Most cases of back pain are caused by strain or sprain on the muscles and ligaments that support the back. A sedentary lifestyle and poor physical conditioning increase risk of muscle strain (stressing of the muscle). Sudden, forceful movements can cause a sprain or injury to a ligament. Obesity and smoking also increase the risk for back pain.
Low back pain is a common problem, affecting up to 90 percent of American adults at some point in their lives. Symptoms most commonly first appear between ages 30 and 50. Men and women are equally affected. It's the most common cause of work-related disability in the U.S., with treatments and lost work time costing as much as $50 billion annually.
Treating Back Pain
Most patients with back pain get better within a few days. Traditional therapy usually involves limited rest from activity, nonsteroidal anti-inflammatory medications, analgesics, and/or muscle relaxants. Hot or cold therapy, massage, and transcutaneous electrical stimulation may also be used. Patients sometimes choose other forms of therapy, such as spinal manipulation or acupuncture. Sometimes back pain is caused by spasms of the muscles in the back, often as a result of an underlying medical problem, such as a herniated disk or severe arthritis. Even when the underlying medical cause is found and treated, chronic muscle spasms can still cause pain. When traditional back pain measures don't work, doctors may turn to a drug called, BOTOX® (botulinum toxin A, based on the bacteria that cases food poisoning). When injected into the back, BOTOX causes a slight degree of temporary muscle paralysis, blocking the ability of the muscle to contract or remain in a spasm.
A study published last year in the journal, Neurology, compared injections of BOTOX against saline solution in patients with low back pain. The researchers found 86 percent of the BOTOX patients reported pain relief versus 31 percent of the saline group. Eight weeks after treatment, 60 percent of the BOTOX patients and less than 13 percent of saline patients had 50 percent or greater pain relief.
BOTOX is generally used when patients have failed to respond to traditional back pain therapy. The drug is toxic to the muscles and needs to be administered by a physician familiar with proper dosing and administration. Giving too high a dose can completely paralyze a muscle group and increase the risk for further pain. BOTOX is generally well tolerated, but can have side effects, such as pain at the injection site, nausea, and dizziness.
For general information on back pain: American Academy of Orthopaedic Surgeons, www.orthoinfo.aaos.org