Rehab Your Back Injury With Swimming, Not Surgery

What Is Lower Back Pain?

Lower back pain (LBP) is a common problem among people. LBP is usually caused by some physical activity or another activity which causes pressure on the spine. Pressure on the spine may cause lumbar disc herniation, compression of nerves and blood vessels in the spine, nerve root irritation, muscle spasm, weakness and even paralysis of muscles around the area where pressure was placed on the vertebrae.

The most common types of LBP are:

Spinal stenosis – a narrowing of the spinal canal resulting from degenerative changes in the discs. Spondylolisthesis – a condition where one or both legs have fused together due to degenerative changes in the vertebral bodies.

Ankylosing spondylitis – a disease characterized by inflammation of the connective tissue between bones and soft tissues, causing progressive loss of strength and mobility in affected joints. Rheumatoid arthritis – a chronic inflammatory disorder of the joints and tendons, often affecting multiple joints.

How Does Lower Back Pain Affect You?

LBP affects different people differently. Some people experience low back pain only when they stand up straight; others do not feel any pain at all while walking down stairs or doing other activities requiring balance. Other people may suffer from LBP every day without experiencing any symptoms whatsoever.

Both men and women can experience lower back pain. It is also more common for people who do strenuous physical labor or people who have poor posture to suffer from back pain.

Contrary to popular belief, athletes are more likely to experience low back pain than non-athletes.

Fortunately, most cases of LBP are temporary and should resolve themselves within a few weeks or months. In some cases, however, the problem persists for years and may even lead to surgery.

For those who are suffering from LBP, it is important to see a doctor or to seek medical treatment as soon as possible. Ignoring the problem for an extended period of time may lead to more serious problems, such as spinal stenosis or cauda equina syndrome.

How Is Lower Back Pain Treated?

Non-Surgical Treatments

Most cases of LBP can be successfully treated without the aid of surgery. The first thing that a person should do when suffering from lower back pain is to rest.

This means taking it easy and not doing any strenuous physical activity (and that includes sports). In some cases, bed rest for a few days or even weeks is recommended.

Over-the-counter pain medication can also be taken to relieve pain and promote healing of the injured area. Heat therapy may also be used to soothe muscle spasms and promote blood flow to the spinal region.

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Some people may find relief from symptoms by applying an ice pack to the painful area.

Physiotherapy can also be used in the treatment of LBP. A trained therapist can instruct a person on proper body mechanics and how proper posture can help prevent future occurrences of back pain.

Some cases can benefit greatly from muscle strengthening exercises. Depending on the cause of the pain, a physiotherapist can prescribe a specific regimen of stretches and exercises that will help relieve symptoms.

Surgical Measures

In some cases, LBP persists even after non-surgical measures have been taken. In this case, surgery may be recommended to repair whatever is causing the pain.

If the problem is due to a herniated disc, removal of the protruding portion of the disc and fusing of the vertebrae may be recommended. Decompression of the spinal nerves may also be necessary to relieve pressure and prevent permanent nerve damage.

If one or more of the spinal bones (vertebrae) have shifted out of place, surgery can be performed to reposition them back into place. If the problem is due to a spinal bone that is too small or deformed, a fusion of the vertebrae may be necessary to prevent future occurrences of back pain.

Unfortunately, the success rate of surgery for lower back pain is relatively low. The reason why is somewhat uncertain, but potential complications such as infection and reaction to anesthesia are likely culprits.

Because of this, surgery should only be performed as a last resort when all other treatment measures have failed.

Surgical Treatments

The two most common surgical treatments for lower back pain are disc removal and spinal fusion. Disc removal is a procedure in which a herniated or degenerative disc is surgically removed from the spinal column.

Failed back syndrome, also known as Slapping spine, is a condition that causes the outer layer of an intervertebral disc to grow excessively and push against the spinal nerves. Herniated discs usually cause no symptoms, but in some cases can put pressure on nearby nerves and cause severe pain.

