Get Rid of Back Pain Once and For All Diabetics!

Summary

In this informative video, Dr. Ahmed Eran, an internist, discusses the common issue of low back pain, which affects many people. He explains that it can be categorized into acute, subacute, and chronic types, each with different causes and treatments. Dr. Eran emphasizes the importance of a holistic approach to diagnosis and treatment, considering both physical symptoms and psychosocial factors. He advises against routine imaging for nonspecific pain but recommends it for severe or progressive neurological issues. The video also covers various treatment options, including physical therapy, non-drug therapies, and when to consider surgery, highlighting the need for a comprehensive strategy to manage low back pain effectively.

Takeaways

• 😀 Low back pain is common and can be categorized into acute, subacute, and chronic based on duration.
• 🔍 Approximately 90% of patients with low back pain do not have a specific identifiable cause.
• 🏥 Common causes for those with identifiable reasons include spinal stenosis and compression fractures.
• 💊 Musculoskeletal issues, such as strains and posture-related aches, are typical for those without a clear cause.
• ⚠️ Serious conditions like cancer and infection, as well as visceral diseases, should be considered as potential causes of back pain.
• 🌿 A holistic approach to treating low back pain is essential, considering both physical symptoms and psychosocial factors.
• 👩‍⚕️ Doctors should perform thorough physical examinations to rule out serious underlying disorders.
• 🚫 Routine imaging within the first 6 weeks of nonspecific low back pain symptoms is generally not beneficial.
• 📈 Imaging is necessary when there are severe or progressive neurological issues, or if red flags are present.
• 🏋️‍♂️ Education and staying physically active are crucial for managing low back pain.
• 💊 Non-drug treatment options, such as physical therapy, heat, massage, and acupuncture, are recommended for acute pain.
• 🤔 Chronic low back pain may require a combination of exercise therapy, manual massage, and cognitive behavioral therapy.

Q & A

What are the three classifications of low back pain based on duration?

Low back pain can be classified into acute, subacute, and chronic based on how long it lasts.

What percentage of patients have low back pain without a specific cause?

Approximately 90% of patients have low back pain that doesn't have a specific cause.

What are some common causes for low back pain with a specific cause?

Common specific causes for low back pain include spinal stenosis, disc degeneration, and compression fractures.

What are some non-musculoskeletal causes of low back pain that should be remembered?

Non-musculoskeletal causes of low back pain can include cancer, infection, visceral diseases like organ diseases, kidney stones, and abdominal aortic aneurysms.

Why is a holistic approach important when dealing with low back pain?

A holistic approach is important because it considers not only physical symptoms but also psychosocial factors like stress, anxiety, and mental health issues that can impact how our bodies feel.

Why is routine imaging within the first 6 weeks of nonspecific low back pain not recommended?

Routine imaging within the first 6 weeks of nonspecific low back pain is not recommended because it does not improve outcomes and can lead to unnecessary and expensive interventions.

What are some situations where imaging is necessary for low back pain?

Imaging is necessary when there are suspicions of severe or progressive neurological issues, such as weakness or numbness in the limbs, or if there is a possibility of fractures, sacroiliitis, or cancer.

What is the role of education in treating low back pain?

Education is important in treating low back pain as it helps patients know what to expect, clear up misinformation, and encourages physical activity and avoiding bad rest.

What are some non-drug treatment options for acute low back pain?

Non-drug treatment options for acute low back pain include physical therapy, heat therapy, massage, acupuncture, and spinal manipulation therapy.

How does cognitive behavioral therapy play a role in treating chronic low back pain?

Cognitive behavioral therapy helps in treating chronic low back pain by addressing mental aspects of pain, such as pain tolerance differences and how mental states can affect the perception of pain.

What is the general advice on using nonsteroidal anti-inflammatory drugs (NSAIDs) for low back pain?

While NSAIDs are a first choice among pharmacological treatments for low back pain, they are not the best option and should be used with caution, considering alternatives and holistic approaches.

What are some alternatives to NSAIDs for managing low back pain?

Alternatives to NSAIDs for managing low back pain include muscle relaxants, some non-benzodiazepine medications, non-inhaled cannabinoids, and considering supplements like the Sugar MD joint support supplement.

When might surgery be considered for low back pain?

Surgery might be considered for low back pain in serious cases such as cauda equina syndrome, severe spinal stenosis, or stubborn chronic pain that does not respond to other treatments.

What is the general effectiveness of epidural steroid injections for low back pain?

