*a Note On The Methods For This Installment Of Show Me The Evidence
Theres a mountain of research on low back pain. So I zeroed in on the highest-quality evidence: systematic reviews. These are syntheses of the research evidence that bring together all the highest-quality studies to come to more fully supported conclusions.
I found the Agency for Healthcare Research and Quality , a federal agency that crunches the best available data on the effectiveness of health care interventions and had recently published a comprehensive 800-page systematic review of research on noninvasive treatments for low back pain. The AHRQ review covered 156 of the best back pain studies from 2008 to April 2015. I then searched for low back painrelated systematic reviews on PubMed Health, the government search engine that specializes in systematic reviews and meta-analyses, to cover the recent period left out of the AHRQ review .
To make sure I wasnt missing anything, I consulted the chronic and acute low back pain articles on UpToDate, , the Cochrane Library of systematic reviews, and guidelines.gov, and sometimes followed the footnotes in these reviews to other studies. Ramins book Crookedwas also an excellent source for thinking on back pain. Finally, I conducted interviews with nine back pain doctors and researchers, including authors of many of the systematic reviews referenced here.
Correction: A previous version of this article referred to John Sarnos medical specialty as psychiatry. Instead, it was rehabilitation medicine.
Soothing Yoga Poses For Lower Back Pain
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Don’t Rest An Achy Back
Doctors used to prescribe bed rest for back pain. But now we know that lying still is one of the worst things you can do. It can make back pain worse and lead to other complications. Don’t rest for more than a day or two. It’s important to get up and slowly start moving again. Exercise has been found to be one of the most effective ways to relieve back pain quickly. Try swimming, walking, or yoga.
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Quick Relief And Prevention
Chronic upper back and neck pain can become a very serious problem. However, some general soreness in your back and neck area is quite common. There are a few measures you can take for quick relief when this discomfort arises, and some things you can do to try to prevent it altogether.
Use a cold pack and anti-inflammatory pain relief for the first three days after the pain starts. After that, alternate applying heat and cold to your injury. Upper back and neck pain usually erupt suddenly, but healing can take a long time. If youre still in pain and your movement is limited after a month, its time to see your doctor.
Is Your Job Causing Back Pain
A job that involves pulling, lifting, or twisting with the low back can cause injury and low back pain. Even prolonged sitting in an awkward position can cause low back pain. Standing on your feet for hours on end? That can cause lower back pain too. The best way to prevent back pain is to know if you are at risk.
Jobs That Can Cause Lower Back Pain
- Airline crew
- Surgeons
- Office personnel
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We Need Make Our Default Choices More Back
Theres a pretty simple adage public health officials stick to: Make it easy for people to stay healthy, and make it hard for them to get sick.
When it comes to back pain in America, we make it easy for people to get sick and hard for them to stay healthy.
Theres a complete disconnect between what insurance providers will cover for people and what actually helps their back pain. Its still much easier to get your opioids or back surgery paid for by your insurance provider than to get a massage or exercise program reimbursed.
More states need to move in the direction of places like Oregon, where insurance payers are making the default options for people with back pain healthier by expanding access to, and coverage for, non-drug options.
For example, the Oregon Health Plan has ensured that alternatives like acupuncture and physical therapy are covered. Its also expanded access to treatment for the behavioral health factors that are associated with back pain by paying primary care clinics extra to be able to hire behavioral health specialists and meet patients who may not have had access to those services. Finally, its opened non-medication pain clinics, where people with low back pain can get a range of treatments as well as help to taper off their opioid prescriptions.
How Your Back Works
The spine, which is also called the backbone or spinal column, is one of the strongest parts of the body and gives us a great deal of flexibility and strength.
Its made up of 24 bones, known as vertebrae, one sitting on top of the other. These bones have discs in between and lots of strong ligaments and muscles around them for support. There are also the bones in the tailbone at the bottom of the back, which are fused together and have no discs in between.
On either side of the spine, running from top to bottom, are many small joints called the facet joints.
The spinal cord passes inside the vertebrae, which protect it.
