Low Back Pain Treatments

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Strains, Sprains, and Spasms Treatments in Los Angeles and Orange County

According to Web.MD, almost everyone will have low back pain at one point in their lives. There are two major categories of low back pain, acute and chronic. Acute low back pain generally comes suddenly and can last days to weeks, rarely a couple months – but ultimately goes away and has no residual or lingering symptoms. Sometimes, this can be described as your “back going out.” Although this can resolve with rest and conservative care, we should be paying close attention if acute low back pain episodes are happening frequently. Chronic low back pain is defined as pain that continues in one way shape or form for longer than 3 months, and according to the NIH, about 20% of people with acute low back pain go on to develop chronic low back pain. 

What is it?

Acute or chronic low back pain can have many different causes, but some of the most common things that patients are told is that their pain is coming from a strain, sprain, or spasm. Strains and sprains are pulled muscles or ligaments respectively that can occur with an injury. A spasm can occur if the muscles are involuntarily cramping, twitching or freaking out because of an injury or repetitive stress. Although these words are commonly used to explain your low back pain, the truth is that strains, sprains, and spasms usually occur because of an underlying reason such as an injury to the disc, joints, or nerves  


Low back pain usually presents as pain… in the low back. BUT, pain from the low back can actually present in other areas such as the ribs, sides, hips, buttocks, pelvic floor or down the legs! Pain can be one-sided, both-sided, or even alternate sides. Symptoms can be sharp, shooting, dull, aching or cramping. Low back pain can be associated with other symptoms as well, including radiating pain, numbness, or tingling, weakness, or even bowel or bladder changes. Sudden weakness or bowel/bladder incontinence may be an emergency and warrants immediate medical attention. 


Since low back pain can come from many possible causes, if you have chronic low back pain or repetitive episodes of acute low back pain, then a thorough physical examination +/- analysis of advanced imaging is often necessary to determine exactly what is going on. It is important to note, however, that looking at an x-ray or MRI alone can NOT tell you the cause of your symptoms. In fact, it is extremely common to find things going on in imaging even in the absence of pain!

Dr. Shounuck Patel


It is an all too common myth that acute low back pain requires bed rest. In fact, there is research that shows that extended rest beyond a couple days can actually make the situation worse! With the exception of situations with red flags such as weakness or bowel/bladder incontinence, 1-2 days of relative rest is the most that is recommended and patients should otherwise get moving sooner than later. Ice or heat may be helpful, and we often recommend my patients stick with over the counter Tylenol – and avoid Non-Steroidal Anti-Inflammatory Drugs (NSAIDs such as ibuprofen) because they have extensive side effects and may interfere with healing. The most important (and in my honest opinion underutilized) treatments for low back pain include exercise guided by a physical therapist and anti-inflammatory nutrition. We often also incorporate hands-on therapy with Osteopathic Manipulation or referral to a trusted DO, Chiropractor or other manual therapist. Another complementary therapy that has supportive research is acupuncture. If needed, we use regenerative injection treatments to treat the whole Functional Spinal Unit.

Lower Back Pain

  • Degenerative Disc Disease

  • Arthritis

  • Stenosis

  • Disc Tear

  • Sciatica or Pinched Nerve, also known as Radiculitis or Radiculopathy

  • Disc Herniation 

  • Sacroiliac Joint Pain, Sprain or Dysfunction

  • Back Sprain, Strain or Spasm

  • Spondylolisthesis

Risks with Traditional Treatments

Unfortunately, it is less common that patients get the above, and more common that standard traditional treatment includes opioid pain medications, palliative short-term and risky cortisone injections, and then surgery. Although these options may actually be reasonable for specific situations, it is our belief that these treatments are used way too excessively and carry real risks.

A pain medication, for example, may be helpful for an acute low back injury, but should not be used long term. The opioid epidemic is a real thing – there should be no doubt that chronic opioid use can lead to addiction – but not enough people talk about the fact that opioid pain medications can also cause hypersensitivity to pain called opioid hyperalgesia. This means that patients that are taking opioid pain medications can actually feel more pain! 

Cortisone injection may be the correct choice for a young healthy patient in pain. But outside of a small set of patients, these only last for a short period of time and have significant side effects including hormonal changes and even decreased healing! For example, cortisone is known to increase blood sugar levels in diabetes, repeated or high doses of cortisone injections in post-menopausal females can actually cause osteoporosis that leads to osteoporotic fractures, and there are multiple reports of cortisone injections causing tissue damage. That said, cortisone should be used with caution. 

And finally, surgery may be absolutely necessary – especially when there are urgent situations such as progressive weakness or emergent situations such as bowel or bladder incontinence. However, any surgery – but especially for the spine – is not a small endeavor! Surgery carries real risks including chronic pain, worsening degeneration, paralysis and even death. While there are risks in every type of treatment, something as irreversible as surgery should be a last resort if possible. 


Dr. Shounuck Patel, DO is a leader in the field of orthopedic regenerative medicine.


Schedule a consultation

Get on a path to comprehensive healing and long-term pain relief today! Learn about how Dr. Patel can help heal your spine injury or cervical condition. We service Los Angeles County, Orange County and San Diego County. For more information contact our patient concierge at or call us at (310) 929-9790.

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