Epidural steroid injections may provide a short-term boost for some patients with low back pain, but their long-term effectiveness is limited.

Why is it suggested to try holistic approaches before considering trigger point injections for low back pain?

It is suggested to try holistic approaches before trigger point injections because the relief from trigger point injections is generally short-lived, and relying on NSAIDs can mask the problem without addressing the underlying issue.

Outlines

00:00

😀 Understanding Low Back Pain

Dr. Ahmed Eran introduces the topic of low back pain, a common condition affecting many people. He explains that back pain can be categorized into acute, subacute, and chronic based on duration. The video discusses various causes of back pain, including muscular skeletal issues, spinal stenosis, disc degeneration, and compression fractures. It also mentions that some cases might be due to cancer or infection. Dr. Eran emphasizes the importance of a holistic approach, considering both physical and psychosocial factors such as stress and anxiety. He advises viewers to allow doctors to conduct thorough physical examinations to rule out serious underlying disorders.

05:01

🏥 When to Consider Imaging for Back Pain

Dr. Eran addresses the question of when imaging is necessary for low back pain. He advises against routine imaging within the first six weeks of symptoms, as it often doesn't improve outcomes and can lead to unnecessary interventions. Imaging abnormalities are common even in asymptomatic individuals. However, imaging is crucial if there are severe or progressive neurological issues, such as weakness or numbness in limbs. Plain radiographs can check for fractures, sacroiliitis, or cancer. MRI is recommended for strong suspicions of serious conditions. Dr. Eran also discusses the importance of recognizing persistent pain or worsening symptoms despite conservative treatments.

10:02

💪 Treatment Options for Low Back Pain

This section focuses on the treatment of low back pain, emphasizing the importance of education and physical activity. Dr. Eran advises against prolonged bed rest unless there are neurological symptoms. He discusses various non-drug treatment options, including physical therapy, heat, massage, acupuncture, and spinal manipulation therapy. For chronic pain, he suggests exercise therapy, manual massage, spinal mobilization, acupuncture, yoga, and interdisciplinary therapies. Cognitive behavioral therapy is also mentioned as a way to address the mental aspects of pain tolerance. Dr. Eran recommends a combination of different approaches for better long-term results and encourages viewers to explore alternatives to nonsteroidal anti-inflammatory drugs (NSAIDs).

15:03

🌿 Holistic Approaches and Surgical Considerations

Dr. Eran concludes the video by discussing holistic approaches to managing low back pain, suggesting the use of natural supplements like those offered by Sugar MD. He advises against relying solely on NSAIDs and encourages exploring alternatives. For chronic pain, he mentions non-benzodiazepine muscle relaxants and cannabinoids as potential treatments. Opioids are noted as less effective than non-opioid medications for chronic back pain. Dr. Eran also touches on the use of imaging for persistent pain and the potential need for surgical intervention in severe cases, such as spinal stenosis or disc herniation. He recommends considering holistic treatments and supplements before resorting to injections or surgery.

Keywords

💡Low back pain

Low back pain refers to discomfort or pain in the lower part of the back, typically below the ribs and above the gluteal muscles. In the video, it is the central theme, affecting nearly everyone at some point in their lives. The speaker discusses the classification of low back pain into acute, subacute, and chronic, and explores various causes and treatments, emphasizing the importance of a holistic approach to understanding and managing this condition.

💡Acute

Acute in the context of the video refers to a type of low back pain that is short-lived and typically lasts less than six weeks. It is one of the three classifications of back pain discussed, along with subacute and chronic. The term is used to differentiate the duration and potential treatment approaches for low back pain.

💡Subacute

Subacute is another classification of low back pain, which lasts longer than acute pain but less than chronic pain, typically between six weeks and three months. It is mentioned in the video to highlight the varying durations of back pain and how they might influence treatment strategies.

💡Chronic

Chronic low back pain is a persistent condition that lasts for more than three months. In the video, it is one of the three categories of back pain, along with acute and subacute. The speaker discusses various treatments and management strategies for chronic pain, emphasizing the need for long-term solutions.

💡Spinal stenosis

Spinal stenosis is a medical condition where the spinal canal narrows, potentially compressing the spinal cord and nerves. In the video, it is mentioned as one of the common causes of low back pain that has a specific identifiable cause, highlighting the importance of diagnosing and treating this condition in managing back pain.