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A spinal fusion is a procedure in which two or more vertebrae are fused together. This prevents movement between the bones, which eliminates painful nerve compression caused by a bone pressing on a spinal nerve.

In some cases, a fusion is done only to alleviate pain and allow time for the patient’s back to strengthen. Other cases require the spinal fusion to be accompanied by a disc replacement, in which a artificial disc is implanted in place of the removed degenerated disc. Discectomy, in which part of the herniated disc is removed to relieve pressure on a nerve, is another form of spinal surgery.

Lumbar Discectomy

This procedure is performed when a patient has a herniated disc that is putting pressure on a nerve. The surgeon removes the portion of the degenerated or herniated disc that is pressing on the nerve.

In most cases, only a portion of the disc is surgically removed. After the surgery, the remaining disc space closes in on the nerve and causes leg pain similar to that of previous condition. In some cases, a lumbar fusion may be performed instead of or in addition to a discectomy.

Lumbar Fusion

Lumbar fusion involves removing a disc in your back and replacing it with bone graft from your pelvis, or synthetic material. The two levels adjacent to the disc that has been removed are then fused together.

Over time, this removes stability from that section of the spine and can increase the risk of spinal cord injury from trauma. This procedure is typically recommended when conservative treatment has failed and only when the patient is still experiencing significant pain.

In a healthy spine, there are no bones rubbing together, and there is free movement in all directions. In the case of scoliosis, one or more of the spinal bones (vertebrae) grow at a different rate than the rest and curve to the side.

A minor curvature of the spine is fairly common, but if the curve is too large, surgery may be necessary to correct it.

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There are three options for scoliosis surgery, according to the Scoliosis Rehabilitation Information website:

Scolioplasty is a procedure in which the spinal bones are fused together. A rod is also implanted to reinforce the spine and reduce the chance of a relapse.

The purpose of this surgery is to correct a major curve in the spine that has not responded to other treatment methods.

Kyphoplasty is a procedure in which a balloon is pushed into the spinal vertebrae to replace the collapsed portion. Then, a wedge-shaped piece of metal is placed behind the vertebrae and the balloon is inflated once more to push the vertebrae together and reinforce it.

Kyphoplasty is useful for correcting fractured vertebrae that cannot be treated with a normal rod. This treatment can be used alone or in combination with other surgical procedures.

In a spinal fusion, the surgeon removes any disc that may be herniated and then braces the two vertebrae to be fused together. The bones are then encouraged to grow together, or “fuse.” The advantage of this surgery is that it alleviates much of the stress on the lower back and it can often be performed using only small incisions.

A disadvantage is that a fusion can cause a loss in flexibility and range of motion.

Other surgical procedures are generally reserved as a last resort if there is an infection, cancer, or severe nerve damage. These may also include such things as the removal of part of a lung in the case of complications related to tuberculosis.

As technology and research progress, so do the medical treatments available to patients. One of the most recent developments is the field of regenerative medicine, which aims to regrow tissue rather than fix it.

Though still in its experimental stages, regenerative medicine has already proven to be effective for the treatment of burns and certain types of injury. As this field advances and is applied to other areas of medicine, more options will become available for patients.

Sources & references used in this article:

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Treat Your Back Without Surgery: The Best Nonsurgical Alternatives for Eliminating Back and Neck Pain by K Bak – Clinical Journal of Sport Medicine, 2010 – journals.lww.com

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The Rije by MI Hasenbring, H Plaas, B Fischbein… – European Journal of …, 2006 – Elsevier

Validity of serum creatine kinase as a measure of muscle injury produced by lumbar surgery by L Berger – 2014 – ancientmariners.org

Peripheral Nerve Injury by D Kumbhare, W Parkinson, B Dunlop – Clinical Spine Surgery, 2008 – journals.lww.com

Accelerated Recovery: How to Recover Your Body After Injury or Surgery by R Ward – 2015 – tbpi-group.org

Strategies for rehab after Achilles tendon surgery by J Powers