The spinal cord connects to the brain through the base of the skull and to the rest of the body by nerves that pass through spaces between the bones of the spine. These nerves are also known as nerve roots.
As you grow older, the structures of your spine, such as the joints, discs and ligaments, age as well. The structures remain strong but its usual for your back to get stiffer as you get older.
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Where Can I Get More Information
For more information on neurological disorders or research programs funded by the National Institute of Neurological Disorders and Stroke, contact the Institute’s Brain Resources and Information Network at:
Office of Communications and Public LiaisonNational Institute of Neurological Disorders and StrokeNational Institutes of HealthBethesda, MD 20892
NINDS health-related material is provided for information purposes only and does not necessarily represent endorsement by or an official position of the National Institute of Neurological Disorders and Stroke or any other Federal agency. Advice on the treatment or care of an individual patient should be obtained through consultation with a physician who has examined that patient or is familiar with that patient’s medical history.
All NINDS-prepared information is in the public domain and may be freely copied. Credit to the NINDS or the NIH is appreciated.
Tired Of Training Clients At 5 Am
We all have to pay our dues. For many fitness pros, that means training clients or teaching classes or opening your gym long before the sun comes up.
But if youve been paying those dues for years on end, maybe its time for a change. Time to try something different. Time to consider another way to make a living while still doing what you love.
Thats why we created the Online Trainer Academy.
Since 2016, weve helped thousands of personal trainers, nutrition coaches, and gym ownersserious, passionate fitness professionals like youlaunch online training businesses.
Some now do all their coaching online. Others do a combination of in-person and online training. Still others work part-time with online clients to supplement their income from another business.
They all have one thing in common: What they were doing before wasnt working for them.
They needed a change, and their Online Trainer Academy Level 1 Certification gave them the knowledge and skills to make it happen.
If you love coaching but hate doing it on someone elses schedule, maybe its time to try online training.
Consider this your wake-up call.
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Home Remedies For Fast Back Pain Relief
Back pain is a common problem that can interfere with a persons work and personal life. Fortunately, many home remedies exist to help relieve bothersome back pain.
Lower back pain is a widespread problem, causing more global disability than any other condition. Up to 80 percent of adults will experience low back pain at least once in their lives.
People can also experience pain in other areas of the back, including the middle and upper back.
The back muscles and spine support much of the bodys weight. A person uses the muscles for everyday movements, including sitting, standing, and walking.
Over-the-counter pain medications, such as ibuprofen or acetaminophen, may help relieve pain. For those who wish to try home remedies, some of the following treatments might help:
Workouts That Can Cause Low Back Pain
Most athletic injuries to the back are sprains of the ligaments or strains of the muscles surrounding the spine. Serious conditions or complications can have similar symptoms to those of a routine sprain or strain. The most common sports injuries occur after repetitive overuse of the spine either through twisting, compression, or flexion. High impact sports such as running, football, or volleyball can often cause low back pain. Sports like golf, in which repetitive twisting is often involved, can also cause low back pain.
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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.
Stay updated on the latest science-backed health, fitness, and nutrition news by signing up for the Prevention.com newsletter here.
Low Back Pain Symptoms: Does Your Back Hurt
Low back pain symptoms range from sharp and stabbing to a dull ache. The pains can be constant or intermittent and positional. Acute low back pain can appear suddenly after injury. Chronic back pain is defined as pain lasting more than three months. Consult a doctor if you have prolonged back pain longer than 72 hours.
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What Are Some Complementary Alternative And Emerging Treatments For Lower Back Pain
In some cases, doctors suggest therapies that are not considered standard of care. They probably wont be covered by insurance, but they may be worth considering. Examples include:
Platelet-rich plasma . PRP treatments use a small sample of your own blood that has concentrated amounts of blood building blocks known as platelets. Your doctor then injects the PRP directly into a damaged disc. The theory is that PRP injections use your own healing system to accelerate improvement of injured tendons, ligaments, muscles, and joints. PRP treatment has a longer track record in knee osteoarthritis, but a recent review article in the Journal of Spine Surgery suggests it may have a useful role for back pain, too. PRP needs a lot more research before it can be considered a proven technique.
