Understanding Chronic Low Back Pain

Chronic Low Back Pain

Although initially bed rest was thought to be the best treatment option for acute low back pain or LBP, recent research has shown that this advice is faulty. In fact, to prevent acute pain from becoming chronic, it’s recommended that patients actually start implementing activity. However, regardless of one’s best attempts, sometimes chronic LBP does occur. This article will explain how to best manage the pain in chronic LBP and what treatment options are available.

Less Invasive Treatment Methods

In some case, creams such as capsaicin can be applied topically for LBP when used in addition to ice and/or heat. Some treatment options for low back pain include assisted exercise therapy, chiropractic care, behavioral therapy,  and acupuncture. Depending on the patient’s particular condition and preferences, using several treatment options at once maybe the best approach for pain management.

Exercise for Low Back Pain

For many people, treatment for LBP can be costly and health care coverage is limited. In these cases, exercise may prove to be the best option since it costs little to nothing. Some exercises are especially designed to eliminate back pain and can be practiced daily at home.

Non-traditional Treatment Options

Some patients choose to go the non-traditional route and use treatment options that have not been fully investigated or tested by professionals. Some of these treatment options include facet joint, epidural injections, trigger point, lumbar supports, antidepressants, and muscle relaxants. While there is a lack of evidence proving that these methods provide actual relief, many people claim to find them helpful in their fight against LBP.

Testing for the Source of Pain

To best determine a treatment plan, doctors may choose to run tests to discover where the pain is originating. In some cases, more than one problem is causing pain, making it important to make sure that all issues are addressed. Doctors use injections of the facet or sacroiliac joints, x-rays, MRIs, and CT scans. These tests can help to determine the presence of arthritis, tumors, and fractures.

What Happens After Treatment?

After treatment, physical therapy is often useful to help patients return to normal living, retraining them to use normal motion, good posture, balance, and a regular walking pattern.

What About Extreme Cases?

While there are many treatment options that can help those who are suffering from LBP, sometimes these steps are unable to relieve pain, and patients find themselves unable to do every-day activities such as function, move normally, and sleep. When all other treatment options have been shown ineffective, it may be time for the patient to consider surgery. Surgery is only an option if the patient truly is in severe pain or experiencing a loss of strength in their muscles.

Patient Education: The Number One Key

The most important part of LBP treatment is educating patients about their condition. Too often, people attempt to fix serious problems such as a bulged or herniated disk with home remedies or by just trying to proceed with life as normal. Understanding their condition and treatment options can help those with LBP avoid surgery. Patients need to understand how weight loss, exercising, and smoking cessation can improve their chances of healing.

Chronic LBP is a challenging condition; however, there are lots of treatment options available. If you are suffering from LBP, education yourself about your condition and find out the best ways to receive help.


In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)


Complete tear of rectus femoris
with large hematoma (blood)


Separation of muscle ends due to tear elicited
on dynamic sonography examination

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