💡Disc degeneration

Disc degeneration refers to the deterioration of the intervertebral discs, which are the shock-absorbing cushions between the vertebrae in the spine. The video mentions it as a potential cause of low back pain, indicating that structural changes in the spine can lead to discomfort.

💡Holistic approach

A holistic approach in the context of the video involves considering all aspects of a patient's health, including physical, psychological, and social factors, when treating low back pain. The speaker emphasizes the importance of this approach in understanding the full picture of a patient's condition and tailoring treatment accordingly.

💡Physical examination

Physical examination is a method used by doctors to assess a patient's health by observing, feeling, and manipulating various parts of the body. In the video, it is highlighted as crucial for diagnosing low back pain, as it helps rule out serious underlying disorders and informs treatment decisions.

💡Imaging

Imaging in the video refers to medical procedures like X-rays, MRI, or CT scans that create images of the body's internal structures. The speaker discusses the appropriate use of imaging in diagnosing low back pain, cautioning against routine imaging for nonspecific pain but recommending it for cases with neurological symptoms or severe pain.

💡Conservative treatments

Conservative treatments are non-surgical approaches to managing medical conditions, such as physical therapy, medications, and lifestyle changes. In the video, the speaker mentions conservative treatments as the first line of action for low back pain, suggesting that surgery should be considered only in severe or unresponsive cases.

💡Cognitive behavioral therapy

Cognitive behavioral therapy is a psychological treatment that helps patients understand and change thought patterns that lead to harmful behaviors or emotional distress. In the video, it is mentioned as a potential treatment for chronic low back pain, highlighting its role in managing pain perception and mental health factors.

Highlights

Low back pain can be categorized into acute, subacute, and chronic based on duration.

Approximately 90% of patients with low back pain do not have a specific cause.

Spinal stenosis and disc compression fractures are common causes for those with identifiable reasons for low back pain.

Musculoskeletal issues are typical for patients without a specific cause, involving strains and posture-related aches.

Cancer and infection can also be underlying causes of low back pain.

Visceral diseases, such as kidney stones and abdominal aortic aneurysms, can contribute to back pain.

A holistic approach is crucial for treating low back pain, considering both physical symptoms and psychosocial factors.

Stress, anxiety, and mental health issues can significantly impact how the body perceives back pain.

Avoiding work or physical activity due to back pain can be maladaptive coping mechanisms.

A thorough physical examination is essential to rule out serious underlying disorders causing back pain.

Routine imaging within the first 6 weeks of nonspecific low back pain symptoms does not improve outcomes.

Imaging abnormalities are common in people without symptoms and may lead to unnecessary interventions.

Imaging is necessary if severe or progressive neurological issues are suspected, such as weakness or numbness.

Conservative treatments should be attempted before considering imaging for persistent back pain over six weeks.

Education about low back pain is vital for patients to manage expectations and understand treatment options.

Staying physically active, even with back pain, is encouraged unless contraindicated by severe symptoms.

Checking for signs of depression is important as it can be related to back pain.

Non-drug treatment options such as physical therapy, heat, massage, and acupuncture are recommended for acute pain.

Spinal manipulation therapy shows promise in reducing pain and improving function for chronic low back pain.

Cognitive behavioral therapy can help understand and manage the mental aspects of pain perception.

Combining different treatment approaches often works better for long-term pain management.

NSAIDs are a first choice among pharmacological treatments for low back pain, but not the best option.

SugarMD joint support supplement is promoted as a natural, holistic approach to reducing back pain.

Surgical treatment is generally not necessary for low back pain unless there are severe underlying conditions.

Epidural shots may provide short-term relief but are not highly effective for long-term pain management.

Alternatives to NSAIDs should be explored, including supplements and non-benzodiazepine muscle relaxants.

Opioids are not as effective as other medications for chronic back pain and have more side effects.

