Despite hundreds of dollars in medical tests, they still don't know what's wrong with my low back. The X-rays show signs of moderate osteoarthritis in the lumbar spine. But the doc doesn't think that's what's causing the problem. I'm really frustrated. What do you recommend?
Low back pain can be a very complex and challenging problem. Most of the time, a clear and accurate diagnosis is impossible. As you have discovered, medical tests just can't pinpoint the exact cause. And that can be equally frustrating for the patient and for the physician. Sure there are degenerative changes present on X-rays or other imaging studies. Most often there are moderate (to even severe) signs of osteoarthritis, stenosis (narrowing of the spinal canal), and degenerative disc disease. But many people develop these problems without any symptoms whatsoever. Current beliefs are that just because there are radiographic signs of degeneration doesn't mean that's the source of the pain or other symptoms. That being said, it doesn't mean you can't get some help. Chronic back pain suffers often find relief through a combined program of education, postural changes, and exercise. Understanding your condition, especially how activities with too much bending or twisting can add to the stress on the spine is essential. A regular, daily routine of exercise is important to improve (and maintain) conditioning, flexibility, strength, and endurance. For some patients, lifestyle changes such as weight loss and quitting smoking (or other tobacco use) are necessary. Rest is acceptable for acute episodes of flare-ups. But with chronic low back pain, physical activity (stay active, keep moving) is a central key to improvement. Some studies have shown a benefit of acupuncture, massage, and cognitive-behavioral therapy. Combining two or more of these additional treatment approaches seems to help the most.