Chronic back pain is defined as pain which persists over twelve weeks, even after the initial trauma or the underlying cause of previously acute low back pain has received treatment. Where the back pain, sciatica or lumbago (as it sometimes called), lasts over a few weeks it is advisable to seek the advice of your GP to ensure that there are no serious underlying conditions causing the pain and discomfort. See back pain conditions above
If your pain is considered as chronic then your healthcare practitioner or GP will advise on painkillers and could recommend or prescribe treatments such as
- Manual therapy such as Physiotherapy, chiropractic, massage, or osteopathy found to be effective in manipulation, increasing mobility and muscle flexibility, and allowing the patient to continue their daily work or home routine. Here is a link to using LumbaCurve for back pain relief
- Exercise classes– a course of group exercise supervised classes to learn and practice exercises aimed at strengthening your muscles, improve posture, and providing back pain relief over time. It may include aerobics or stretching exercise through say yoga , pilates, or Alexander technique (although this method is not currently recognised or recommended by NICE)
- Acupuncture– in this treatment, fine needles are inserted at different points in the body known in traditional oriental medicine as energy meridians . It’s been demonstrated to help reduce lower back pain, although this treatment may not be available in all ares of the NHS in the UK.
Other treatments aimed at providing long term pain relief include:-
- Antidepressants -Here painkillers do not give relief, your specialist could prescribe you may be prescribed tricyclic antidepressants (TCAs), which were originally developed for the treatment of depression but have since been found to be effective in the treatment of some back pains.
- Psychological counselling – In cases where conventional physiological or medical treatments are ineffective, the patient could be referred for psychological counselling to help cope with the back condition, using such therapies as CBT (cognitive behavioural therapy), in an attempt to help the thought processes involved in dealing with the pain
- Pain clinics – A pain clinic referral could be made to help educate the individual about pain and to manage and cope with long term back pain which could involve group exercise, therapy, and relaxation classes
- Surgery – surgical intervention is used only as a very last resort where the back pain is so severe that this is considered the only course of action to alleviate it. This process is risky , with no guarantee that it will stop the pain. Dependent on the cause there are two main surgical procedures associated with spinal disorders:-
- Discectomy – sometimes known as a herniated, slipped, or prolapsed disc. Here part of the intra-vertebral disc located between the spinal segments is cut away or removed where it has herniated or bulged and is impinging on the adjacent nerves.
- Spinal fusion – surgery is carried to to fuse two or more vertebrae together to help stablise the spain in an attempt to reduce the pain.
Risks associated with any treatments should always be discussed with your specialist and understood.