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Low back pain can be classified into acute, subacute, and chronic categories. Most cases of low back pain have no specific cause, but spinal stenosis, disc herniation, and compression fractures are common culprits. Physical symptoms and psychosocial factors should be considered when treating low back pain. Routine imaging within the first six weeks of symptoms is not necessary unless there are severe or progressive neurological issues. Education, physical activity, and non-drug treatments such as physical therapy, heat therapy, and acupuncture can help manage low back pain. NSAIDs are not the best option, and alternative treatments like the Sugar MD joint support supplement can be beneficial. Chronic low back pain can be treated with non-benzodiazepine muscle relaxants, duloxetine, or non-inhaled cannabinoids. Opioids are not recommended due to their side effects. Imaging may be necessary for further evaluation if pain persists. hey there welcome back to our channel i am dr ahmed ergin i am an internist and an ethnologist today we are talking about something that affects nearly everyone at some point in their lives which is low back pain did you know that low back pain can be classified into three categories based on how long it lasts well no-brainer acute subacute chronic low back pain can all have different causes and treatments which we'll talk about in fact approximately 90 of patients have low back pain that doesn't have a specific cause bummer but for those that do spinal stenosis disc herniation and compression fractures are the most common culprits now those people we say don't have any cause typically are musculoskeletal which is just some strains and some typical aches from posture etc okay but cancer and infection can also be common reasons which can be important to remember also visceral disease like organ diseases kidney stones abdominal aortic aneurysms could also be the plane to blame so whether you're dealing with back pain yourself or just curious to learn because your mama got it or your husband is struggling with it keep watching for some important insights when it comes to dealing with low back pain it is important to take a holistic approach you heard me right now it's holistic md channel right you have to be holistic it's not just about looking for physical symptoms though but you also have to consider psychosocial factors that could be contributing to the problem now things like stress anxiety and other mental health issues can have a big impact on how our bodies feel the same goes for maladaptive coping mechanisms like avoiding work or physical activity all together just because you have a little back pain well if you don't assess these factors as doctors i'm talking to myself we might not get the full picture of what's going on and if doctors are watching it thanks for watching i think that will help you too that being said that the real physical examination is crucial so patients let your doctors examine you when needed okay they need to rule out some important underlying disorders that could be causing the pain like disc herniation or cauda equina syndrome yeah sounds fancy right it's a serious problem that can leave you paraplegic let's talk about imaging so for non-specific low back pain shall we right here's the deal a lot of people ask for imaging routine imaging within the first six weeks of symptoms does not really make a difference in improving outcomes it is true you see imaging abnormalities are pretty common in both people like without any symptoms or those who have non-specific low back pain if you emit someone you will find something so discovering these abnormalities might actually lead to unnecessary and expensive interventions yikes nobody wants that right and then you get more complications now but don't you worry my friends there are situations where imaging is totally necessary you got to go for it if you suspect severe or progressive neurological issues like weakness numbness things like that going on your legs and or arms etc that is painful yeah and then you have a back pain on top of that definitely that could be sometimes life-threatening in those cases plain radiograph can be helpful to check for fractures which is the most important thing you don't want to miss that sacroiliitis which is an inflammation in your pelvis area or or cancer so if the suspicion is still strong an mri also should be your go-to choice and you can discuss that with your doctor you're not going to order an mri for yourself but that's how it is now listen up if you've been dealing with that back pain for more than six weeks without any red flags or if your symptoms persist when i say red flags are they are the neurological symptoms right or if your symptoms persist or worsen despite trying conservative treatments or if you experience any neurological symptoms like we discussed you know the painful sensations or numbness or tingling or problem with urination etc or you may not you may be incontinent you cannot hold your urine or stool then you need to talk to your doctor immediately it will be worth it believe me especially if you're not uh fit for invasive procedures um you know you need to get that taken care of like immediately so if by the way cancel that last sentence just remove that last two sentence treatment let's talk about that when it comes to treating low back pain education is super important you need to know what to expect help yourself sometimes to clear up some misinformation that you may have heard online or from some friend or something you need to encourage yourself to do physical activity if it is possible so if you can tolerate it stay physically active even if you have a back pain it's all about staying active avoiding bed rest if your doctor is telling you go rest in the bed change your doctor so unless you know like i said you have neurological symptoms you need a hospitalization you need immediate imaging something serious going on i'm not talking about this i'm talking about you wake up one day your back hurts don't just say i'm calling day off i'm gonna stay in bed don't do that okay let's not forget about checking for signs of depression all right dealing with that appropriately is important who would say that depression can give back pain right but now let's move on to the fun part more treatments so let's say you want treatment you can't take it we have got both non-drug and drug options to consider here of course we like the non-drug stuff right holistic stuff but sometimes even surgery i mean if it isn't really needed right but for acute pain we might recommend things like physical therapy although people like i don't do that but super important you can use