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Annie asked...

I have chronic lower back pain.

I`m a chronic lower back pain sufferer and the nhs has basically told me there is nothing they can do other than physio, i've had this probably since 2000 due to job I have done. I`ve done Tens therapy, Cortison injection and all sorts of pills but the doctors keep sending me home in tears, saying nothing can be done. I'm in so much pain I can't do anything and I was always so active, friends called me roadrunner. I just want to get back to work and not sit on benefits until I retire, i'm only 37.

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The answer

Low back pain is by far the single commonest cause for time off work and long term disability. There are a variety of reasons why back problems start e.g. poor posture, heavy repetitive lifting or twisting, falls or injuries.

On average a simple back sprain will settle down over six weeks but there are a proportion of back pain patients who will go on to struggle with long term symptoms. The most important aspect of treatment is to try to maintain the muscle structures which support the spine and pelvis. Encouraging some movement of the spine is essential to help prevent further deterioration in the vicious cycle of weakness and chronic spinal dysfunction. 

Physiotherapists, osteopaths and chiropractors would be able to advise as to the best regime to suit your particular symptoms and make changes as necessary if a particular aspect of an exercise is not helping. For those who suffer with referred pain down into the buttock or legs, spinal epidural therapy can sometimes help in the short term and can allow patients to start mobilising again.

Occasionally spinal surgery may be necessary for those who have more severe leg nerve root symptoms but this will only help resolve the leg symptoms and not the low back pain. It is important not to give up trying to encourage movement as this may be the one thing that helps prevent a further deterioration. Acupuncture and analgesic medication can also be helpful in relieving pain but needs to be followed by exercise therapy to get the longer term benefits.

Answered by Dr A Wright.


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