Stretch #5 Hip Flexor Stretch
Building off of the concept of posterior chain it is important to consider the anterior chain as well.
Deficits in strength and flexibility can lead to several issues and lower back pain is most commonly coupled with weak and tight hip flexors. The hip flexors are the iliacus and psoas muscles. They are primarily responsible for lifting the femur into flexion .
When the pelvis is tilted forward through sitting, poor exercise technique, etc. there is a higher likelihood that the hip flexors will be in a shortened position as they attach to the lower spine and inside of the pelvis.
Over time this can cause weakness and tightness and encourage lower back pain. Fixing this issue at home takes time, but can be done through a hip flexor stretch.
Kneeling on the ground with the front foot put far out in front of you lunge forward while keeping your trunk over your hips and head up. The stretch will occur in the front of the thigh and hip toward the medial part of the leg that you are kneeling on. Hold this stretch for 30 seconds breathing in and out then switch to the other leg.
Diagnosis Of Lower Back Pain
Your physiotherapist or GP will usually be able to diagnose lower back pain from your symptoms and by examining you. Theyll want to rule out whether theres any underlying problem that could be causing your pain.
Your physiotherapist or GP will ask you lots of questions about your back pain. These may include when it started, how bad it is and if theres anything that makes it better or worse. They may press against your back to see if theres any tenderness and check for any deformities. They might ask you to move around too, to see if you have problems bending or extending your back.
Usually, further tests wont help. But if your symptoms indicate an underlying problem, your GP may recommend tests including:
- an X-ray
They may also refer you to a specialist for further investigations.
How Long Does Lower Back Pain Usually Last
Lower back pain can be categorized as acute, subacute or chronic. Acute episodes of lower back pain usually last from a few days to 4 weeks and subacute lower back pain lasts between 4 to 12 weeks. However, according to the National Institutes of Health, about 20 percent of people with acute back pain go on to develop chronic back paindefined as pain that lasts 12 weeks or longer. Even in these cases, there are many different treatment options to help relieve lower back pain symptoms.
When your back is really killing you, you might worry something is seriously wrong. The same goes for back pain that seems unending. The good news is that while back pain is a major inconvenience, it is rarely an urgent medical issue. In fact, most of the time you dont have to treat it. Back pain usually resolves on its own unless you have a major underlying issue.
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Find Activities That Make You Happy
Ongoing back pain can wreak havoc on your life, affecting your cherished relationships, finances, and your ability to get stuff done at work and at home. Finding activities that make you happy can help reduce some stress and may relieve some pain.
Some people find that even doing just 3 things that make them feel good each daysuch as enjoying a comforting cup of tea or coffee, calling an old friend, walking the dog, or receiving a longish 30-second hug from a loved onecan make pain more tolerable.
Even something as simple as laughter with a friend may stimulate feel-good endorphins.1, 2
What Are The Symptoms Of Back Spasms
A back spasm may feel mild like a dull ache or twitch, or it can get so sharp and painful that its debilitating.
If you experience any of the following symptoms in addition to back spasms, you should see your healthcare provider right away:
- Loss of bladder or bowel control.
- Muscle weakness in arms or legs.
- Odd sensations, numbness or weakness on one side of your body.
- Loss of balance and coordination.
- Loss of a sense of feeling in a limb/limbs.
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Treatment Options For Lower Back Pain
If you see a physiotherapist or GP for lower back pain, they will probably encourage you to try the self-help measures outlined above first. They can also advise you on what exercises you can do to help your back, or may refer you to a group exercise programme. But if your pain doesnt improve, they may be able to recommend other options you can try. They can also refer you to a specialist if necessary.
How Is Back Pain Treated
You can do several things to manage back pain. A conversation with your doctor or physiotherapist can help address any concerns you may have and help you to better understand your treatment. Remember that not all information is trustworthy, so let your healthcare team know about treatments you are considering before you begin them.
Ways to manage back pain include the following:
Strong pain medication is not recommended for back pain. Research shows strong pain medication provides little benefit and can cause side effects such as drowsiness, sedation and/or dependence.
If you have severe back pain and your current medication is not adequately managing it, talk to your doctor about a suitable treatment plan. In some cases, your doctor may suggest an injection that can numb the pain such as an epidural injection, or a surgical procedure, such as a laminectomy to help manage your pain.
There are many other treatments to manage back pain, but they have not been well proven. These include:
- herbal medicines
- laser therapy
- heat and cold therapy
FIND A HEALTH SERVICE The Service Finder can help you find doctors, pharmacies, hospitals and other health services.
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What Is Upper Back Pain
Upper back pain occurs anywhere from the base of your neck to the bottom of your rib cage. Your upper and middle back is called the thoracic spine. Your thoracic spine has 12 small bones called vertebrae. Your vertebrae form your backbone.
