Patient: On Saturday I helped pick up a push mower and when I turned my back popped and I was in terrible pain. It is on my right lower back and has some swelling and tenderness. I have severe leg pain and it is very painful to walk. I am having some muscle spasms. It is worse when I cough, laugh, or sneeze.. I have used a heating pad and bengay with no releif. I have also taken advil and ultram and it doesn’t help either. It is hard for me as a single mom to do my day to day activities. I also have fibromyalgia and some of the pain could be coming from that. I am wondering if this has to do with muscles or a disk????
Doctor: Due to the effort performed you most likely got a Mechanical low back pain (LBP) , which is the second most common reaso on for seeing a physician in the United States. Of the US population, 85% will experience an episode of mechanical LBP at some point during their lifetime. Fortunately, the LBP resolves for the vast majority within 2-4 weeks. Sometimes it may complicate with a persistent muscle contracture and/or a sciatic nerve inflammation and the healing process takes a little longer.The suggested conservative treatment would be: a physical therapy program aimed to: control the pain and the inflammatory process, relative rest, flexion and extension exercises of the spine to reduce the nerve tension, exercises that improve the muscular strength and endurance of lumbar muscles. The main goal of physical therapy in persons with post-traumatic acute back pain is not to increase strength but to achieve adequate pain control. Acetaminophen (“Tylenol”) remains one of the best first-line treatments of acute LBP. It is generally well tolerated, has few adverse effects or drug reactions with other medications, and is inexpensive. You can also try anti inflammatory drugs (“Aleve”) or the one that you are actually taken “Celebrex”. Also, try avoiding all the activities that produce pain or discomfort, such as weight lifting, keep a good posture at all times and sleeping with a pillow between the knees while lying on one side may increase comfort. Some doctors recommend lying on your back with a pillow under your knees. The back pain will improve within several days. Do not be discouraged if you don’t get a fast improvement. Almost everyone gets better within a month of onset of the pain if it is an uncomplicated mechanical lower back pain.