Acute attacks of low back pain commonly afflict young and middle-aged adults. They can occur with little warning, or can develop slowly over a number of days. In about half of these cases, no obvious trigger for he pain can be identified. The pain can be severe and temporarily disabling, and last for 10-14 days on average.

Lower Back Pain
Lower Back Pain

Causes

The causes of acute low back pain may include a fall or stumble, repeated heavy lifting, an awkward bend, prolonged bending and stooping, or a cough or sneeze. Occasionally it may occur suddenly, without any obvious cause, such as waking in the morning and finding it impossible to get out of bed. The actual physical causes of the pain are probably one of the following: acute dysfunction of a segment of the lumbar spine, lumbar disc internal disruption or herniation, irritation of a sciatic nerve, a sacroiliac strain, ligament strain or, very occasionally, a muscle strain. Accompanying muscle “spasm” is a common result of these strains, but is not the cause in itself.

Symptoms

The symptoms of acute low back pain are sharp pain, either centrally or to one side of your lower back, with an intense dull aching which can spread further into your buttocks, groin, and even thighs. Muscle spasm can grip your spine – known as “splinting” – causing immobility and stiffness; the pain may be worse with one or two particular movements such as bending forwards, backwards, or sideways, and you find it hard to sustain some positions, such as sitting, for long.

Risks and Complications

Normally, episodes of acute low back pain will resolve within a few weeks without the need for specific treatment, and the threat of any serious complications as a result of them is very small. The main risks are associated with resting for too long, which can cause stiffness. You may become fearful of any movement because of the memory of the initial pain or the idea that any pain caused by moving means further harm. Rarely, a disc strain can develop into cauda equina syndrome, when the disc prolapses or herniates fully into the spinal canal and damages the nerves that run into the legs, bladder, and bowels.

Treatment – Acute Lumbar Dysfunction

Immediate

  • If you suspect your pain is caused by acute lumbar dysfunction, you should:
    • take painkillers for the first few days of pain

Short Term

  • If after 3 days, you are still unable to move, you should:
    • seek medical attention.

Medium Term

  • If after 7-10 days you are not able to resume normal activities, you should:
    • consult a doctor for further treatment.

Long Term

  • If after 6-8 weeks you are not recovering as expected, your doctor may:
    • arrange investigations such as an X-ray, MRI or blood tests.

Treatment – Disc Herniation and Sciatica

Sciatica
Sciatica

Immediate

  • If you suspect your pain is caused by sciatica, you should:
    • consult a doctor for examination and diagnosis

Short Term

  • If the pain increases when you are upright, you should:
    • lie flat for short periods.

Medium Term

  • If after 7-10 days you are unable to resume normal activities, consult a doctor, who may:

Long Term

  • If after 6-8 weeks you are not recovering as expected, you should:
    • seek further advice from your doctor, who may arrange MRI.
  • If you have not responded to physiotherapy within 3 months, then:

Treatment – Sacroiliac Strain

Immediate

If you suspect your pain is caused by acute lumbar dysfunction, you should:

  • take painkillers for the first few days of pain

Short Term

  • If, after 3 days, the pain has not settled, you should:
    • consult a doctor

Medium Term

  • If, after several weeks, you are still unable to resume normal activities, you should:
    • consult your doctor for further examination, advice, or treatment.

Long Term

  • If, after 6-8 months, you still have recurring pain, you should:

Call +65 64712674 for an appointment to treat Acute Low Back Pain today. Same day appointment.

When the annulus – the cover around the disc – tears, pain may occur. The annulus has nerve fibres, unlike the nucleus. When a tear occurs in the annulus, you may feel pain in the neck or lower back and areas overlying and around the tear. Pain may also travel down the arm or leg as with a true disc herniation.

Although an annular tear may produce pain that is referred or travels from the neck to an arm or from the lower back to a leg, it can never produce weakness or numbness. Only compression of the root can do that. Annular tears usually heal inn two to three months. However, they can tear again and cause pain again. This phenomenon is part of chronic discogenic pain. Discogenic pain, to the extent it is understood arises from abnormalities within the disc iteself and has nothing to do with pain from a herniation, which occurs as a result of root compression by herniated disc.

Diagnosing Discogenic Pain

If an MRI shows a tear in the annulus or disc covering, usually coupled with other signs of disc degeneration.

Conservative Treatment of Discogenic Pain

Most people with annular tears recover with rest, pain medications, and a gradual resumption of normal activity. NSAIDs, muscle relaxants for spasm, and narcotics should be used as needed. Sometimes physiotherapy or epidural steroid injections may be used.

Most discogenic pain comes from an annular tear, although that may not be the whole story. Although there is no pressure on a spinal root in this condition, it does hurt. Activity reduction and lifestyle modification so as not to bear down – risking a further tear or a disc herniation through the tear – is important.

The vast majority of annular tears causing discogenic pain heal without difficulty. For those that don’t, there are several minimally interventional treatments presented below.

Epidural Steroid Injections

Besides acting on the swollen, inflamed nerves, the liquid in the steroid epidural injection also flushes away the chemicals produced by the annular tears that cause root inflammation and pain. Studies on epidurals show that they work well for a very small specific group of people, such as those under forty who have not previously has surgery or those with pain lasting less than three months. If used at all, epidural injections are most appropriate as a short-term treatment for those whose spine-related pain also travels or radiates down a leg or arm.

Key Points about Discogenic Back Pain

  • Discogenic back pain arises from abnormalities within the disc itself. It has nothing to do with pain from a herniation, which occurs as a result of root decompression by the herniated disc.
  • Most people with discogenic back pain recover with rest, pain-relieving medications, and other conservative treatment.
  • Epidural injections work well for short-term relief on some people with this type of pain.
  • There is no need surgery for most discogenic back pain.

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