily self-care difficulties it causes. The type of operation depends on the condition.
The main thing, however, that those suffering from low back pain should keep in mind is that they shouldI to the specialized spine surgeon when the pain lasts more than two or three weeks. He will evaluate patients and perform clinical and imaging tests to determine the cause of the pain and recommend appropriate treatment.
“Early diagnosis can speed up definitive treatment and free them from repeated incidents that inevitably impact quality of life,” concludes Dr. Starantzis.