What is the natural history of low back pain?
The natural history of low back pain improves over a few days to one to two weeks. In fact, 90% of patients report that pain has subsided by two months without any intervention. However, 40% of patients develop significant recurrent symptoms within six months of the initial onset of symptoms. Fortunately, most recurrences are not disabling but may lead to chronic problems with intermittent episodes of exacerbation. Approximately 10% to 20% of patients who develop low back pain develop significant chronic low back pain which limits them.
Is bed rest a good treatment for back pain?
Traditionally, bed rest was the recommended treatment for back pain. However, recent studies show that bed rest is counterproductive and often detrimental as prolong bed rest results in de-conditioning of the back muscles. A person with back pain should remain as active as possible and try not to do activities that increase their pain in the acute phase of back pain and slowly build up muscles by doing regular exercise as directed by a physician or physical therapist.
Does smoking cause spine problems?
Yes, smoking accelerates disc degeneration. There are multifactorial reasons for disc degeneration, but none except the effect of smoking has been shown to accelerates disc degeneration in multiple studies. Also, smoking interferes with bony fusion and results in pseudoarthrosis, implant failure, and persistence of chronic back pain. Smoking causes blood vessels throughout the body to become smaller, reducing the amount of blood and thus oxygen and nutrients delivered to tissues. The discs are greatly affected since they already have a poor blood supply.