Transcripts

hey there welcome back to our Channel I

am Dr Ahmed Eran I am an internist and

an anron list today we are talking about

something that affects nearly everyone

at some point in their lives which is

low back pain did you know that low back

pain can be classified into three

categories based on how long it lasts

well no-brainer acute Subacute chronic

low back pain can all have different

causes and treatments which we'll talk

about in fact approximately 90% of

patients have low back pain that doesn't

have a specific cause bummer but for

those that do spinal stenosis

discreation compression fractures are

the most common culprits now those

people we say don't have any cause

typically are muscular skeletal which is

just some strains and some typical aches

from posture Etc okay but cancer and

infection can also be common reasons

which can be important to remember also

visceral disease like organ diseases

kidney stones abdominal aortic Ander

isms could also be to blame so whether

you're dealing with back pain yourself

or just curious to learn because your

mama got it or your husband is

struggling with it keep watching for

some important insights when it comes to

dealing with lower back pain it is

important to take a holistic approach

you heard me right Dallas holistic MD

channel right we have to be holistic

it's not just about looking for physical

symptoms though but you also have to

consider psychosocial factors that could

be contributing to the problem now

things like stress anxiety and other

mental health issues can have a big

impact on how our bodies feel the same

goes for maladaptive coping mechanisms

like avoiding work or physical activity

alt together just because you have a

little back pain well if you don't

assess these factors as doctors I'm

talking to myself we might not get the

full picture of what's going on and if

doctors are watching it thanks for

watching I think that will help you too

that being said a thorough physical

examination is crucial so patients let

your doctors examine you when needed

okay they need to rule out some

important underlying disorders that

could be causing the pain like

discernation or Kaa uina syndrome you

know sounds fancy right it's a serious

problem that can leave you

paraplegic let's talk about Imaging so

for nonspecific low back pain shall we

right here's the deal a lot of people

ask for Imaging routine Imaging within

the first 6 weeks of symptoms does not

really make a difference in improving

outcomes it is true you see Imaging

abnormalities are pretty common in both

people like without any symptoms or

those who have non-specific lowback pain

if you imit someone you will find

something so discovering these

abnormalities might actually lead to

unnecessary and expensive interventions

yikes nobody wants that right and then

you get more complications now but don't

you worry my friends there are

situations where Imaging is totally

necessary you got to go for it if you

suspect severe or Progressive

neurological issues like weakness

numbness things like that going on in

your legs and or arms Etc that is

painful yeah and then you have a back

pain on top of that definitely that

could be sometimes life-threatening in

those cases plain radiograph can be

helpful to check for fractures which is

the most important thing you don't want

to miss that sacroiliitis which is an

inflammation in your pelvis area or or

cancer so if the suspicion is still

strong and MRI also should be your go to

choice and you can discuss that with

your doctor you're not going to order an

MRI for yourself but that's how it is

now listen up if you have been dealing

with that back pain for more than six

weeks without any red flax or if your

symptoms persist when I say red flax

they are the neurological symptoms right

or if your symptoms persist or worsen

despite trying conservative treat ments

or if you experience any neurological

symptoms like we discussed you know the

painful Sensations or numbness or dling

or problem with urination Etc or you may

not you may be incontinent you cannot

hold your urine or stool then you need

to talk to your doctor immediately

treatment let's talk about that when it

comes to treating low back pain

education is super important you need to

know what to expect help yourself

sometimes to clear up some

misinformation that you may have heard

online or from some friend or something

you need to encourage yourself to do

physical activity if it is possible so

if you can tolerate it stay Physically

Active even if you have a back pain it's

all about staying active avoiding bad

rest if your doctor is telling you go

rest in the bed change your doctor

so unless you know like I said you have

neurological symptoms you need the

hospitalization you need immediate

Imaging something serious going on I'm

not talking about this I'm just talking

about you wake up one day your back

hurts don't just say I'm calling day off

I'm going to stay in bed don't do that

okay let's not forget about checking for

signs of depression all right dealing

with that appropriately is important who

would say that depression can give back

pain right but now let's move on to the

fun part more treatments so let's say

you want treatment you can't take it we

have got both non-drug and Drug options

to consider here of course we like the

non-drug stuff right holistic stuff but

sometimes even surgery I mean if it

isn't really needed right but for acute

pain we might recommend things like

Physical Therapy although people like ah

I don't want to do that but it's super

important you can use Heat you can use

massage acupuncture all of these will

help but has to be done regularly not

like once a month every six months not

like that although to be honest you know

there's not a lot of evidence because

it's hard to do studies on those things

now on the other hand spinal

manipulation therapy shows some promise

in reducing pain and improving

function now when it comes to chronic

chronic chronic low back pain there are

a whole bunch of options

well there's actually exercise therapy

for that manual massage spinal

