In both younger and older patients, vertebral fractures take weeks to heal with rest and pain relievers. Compression fractures of vertebrae associated with osteoporosis can also be treated with a procedure called vertebroplasty or kyphoplasty, which can help to reduce pain. In this procedure, a balloon is inflated in the compressed vertebra, often returning some of its lost height. Subsequently, a "cement" (methymethacrylate) is injected into the balloon and remains to retain the structure and height of the body of the vertebra. Pain is relieved as the height of the collapsed vertebra is restored.
Long periods of inactivity in bed are no longer recommended, as this treatment may actually slow recovery. Spinal manipulation for periods of up to one month has been found to be helpful in some patients who do not have signs of nerve irritation. Future injury is avoided by using back-protection techniques during activities and support devices as needed at home or work.
A few cancers in their early stages can be hard to tell apart from ordinary back pain — a bone cancer in the vertebrae, for instance — and these create a frustrating diagnostic problem. They are too rare for doctors to inflict cancer testing on every low back pain patient “just in case.” And yet the possibility cannot be dismissed, either! It’s an unsolveable problem.
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Following any period of prolonged inactivity, a regimen of low-impact exercises is advised. Speed walking, swimming, or stationary bike riding 30 minutes daily can increase muscle strength and flexibility. Yoga also can help stretch and strengthen muscles and improve posture. Consult a physician for a list of low-impact, age-appropriate exercises that are specifically targeted to strengthening lower back and abdominal muscles.
For those with pain localized to the lower back due to disc degeneration, fair evidence supports spinal fusion as equal to intensive physical therapy and slightly better than low-intensity nonsurgical measures. Fusion may be considered for those with low back pain from acquired displaced vertebra that does not improve with conservative treatment, although only a few of those who have spinal fusion experience good results. There are a number of different surgical procedures to achieve fusion, with no clear evidence of one being better than the others. Adding spinal implant devices during fusion increases the risks but provides no added improvement in pain or function.
If certain activities or overuse are causing hip pain, stop those that aggravate the discomfort and talk to your doctor. Excess weight can put pressure on the hip joint, so losing the pounds can provide relief and help you avoid further problems. Some causes of hip pain, such as fractures or hernias, may need surgical repairs. If your hip pain persists, talk to your doctor about the possible causes and treatments.
If low back pain gets worse or does not improve after two to three days of home treatment, contact a primary-care physician. The physician can evaluate the patient and perform a neurological exam in the office to determine which nerve root is being irritated, as well as rule out other serious medical conditions. If there are clear signs that the nerve root is being compressed, a physician can prescribe medications to relieve the pain, swelling and irritation; he or she also may recommend limitation of activities. If these treatment options do not provide relief within two weeks, it may be time to consider other diagnostic studies and possibly surgery.
Some of these red flags are much less red than others, especially depending on the circumstances. For instance, “weight loss” is common and often the sign of successful diet! (Well, at least temporarily successful, anyway. 😃) Obviously, if you know of a harmless reason why you have a red flag symptom, it isn’t really a red flag (duh!). But every single actual red flag — in combination with severe low back pain that’s been going on for several weeks — is definitely a good reason to get yourself checked out.
The hip is a common site of osteoarthritis. To help protect the hip joint from "wear and tear," it is important to strengthen the muscles that support it. Your hip also controls the position of your knee, and strengthening your hips may be one component of your rehab program for knee pain. Your physical therapist may also prescribe hip exercises after total hip replacement if you have a hip labrum tear or as part of your hip exercise program for hip pain.
The pain of back pain almost always makes it seem worse than it is. The most worrisome causes of back pain rarely cause severe pain, and many common problems (like slipped discs) are usually much less serious than people fear. Only about 1% of back pain is ominous, and even then it’s often still treatable. Most of the 1% are due to cancer, autoimmune disease, or spinal cord damage.
The big idea of classification-based cognitive functional therapy (CB-CFT or just CFT) is that most back pain has nothing to do with scary spinal problems and so the cycle of pain and disability can be broken by easing patient fears and anxieties. For this study, CFT was tried with 62 patients and compared to 59 who were treated with manual therapy and exercise. The CFT group did better: a 13-point boost on a 100-point disability scale, and 3 points on a 10-point pain scale. As the authors put it for BodyInMind.org, “Disabling back pain can change for the better with a different narrative and coping strategies.” These results aren’t proof that the confidence cure works, but they are promising.