Each of the vertebrae on your thoracic spine is connected to a pair of ribs. Your ribs wrap around your body to a long, flat bone down the center of your chest called the sternum. This forms your rib cage.
Your upper back also has disks that separate each vertebrae. These disks absorb shock as you move. There are also many muscles and ligaments in your upper back that hold your spine together. Upper back pain may be caused by many different medical issues or injuries to the bones, disks, muscles and ligaments in your upper back.
Upper back pain is not as common as neck pain or low back pain. This is because the bones in the upper area of your back don’t move or flex as much as the bones in your neck and lower back. The bones in your upper back work with the ribs to keep the back stable. They work together to help protect vital organs in your body including your heart and lungs.
How Are Back Spasms Evaluated And Diagnosed
After talking to you about your symptoms and getting a list of your medications, your healthcare provider may ask about your entire medical history. Be sure to mention any trauma to your back. Your provider may diagnose your back spasms based on the symptoms you describe.
Which healthcare providers evaluate and diagnose back spasms?
You can see your primary healthcare provider about your back spasms. If needed, they may send you to a specialist.
What questions might a healthcare provider ask to help diagnose back spasms?
- What does the pain feel like?
- Where is the pain located?
- Have you ever loss control of your bowel or bladder?
- How long do the spasms last?
- How often do you have back spasms?
- Any stiffness?
- Do you get any tingling or numbness in your body?
- Do you ever feel weak or uncoordinated when youre having back spasms?
- What medications are you taking?
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Prevention Of Lower Back Pain
Looking after your back can help to reduce your risk of getting back pain. It can help to do the following.
- Get plenty of exercise. Keeping active with regular exercise can help to prevent back pain coming back, or reduce your risk of getting it in the first place.
- Take care with lifting and carrying heavy items. Dont lift or carry more than you can manage, and make sure youre using the right technique. This means slightly bending your back, knees and hips when lifting, rather than stooping from your back.
- Keep a good posture. If you work at a desk, make sure your chair, desk and computer screen are set up correctly. Your employer should be able to assess your workstation.
- Move regularly dont sit in the same position for long periods of time.
What Are Some Other Causes Of Lower Back Pain
The shape of your spine, and well as spinal diseases, are other culprits in lower back pain. Depending on a range of factors, your doctor may look for:
Abnormal spinal curvature. A normal spine resembles a gently curved letter S when seen from the side. Abnormal curves include:
Lordosis, in which the spine curves too far inward at the lower back
Kyphosis, in which the spine is abnormally rounded in the upper back
, in which the spine curves from side to side, often in a C shape
Normal and abnormal curves of the spine
Arthritis. There are more than 100 types of arthritis, many of which can cause lower back pain. The most common types include osteoarthritis , , and .
. Compression of the bundle of nerves that forms below the spinal cord in the lumbar spine. It is a rare but serious disorder that requires immediate medical attention and possibly emergency surgery. CES got its name from the fact that the fanned-out bundle of nerves resembles the base of a horses tail.
. Both infections of discs and bone can cause severe pain and require prompt medical attention.
. Your bones lose mass faster than it can be replaced, making them brittle. They can even fracture with little or no warning. These fractures are especially common in the spine, where they’re called vertebral compression fractures. Both men and women lose bone mass as they age, but postmenopausal women lose it much faster and so are more at risk for osteoporosis.
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What Are The Most Important Prognostic Indicators For Chronicity
Early identification of patients with low back pain at risk for long term disability and sick leave is theoretically and practically important because early and specific interventions may be developed and used in this subgroup of patients. This is of special importance because recovery for people who develop chronic low back pain and disability is increasingly less likely the longer the problems persist.
The transition from acute to chronic low back pain seems complicated, and many individual, psychosocial, and workplace associated factors may play a part. In this respect, increasing evidence indicates the importance of psychosocial factors.w7 A recently published systematic review of prospective cohort studies found that distress, depressive mood, and somatisation are associated with an increased risk of chronic low back pain.13
Table 1 shows a list of individual, psychosocial, and occupational factors, which have been identified as risk factors either for the occurrence of low back pain or for the development of chronicity. Yellow flags have been developed for the identification of patients at risk of chronic pain and disability. A screening instrument based on these yellow flags has been validated for use in clinical practice.14 The predictive value of the yellow flags and the screening instrument need to be further evaluated in clinical practice and research.
When Should I Go To The Emergency Department
Back spasms are sometimes a symptom of a serious condition. See your healthcare provider right away if you also experience:
- Loss of bladder or bowel control.
- Muscle weakness in arms or legs.
- Odd sensations or numbness or weakness on one side of your body.
- Loss of balance and coordination.
- Loss of a sense of feeling in a limb/limbs.
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What Causes Back Spasms
There are a number of possible causes for back spasms:
- Not using your muscles enough. If you sit too much, have poor posture, dont exercise or rarely use your back or stomach muscles, those muscles can get weak and spasm.