Stem cells. In this emerging treatment, your doctor injects stem cells harvested from your hip into the intervertebral disc or discs causing your pain. Doing so may lessen pain and the degenerative effects of aging, though, like PRP, more research is needed before stem cells for lower back pain could eventually become the standard of care.
Acupuncture. Your doctor probably doesnt perform acupuncture , but may support you trying it as a complementary therapy. Acupuncture involves careful insertion of fine, sterile needles into specific points on your body. This may stimulate the release of your natural pain-killing chemicals.
Low Back Pain Fact Sheet
If you have had lower back pain, you are not alone. Back pain is one of most common reasons people see a doctor or miss days at work. Even school-age children can have back pain.
Back pain can range in intensity from a dull, constant ache to a sudden, sharp or shooting pain. It can begin suddenly as a result of an accident or by lifting something heavy, or it can develop over time as we age. Getting too little exercise followed by a strenuous workout also can cause back pain.
There are two types of back pain:
- Acute, or short-term back pain lasts a few days to a few weeks. Most low back pain is acute. It tends to resolve on its own within a few days with self-care and there is no residual loss of function. In some cases a few months are required for the symptoms to disappear.
- Chronic back pain is defined as pain that continues for 12 weeks or longer, even after an initial injury or underlying cause of acute low back pain has been treated. About 20 percent of people affected by acute low back pain develop chronic low back pain with persistent symptoms at one year. Even if pain persists, it does not always mean there is a medically serious underlying cause or one that can be easily identified and treated. In some cases, treatment successfully relieves chronic low back pain, but in other cases pain continues despite medical and surgical treatment.
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What Are The Symptoms Of Mechanical Back Pain
Most people with mechanical back pain experience pain primarily in their lower back. The pain may radiate to your buttocks and thighs. Many people may also experience spasms with mechanical back pain. The symptoms of mechanical back pain are generally more noticeable with flexion of the back and when lifting heavy objects.
Yoga Pilates And Tai Chi Seem To Help But Its Not Clear That Theyre Any Better Than Other Exercise
Theres lots of research on back pain and yoga. Not all of it is high-quality, but taken together, the evidence pretty uniformly suggests yoga can both decrease pain and improve back-related function.
The most recent Cochrane systematic review on yoga and chronic low back pain, published in 2017, sums up the results of the best available studies, which mostly focused on the Iyengar, Hatha, or Viniyoga forms of yoga:
There is low- to moderate-certainty evidence that yoga compared to non-exercise controls results in small to moderate improvements in back-related function at three and six months. Yoga may also be slightly more effective for pain at three and six months, however the effect size did not meet predefined levels of minimum clinical importance.
So again, this isnt an end-all treatment but the evidence we have points in the direction of a benefit.
Importantly, the review authors also noted that its not clear whether yoga is better than other exercises, since there were few head-to-head comparisons tracking yoga against other kinds of workouts.
For Pilates, the evidence was a little more mixed: It was associated with small or no effects on pain and no effects on function compared with other types of exercise. Again, though, pretty much every back expert I spoke to said any exercise is better than no exercise, so if Pilates is something you enjoy, do it.
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When To See A Doctor
People can often treat back pain with home remedies and some patience. However, a person should speak to a doctor about chronic or severe back pain.
A doctor may recommend physical therapy, medication, or other treatments. People who have existing health conditions or who take regular medications should speak to a doctor before trying any herbs or supplements.
The U.S. Food and Drug Administration do not monitor supplements for purity or quality, so it is essential to research reputable companies first.
What Are The Warning Signs Of A Serious Problem
Very rarely back pain or pain that travels down the leg is a sign of a serious problem.
If you have any of the following symptoms, you should seek urgent medical attention:
- difficulty controlling or passing urine
- loss of control of your bowels
- numbness around your back passage or your genitals
- serious weakness in your legs so you find standing really difficult
- severe and ongoing back pain that gets worse over several weeks.
The above symptoms could potentially be linked to a rare but serious condition that needs urgent medical attention.
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