If you or someone you love is suffering from back pain, you understand the search for an answer for the resolution of the pain. The search can go on year after year, as relief is sought.

Back pain sufferers have surely tried many different treatment options like supplements, painkillers, anti-inflammatories, antidepressants, massage, manipulation, and possibly even surgery. But are these the best treatments for lower back pain?
<h2>Why Do These Common Treatments Fail to Give Relief?</h2>
<img class="alignright wp-image-5729" src="https://www.drfields.com/wp-content/uploads/2023/03/DDD-Treatment-2-500x419.png" alt="Best Treatments for Low Back Pain" width="300" height="251" />Unfortunately, these common treatments for back pain do not address the real problem. Sure, they may address pain or they may address inflammation, but pain and inflammation are symptoms of the underlying problem. What is the root cause of the pain and inflammation?

Very often, the underlying problem causing back pain is instability. Instability in the back occurs when the ligaments connecting bone to bone become injured. Once ligaments are injured, they become more lax or loose. With this laxness comes abnormal motion in the joints.

You've probably noticed that for many people, back pain comes and goes. Back pain may be worse on some days and better on others. And when back pain is chronic, it continually comes back. Why does the pain always come back? If the underlying problem of the instability is not addressed, then the pain medications and anti-inflammatories are only touching the symptoms of pain and inflammation. They do not repair the instability and abnormal motion in the vertebrae.
<h2>What About Pain Medications?</h2>
Care for chronic low back pain is often very frustrating to both clinicians and patients. It's frustrating because the commonly used treatments come up short. The Journal of Orthopaedic Surgery and Research says this, <em>"The benefits are just not there to justify the routine prolonged use of any given drug in nonspecific chronic low back pain: this is a major challenge, and it is often hard to accept for clinicians and patients . . . ”(1)</em><em> </em>

There is also a subset of patients that have been prescribed narcotic pain relievers. Do these help long-term? The Journal of Osteopathic Medicine says,<em> "Long-term opioid use (more than 12 months) patients had a worse disability, physical function, fatigue, and other pain-related problems including the earlier onset of sleep disturbance."(2) </em>As you can see, opioids do not help long-term, but rather increase disability.
<h2>When Physical Therapy or Manipulation Aren't Working</h2>
Physical therapy and chiropractic manipulation are great treatment modalities and effective in many cases of back pain. However, if after the recommended treatments, the back pain is still an issue, then ligament injury should be looked into, and Regenerative Orthopedics sought.
<h2>What Can Repair the Abnormal Motion or Instability?</h2>
Regenerative Orthopedic treatments repair the underlying damage to the ligaments and any involved tendons. These injured soft tissue naturally have a poor blood supply. But Regenerative Orthopedics boost the blood supply to the ligaments. This increased blood supply helps the body to heal and repair. The result? The back is strengthening, the abnormal  joint motion is stabilized, and the back pain sufferer experiences decreased pain and increased function!
<h2>But I Have Disc Problems, What About That?</h2>
Even if you have disc problems, the underlying problem can very likely be instability. The injured ligaments allow for abnormal motion in the vertebrae and increase problems with the discs. Spinal ligament damage is at the core of the problem.

In degenerative disc disease, the disc height increases, and the lax ligaments loose tension. The vertebrae move even more, and the lack of stabilization increases pain at the discs and other spinal joint structures.

In many instances, the common underlying low back pain complaints, including arthritis and loss of spinal curve, are in large part due to ligament injury. Instability in the spine is at the root of most chronic spinal pain.<em>  </em>
<h2>The Most Common Cause of Unresolved Back Pain is Spinal Instability</h2>
Muscles are one of the stabilizing structures of the spine. If injury in the back is muscular, common treatments will address the pain. The spine is also held together and stabilized by the intervertebral discs, and the surrounding ligaments.

When these common treatments do not solve the problem of low back pain, underlying ligament damage and spinal instability need to be addressed. And the best treatment for back pain due to ligament damage is Regenerative Orthopedics.
<h2>Regenerative Orthopedics Resolves the Underlying Problem</h2>
Over time, after a traumatic injury has occurred, the ligaments will start to elongate and become loose and lax. Physically demanding activities or even sedentary postures can lead to this gradual loosening over time. Muscle spasms will develop because of these elongated ligaments. Swelling may occur, and eventually arthritis will develop as the body attempts to stabilize the area by the creation of bone spurs.

Regenerative Orthopedics strengthen the ligaments of the spine and prevent further degeneration. Prolotherapy is a type of Regenerative Orthopedics. In the J<em>ournal of Prolotherapy</em> researchers say, “<em>In comparison to other soft tissues, ligaments have less vascularity. Once injured or degenerated, this lack of blood supply may delay healing. Prolotherapy may offer the stimulus for ligament regeneration."(3)</em>

The <em>Journal of Back and Musculoskeletal Rehabilitation</em> concluded, <em>“Prolotherapy can be regarded as a safe way of providing a meaningful improvement in pain and musculoskeletal function compared to the initial status. ...5% dextrose is a more simple and painless solution for Prolotherapy and also has a high success.”(4)</em>

Remember, when back pain is an issue, the muscles may be in spasm because they are overcompensating for the injured ligaments as they try to stabilize the spine. Regenerative Orthopedics are the best treatment to repair the ligaments and get to the root of the back pain problem. Additionally, in cases of degenerative disc disease, Prolotherapy tightens the ligamentous structures and limits the abnormal vertebral motion, reducing the incidence of discogenic low back pain by improving stability.
<h3>References</h3>
(1)Migliorini F, Maffulli N. Choosing the appropriate pharmacotherapy for nonspecific chronic low back pain. Journal of Orthopaedic Surgery and Research. 2022 Dec;17(1):1-3.

(2)Schultz MJ, Licciardone JC. The effect of long-term opioid use on back-specific disability and health-related quality of life in patients with chronic low back pain. Journal of Osteopathic Medicine. 2022 Aug 11.

(3)Inklebarger J, Petrides S, Prolotherapy for Lumbar Segmental Instability Associated with Degenerative Disc Disease. Journal of Prolotherapy. 2016;8:e971-e977.

(4)Solmaz I, Orscelik A, Koroglu O. Modified prolotherapy by 5% dextrose: Two years experiences of a traditional and complementary medicine practice center in Turkey. Journal of Back and Musculoskeletal Rehabilitation. 2021(Preprint):1-8.