- Using your muscles too much. Athletes and those who do a lot of heavy lifting may experience back spasms. Such activities can cause a muscle strain, which is a tear, and that can cause inflammation.
- Dietary issues. Back spasms can be caused by too little water, potassium and/or calcium in your diet.
- Mental/emotional health issues. Anxiety and stress can tense up your muscles.
- Trauma. You may injure your back in a fall or car accident.
Sometimes, your back spasms may mean that you have a serious condition, including:
- Epidural abscess.
Symptoms Of Back Pain
Back pain can range from local pain in a specific spot to generalized pain spreading all over the back. Sometimes the pain radiates away from the back to other areas of your body, such as the buttocks, legs, or abdomen. The intensity of back pain varies for each person. Depending on the type, cause, and location of your back pain, you may experience:
- Increasing pain with lifting and bending.
- Worsening pain when resting, sitting, or standing.
- Back pain that comes and goes.
- Stiffness in the morning when awakening and lessened back pain with activity.
- Pain that radiates away from the back into the buttocks, leg, or hip.
You should see a doctor if your pain does not improve after a few weeks or if any of the following symptoms happen with your back pain:
- Numbness and tingling.
- Severe back pain that does not improve with medication .
- Back pain after a fall or injury.
- Back pain along with:
- Weakness, pain, or numbness in your legs.
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Inhale Slowly And Deeply For A Count Of 5 Seconds Pause 1 Second And Exhale 3
Visualization will help by imagining a tight knot being unraveled as you inhale. Picture the muscles extending as you inhale to stretch your rib cage fully.
As the muscles are contracting intensely, they are also over contracting, making it counter-productive.
Since you have already stopped moving, you are now trying to shut off the muscles need also to do this. Breathing deeply is key to relaxing a muscle which is becoming progressively shorter and more painful.
As you try to relax, avoid any movements that allow the muscle to shorten
Because of the intensity, duration and source of the injury, it is natural to react and to contract your body further. Even unwillingly.
To avoid this, focus on slowly inhaling while at the same time minimizing your movements. When in contraction, the reduced circulation and the build up of lactic acid makes you feel much worse.
How Effective Are Conservative Treatments In Chronic Low Back Pain
That exercise and intensive multidisciplinary pain treatment programmes are effective for chronic low back pain is supported by strong evidence. Some evidence supports the effectiveness of behaviour therapy, analgesics, antidepressants, nonsteroidal anti-inflammatory drugs, and back schools and spinal manipulation. No evidence supports using other interventions . For most effective treatments, the effects are usually only small and short term. Unfortunately, many commonly used interventions lack sufficient evidence for clinically relevant long term effects.4
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Need Help For Chronic Pain We Got Your Back
Anytime youre experiencing back pain that lasts longer than two weeks with no improvement, we strongly recommend you seek care.
If you think you need care right away, you can also go to your nearest orthopedic urgent care location.
If you have a new injury or you dont think youre ready for an intensive program like TRIA Neck and Back Strengthening Program, a great place to start is to find a physical therapy location and make an appointment. Our physical therapists will tailor strengthening and mobility exercises to your unique needs, and you can plan on about six visits.
But if youre experiencing yet another chronic back pain flare up, home remedies and short-term treatments alone wont provide lasting relief. While chronic pain is long-lasting, it doesnt have to be permanent and you probably dont need surgery. And thats where the TRIA Neck and Back Strengthening Program spinal strengthening program might be able to help.
So, if youre ready to find a better way to manage and heal your back pain, schedule an in-person or video visit consultation with TRIA Neck and Back Strengthening Program today.
Is TRIA Neck and Back Strengthening Program right for you? Schedule a consultation appointment.
Chronic Or Acute Pain
- Acute pain starts suddenly and lasts for up to 6 weeks.
- Chronic or long-term pain develops over a longer period, lasts for over 3 months, and causes ongoing problems.
If a person has both occasional bouts of more intense pain and fairly continuous mild back pain, it can be hard for a doctor to determine whether they have acute or chronic back pain.
Back pain usually resolves with rest and home remedies, but sometimes medical treatment is necessary.
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One Back Pain Treatment You Probably Dont Need
Back pain can be incredibly frustrating, and going under the knife may seem like the quickest, easiest fix to bring relief. But the truth is, many people dont need surgery for lower back pain management, Dr. Park says.
If your back pain is musculoskeletal, you will not require surgery, but if its a pinched nerve thats due to a disc herniation or something else, you may need to have surgery, he says. But even in those people, when you go through a six-to-eight-week course of treatment that includes physical therapy and activity modification, 85 to 90 percent of the time, they wont need surgery.
However, if you try the treatments above and dont see any improvement or still feel pain, talk to your doctor about a referral to a pain management specialist, as more specific tests or treatments may be required to get to the bottom of whats going on.
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