Things to Think About before You Think About Surgery

Lifestyle Issues

Have you done all you can to give your back a chance? There is a lot of helpful advice available from many sources but areas to think about include:

1. Getting your weight down. Being overweight overloads the back and makes back pain more likely and more of a problem.
2. Lead a less sedentary life. Our backs are meant to be mobile. Sitting at a desk all day is not good for structures such as the intervertebral discs and leads to deconditioning of muscles and ligaments in the back.
3. Improve your level of activity. Regular exercise helps in so many ways. The discs and joints in the back generally respond well to movement and moderate exercise will help improve the muscles which are vital for support of the back. The increased activity will help get your weight down too if this is a problem.
4. Stop smoking. As if there weren't enough reasons to kick the habit, smoking accelerates degeneration of the discs in the lower back and increases your susceptibility to back problems.

Strengthening Your Back

1. Pilates Exercises. These include a number of exercises specific to the lower back and can be very helpful.
2. Physiotherapy. It is often useful to have guidance and advice on back exercises and physiotherapists with experience in dealing with low back problems have considerable expertise in this area. Hydrotherapy (a form of physiotherapy undertaken in water) may be particularly beneficial early on, especially in the acute phase of a back pain episode. Core stability work is vital and other techniques, after a careful and detailed assessment, can make a real difference.

Managing Pain

1. Medication. Tablets may not be a solution in the long term but analgesics (such as paracetamol) and anti-inflammatories (such as ibuprofen or voltarol) can be very useful in helping to bring acute symptoms of back pain under control. The two in combination can be particularly useful, but ensure that you keep to recommended doses. Anti-inflammatories can cause certain adverse effects and may not be tolerated by some people. They should always be taken with food. Muscle relaxants can be helpful too in acute episodes of back pain but generally should not be continued for more than a few days.
2. Acupuncture. A good proportion of people find acupuncture helpful in acute back pain and some physiotherapists will include acupuncture among the treatments they offer.
3. Balancing rest and mobilisation. Long periods of bed rest tend to be counter-productive, adding to muscle deconditioning and vulnerability as well as leading to back stiffness. When hit by an acute episode try and get moving as soon as you can and certainly within a couple of days.

If back pain remains a significant and intrusive problem despite allowing a reasonable period for things to settle and attending to these issues as far as you can, then perhaps it is time to explore the possibility of surgical treatment.

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