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Sanjita asked...

Severe lower back pain.

I have been suffering from severe lower centre back pain for almost 4 monthes. If I press on my buttocks even gently, I am in pain....the pain is unbearable on my back and is there 24/7. I do heat and ice packs. I have been to the Dr and have had a MRI but it is clear. My spine is very tender and painful to touch and I am in pain even on my shoulders and neck. Surely this is not normal?

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The answer

Mechanical low back pain is extremely common, with most people suffering from this problem at some point in their life. The majority of new onset low back pain will resolve within 6 weeks but unfortunately in some cases problems can go on for many months with a further risk that symptoms will recur sometime in the future. The key is to take action early by working with a physical therapist (physiotherapist, osteopath or chiropractor). 

It is important to maintain strength in the muscles which support the spine, otherwise abnormal spinal movements will occur, leading to a vicious cycle of pain and dysfunction. It is not uncommon for the entire spine to become uncomfortable as all parts are connected and will only move correctly when each level is working in harmony. Hands on physical treatment will release some of the muscle spasm associated with spinal pain but it is the home exercises and maintenance of good posture that will lead to further resolution of back pain. If you have pain or tingling which radiates into the buttock or down one leg, then this indicates that there is pressure on the nerve roots which exit from the lumbar spine. In this case it may take longer for symptoms to resolve but the same principles of encouraging good posture and muscle strengthening apply.  Pain control through the use of analgesics prescribed by your GP will also help. If you have pain radiating to the lower limbs, then nerve pain killing medications such as amitriptyline, gabapentin or pregabalin may be helpful. 

Acupuncture can also be very helpful in relieving back pain but this needs to be coupled with a physical therapy regime in order to get long term resolution.

Answered by Dr A Wright.


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