heat you can use massage or acupuncture all of these will help but it has to be done regularly not like once a month every six months not like that although to be honest you know there's not a lot of evidence because it's hard to do studies on those things now on the other hand spinal manipulation therapy shows some promise in reducing pain and improving function now when it comes to chronic chronic chronic low back pain there are a whole bunch of options well there's actually exercise therapy for that manual massage spinal mobilization acupuncture yoga intensive there's some interdisciplinary therapies at physical therapy centers or even cognitive behavioral therapy pain is something very mental that's why we talk about pain tolerance between people you know one person is going to perceive the pain very different than the other person if you're depressed you're going to perceive the pain a lot more than the other person you're in a rush i don't know in russia and doing some sports you may be cut you may break a bone you may not even realize because you're in a mental state of like something totally different you may not even feel the pain it happens a lot to soldiers now so that's why cognitive behavioral therapy discovering what is exaggerating the pain is very important now i would say combining different approaches seems to work better in the long run so when it comes to low back pain don't expect miracles just try things out stay consistent and you'll be good now let's talk about imaging a little more you don't always rush into that like i said unless we see some red flags or pain has been going on for more than six weeks with no improvement whatsoever there are neurological symptoms and if someone is not fit for surgery imaging might not be as helpful because think about this i mean you find something you know the person is in the hospice already about to die what do we need the imaging for right but let's talk about how to tackle that back pain a little more there's this thing called NSAIDs like your ibuprofen your advil you heard of them they're all over the place on tv they advertise it they're like candies they're supposed to help with pain and disability caused by a low back pain but guess what they are not the best option at all you are just they're just the first choice among pharmacological treatments can you believe that the first choice but fear not my friend there is something way better out there and that's called sugar md joint support supplement did you hear that it's like a superhero for your back pain at sugarmds.com not only does it reduce your pain and disability uh or it may i will say i don't say i never say it will for everyone but it may help with with some pain it's a holistic approach but also it may help reduce the amount of NSAIDs you use now i would say say goodbye to popping pills and say hello to some natural goodness now if you're dealing with chronic low back pain on a daily basis the story is pretty story is pretty much the same so regardless you have the pain in for two days or 10 weeks they're still gonna give you the same shit sorry my language here but we talked about that right don't lose hope there are other alternatives to explore like for example there are some non-benzodiazepine muscle relaxants which are if you know benzodiazepines are like very depending forming medications there's a medication called duloxetine again i'm not a big medication guy but sometimes these medications as a loss resort may help and duloxetine is one of them or cymbalta some of you will know with that name if you are feeling a bit adventurous you can actually even try some non-inhaled cannabinoids although i cannot promise you the long-term efficacy on this one here's some juicy gossip for you too opioids aren't all that cracked up to be in fact in 2018 studies show that medications were just as effective if not better in improving pain-related function for chronic back pain plus they come with fewer side effects so don't take opioids if you can you know what they say a picture is worth a thousand words well in this case an image might just be worth some answers i mean imaging so if your pain sticks around for more than six weeks despite trying other treatments is that clear and if you start experiencing neurological symptoms it might be time to consider some imaging so if you're putting that doctor off and your pain is sticking around six weeks you start getting pain numbness in your extremities see that doctor get your imaging but they will be able to examine you they'll get the imaging done and hopefully nothing serious but you don't want to miss something serious there's always hope for a pain can't cancel that that's that was stupid i would finally suggest that if you can't stay away from NSAIDs and explore some alternatives that will be your best bet if you're looking for a sidekick on this journey sugar md joint support supplement that you can get at sugar mds.com will hopefully help you another replacement to your medical management but it's a good holistic approach so what about some sort of so what about some surgical treatment now most patients with low back pain don't need to go under the knife thankfully unless it's a serious case of like cord compression or that fancy sounding cauda acuna syndrome right some people with tumors get that we might consider surgery for those with messed up nerves and worsening spinal stenosis situation or some stubborn chronic pain that is in the back actually sometimes fixed by scalpels procedures like this cactomy for herniated discs or or decompressive luminoctomy for spinal stenosis they're on the menu your doctor your orthopedician will decide on that let's talk about those trendy epidural shots the glucocorticoid shots well if you're diabetic forget that but they may be a popular choice for some pains and stuff but honestly they only give you a teeny tiny boost and only in the short term not that impressive right but hey i would suggest use your holistic approaches try the sugar md joint support supplement you will hopefully be happy at the end of the day so you can give it a shot to all these things before you try the injections but sometimes trigger point injections are necessary if the pain is very stubborn so trigger point injections can be actually okay because they are not necessarily steroids they are like combination of some NSAIDs etc lidocaine and at some point you will have relief but it's generally short-lived but if you're an NSAID junkie like if you're popping edibles every day you're just masking the problem you're not fixing anything so don't fall for them that's it for today if you want to learn more sign up to my newsletter at sugarmds.com i will see you in the next video
