Back Pain Archive

Each year, several million people with neck or back pain get injections of anti-inflammatory steroid medications. When they work (they don’t always), such injections can bring profound relief. But injecting these medications into the spine can cause partial or total paralysis, brain damage, stroke, and even death. Case reports beginning in 2002 highlighted serious problems linked to spinal steroid injections. In 2014, the FDA started requiring a warning on the labels of injectable steroids. A Viewpoint article in this week’s Journal of the American Medical Association spotlights new safety recommendations to help prevent these rare but real problems. The new recommendations are part of the FDA’s Safe Use Initiative.

There's been a lot of research on what puts men at greater risk of back problems, like being overweight or sedentary. But we know less about what exactly triggers a bout of back pain. A new study in Arthritis Care and Research helps fill that gap.

The study involved 1,000 people who went to 300 different clinics in Australia with low back pain. The researchers carefully interviewed the participants to figure out when the back pain started and possible triggers they noticed within two hours of when the pain started.

Older adults with new back pain usually end up getting a CT scan or MRI. That’s often a waste of time and money and has little or no effect on the outcome, according to a new study from the University of Washington. The results of the study contradict current guidelines from the American College of Radiology. The guidelines say that it’s “appropriate” for doctors to order early MRIs for people ages 70 and older with new-onset back pain, and many doctors do just that. The study, which followed more than 5,200 men and women over the age of 65 who saw a primary care physician for a new bout of back pain, found that people who got early back scans did no better than those who didn’t have scans. The scans added about $1,400 per person to the overall cost of back pain care — with no measurable benefit.

Bed rest, once a key part of treating back pain, has a limited role in healing sore backs. In very small doses, bed rest can give you a break when standing or sitting causes severe pain. Too much may make back pain worse. Here is how to do bed rest "right."

To get the most from staying in bed, limit the time you are lying down to a few hours at a stretch, and for no longer than a day or two. You can rest on a bed or sofa, in any comfortable position. To ease the strain on your back, try putting pillows under your head and between your knees when lying on your side, under your knees when lying on your back, or under your hips when lying on your stomach. These positions reduce forces that sitting or standing impose on the back — especially on the discs, ligaments, and muscles.

It can reduce discomfort and get you back on your feet faster.

Chiropractic manipulation of the spine provides limited and short-term relief from back-related leg pain, reports a study in Annals of Internal Medicine. Shooting nerve pain in the legs, or sciatica, is a common problem for men with back pain related to spinal disc problems or narrowing of the space around the spinal cord (spinal stenosis).

Pain from ruptured discs and arthritis doesn't have to flatten you. There are a variety of ways to ease lower back pain discomfort and reduce disability, often without drugs.

Spinal problems are the price we pay for walking upright. Wear and tear on our backbones and the constant pull of gravity on our vertebrae take their toll over time. Nearly every adult has had a stiff or sore back at some time.

Try conservative measures first to control pain, and know the limits and risks of cortisone  shots if you choose to try it.

Most people who suffer with back pain already know the drill: time heals this wound. Over weeks to months, the pain will calm down, and you will slowly return to your normal life. In the meantime, try to stay as active as possible and rely as much as possible on over-the-counter pain relievers to help avoid needing cortisone shots. Doctors call these shots corticosteroid injections.

But for some, these conservative measures may not relieve the agony soon enough—especially if the problem is back pain caused by irritated spinal nerves. After a few weeks, just getting to the bathroom may start to feel like Napoleon's winter march in Russia. At that point, you may be offered a cortisone injection to calm the war zone in your lower back.

The first advice you are likely to get if you have low back pain is "take a Tylenol." However a study published July 24, 2014, online by the journal Lancet indicates that you might do just as well without Tylenol, Panadol, or any of the other pain relievers containing acetaminophen.

Acetaminophen has long been recommended as first-line treatment for low back pain, but there wasn't much research to indicate how well it worked