The goal of lower-back-pain-management focuses on relieving the pain, correcting the cause of the pain and the prevention of complications.

Medications used for lower back pain include NSAIDs, which inhibit the synthesis and release of prostaglandins, a chemical substance in our body that causes inflammation and initiation of pain. The exact mechanism of analgesics is unknown, but these drugs are given in mild to moderate back pains, as they are thought to increase your pain threshold. To relieve muscle spasms, muscles relaxants are also included in the therapy. The more severe and intractable pains do not usually respond to analgesics, and so, an epidural steroid injection may be needed to bring about pain relief. Steroids decrease tissue inflammation and pain by suppressing the inflammatory responses in our body. Low doses of tricyclic antidepressants can alleviate chronic back pains by raising the level of the hormone endorphin. Endorphins cause the natural highs within the human body. A natural pain killer, it increases the pain threshold by inhibiting the pain sensation. Furthermore, TCAs do not only relieve back pain but improve sleep, as well.

Back pain is mostly treated conservatively. Ample rest, in addition to an exercise regimen focusing on strengthening and stretching of the back, abdominals and hips is recommended to decrease and prevent reoccurrences. Pain is also relieved by alternate cold – hot pack applications on the back. Deep heat therapy, or diathermy, ultrasonography, hydrotherapy, and transcutaneous electrical nerve stimulation (TENS) units are commonly used in conjunction with exercise regimen. These therapies have a basic principle of releasing muscle tension and encouraging muscle relaxation to achieve pain relief.

Surgeries are not usually performed for just typical back pains. An underlying pathological condition would usually suggest the need for surgery, if it causes severe and debilitating complications. In spinal fusions, two vertebrae are joined together to form a new bone to decrease painful spinal movements. In some cases of back pain associated to disc degeneration, the replacement of the disc is accomplished to maintain the integrity of the spine. A partial removal of the vertebra is also performed to release the compressed nerves, leaving a small passage to prevent them from being squeezed in by the bony growths.

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