mobilization acupuncture yoga intensive

there's some interdisiplinary therapies

at physical therapy centers or even

cognitive behavioral therapy pain is

something very mental that's why we talk

about pain tolerance between people you

know one person is going to perceive the

pain very different than the other

person if you're depressed you're going

to perceive the pain a lot more than the

other person you're in a rush adal in

Rush you're doing some sports you may be

cut you may break a bone you may not

even realize because you're in a mental

state of like something totally

different you may not even feel the pain

that happens a lot to soldiers so that's

why cognitive behavioral therapy

discovering what is exaggerating the

pain is very important now I would say

combining different approaches seems to

work better in the long run so when it

comes to lowb pain don't expect miracles

just try things out stay consistent and

you'll be good now let's talk about

Imaging a little more we don't always

rush into that like I said unless we see

some red flags or pain has been going on

for more than 6 weeks with no

improvement whatsoever there are

neurological symptoms and if someone is

not fit for surgery Imaging might not be

as helpful because think about this I

mean you find something you know the

person is in the hospice already about

to die what do we need the Imaging for

right but let's talk about how to tackle

that back pain a little more there's

this thing called anets like your either

peren your Advil you heard of them

they're all over the place on TV they

advertised they're like candies they're

supposed to help with pain and

disability caused by low back pain but

guess

what they are not the best option at all

they're just the First Choice among

pharmacological treatments can you

believe that as a first choice but fear

not my friend there is something way

better out there and that's called sugar

MD joint support

supplement did you hear that it's like a

superhero for your back pain at Sugar

mds.com not only does it reduce your

Pain and Disability or it may I will say

I don't say I never say it will for

everyone but it may help with with some

pain it's a holistic approach but also

it may help reduce the amount of Nets

you use now I would say say goodbye to

popping pills and say hello to some

natural

goodness now if you're dealing with

chronic low back pain on a daily

basis the story is pretty much the same

so regardless you have the pain in for

two days or 10 weeks they're still going

to give you the same sorry my

language here but we talked about that

right there are other alternatives to

explore like for example there are some

non benzodiazapine muscle

relaxants which are if you know benaz

aines are like very depending form

medications and there's a medication

called theatine again I'm not a big

medication guy but sometimes these

medications as a lost Resort may help

and and delatin is one of them or simala

some of you will know with that name if

you are feeling a bit adventurous you

can actually even try some non- inhaled

cannabinoids although I cannot promise

you the long-term efficacy on this one

here's some juicy gossip for you too

opioids aren't all that cracked up to be

in fact in 2018 study showed that non

ofate medications were just as effective

Ive if not better in improving pain

related function for chronic back pain

plus they come with fewer side effects

so don't take a it if you can you know

what they say a picture is worth a

thousand words well in this case an

image might just be worth some answers I

mean Imaging so if your pain sticks

around for more than six weeks despite

trying other

treatments is that clear and if you

start experiencing neurological symptoms

it might be time to consider some

Imaging so if you're putting that doctor

off and your pain is sticking around six

weeks you start getting pain nous in

your

extremities see that doctor get your

Imaging but they will be able to examine

you they'll get the Imaging done and

hopefully nothing serious but you don't

want to miss something serious I would

finally suggest that if you can stay

away from end sets and explore some

Alternatives that will be your best bet

if you're looking for a sidekick on this

journey sugar MD join support supplement

that you can get at Sugar mds.com will

hopefully help you not a replacement to

your medical management but it's a good

holistic

approach so what about some surgical

treatment well most patients with low

back pain don't need to go under the

knife thankfully unless it's a serious

case of like Court compression or that

fancy sounding CA Acuna syndrome right

some people with tumors get that we

might consider surgery for those with

messed up nerves a worsening spinal

stenosis situation or some stubborn

chronic pain that is in the back

actually sometimes fixed by scal pills

procedures like disomy for he needed

discs

or the compressive laminotomy for spinal

stenosis they're on the menu your doctor

your orthopedician will decide on that

let's talk about those trendy epidural

shots the glucocorticoid shots well if

you're diabetic forget that but they may

be a popular choice for some pains and

stuff but honestly they only give you a

teeny tiny boost and only in the short

term not that impressive right right but

hey I would suggest use your holistic

approaches try the sug join support

supplement you will hopefully be happy

at the end of the day so you can give it

a shot to all these things before you

try the injections but sometimes trigger

point injections are necessary if the

pain is very stubborn so trigger point

injections can be actually okay because

they are not necessarily steroids they

are like combination of some Nets

Etc Liane and at some point you will

have relief but it's generally

shortlived but if you're an net junkie

like if you're popping Advils every day

you're just masing the problem you're

not fixing anything so don't fold for

them that's it for today if you want to

learn more sign up to my newsletter at

Sugar mds.com I will see you in the next

video

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