Nonspecific Low Back Pain
This is the most common type of back pain. The majority of cases of sudden-onset low back pain are classed as nonspecific. This is the type of back pain that most people will have at some point in their lives. It is called nonspecific because it is usually not clear what is actually causing the pain. In other words, there is no specific problem or disease that can be identified as the cause of the pain. The severity of the pain can vary from mild to severe. This type of back pain is discussed further below.
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.
Do Morning Stretches In Bed
Simple stretching exercises can relieve back pain, and there are stretches you can do before you get out of bed.
For example, you can lie on your back and do a full-body stretch when you first wake up. For this exercise, stretch your arms and hands above your head as far as you can, with your legs and feet stretching in the opposite direction. Hold for a few seconds before releasing.
It may also help to stretch out your lower back. To do this, you can bring your knees into your chest and hold, wrapping your arms around them. Then gently rock from side to side.
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Common Causes Of Chronic Back Pain
Chronic back painis usually age-related, but can also result from a prior injury. The mostcommon causes include:
- Arthritis of the spine the gradual thinning of the cartilage inside the spine
- Spinal stenosis narrowing of the spinal canal that may lead to nerve pain
- Disc problems, such as a herniated or bulging disc
- Myofascial pain syndromeunexplained muscle pain and tenderness
In some cases, its difficult to pinpoint the cause of chronic back pain.If your doctor has exhausted all diagnostic options, its time to seek asecond opinion from a back pain specialist, recommends Nava. Itsimportant not to make rushed decisions or undergo extensive medicalprocedures until the origin of the pain is found. Not only may they nothelp they could make the pain worse, warns Nava.
If the source of the pain is not known or cant be treated, your bestoption may be to work with your doctor on reducing the flare-ups and makingthe pain manageable with nonsurgical treatments.
Ways To Relieve Back Pain Naturally
There are a wide variety of natural remedies to soothe your back, which can help reduce the intake of medications or provide an added benefit to your existing medical treatment.
Take a look at these natural pain-relieving strategies and find out what works best for you:
Read on to learn more about effective pain-relieving strategies for chronic back pain from natural methods.
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Put Out That Cigarette
We all know smoking is a serious health risk, and smokers are also more likely to experience back pain than nonsmokers. One reason for this is that nicotine restricts blood flow to the disks in the spine. This can cause them to dry out, crack, or rupture. Smoking also reduces the amount of oxygen in the blood, which causes a reduction in nourishment to the muscles and tendons in the back. An unhealthy, weak back is more vulnerable to accidental strains and pulls that cause back pain.
Change Up Your Sleep Position Or Mattress
Switching to a more supportive sleep position can reduce lower back pain. Also consider how you can use pillows or invest in a new mattress to support better spinal alignment and relieve lower back pain.
Research suggests medium firm mattresses are the best mattresses for back pain. In one study of people with low back pain, those who slept on medium firm mattresses reported lower pain scores both during sleep and upon getting up in the morning.
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What Are Some Common Lower Back Pain Causes
The causes of lower back pain are sometimes viewed as being mechanical, organic or idiopathic. Sometimes spinal conditions are congenital or acquired meaning the disorder develops later in life.
- Mechanical lower back pain is often triggered by spinal movement and involves spinal structures, such as the facet joints, intervertebral discs, vertebral bodies , ligaments, muscles or soft tissues.
- Organic lower back pain is attributed to disease, such as spinal cancer.
- Idiopathic refers to an unknown cause.
These are some of the things your doctor might look for or rule out when you schedule a visit for back pain.
The common symptoms of lower back pain.
Sprains and strains. Ligament sprains and muscle or tendon strains are the most common causes of lower back pain. Theyre often related to overuse.
Degenerative disc disease. While the name sounds worrisome, it just means you have a damaged disc causing pain. Over time, discs become thinner and flatter due to wear and tear. That leaves them less able to cushion the vertebrae and more likely to tear .
Herniated disc. The protective covering on intervertebral discs can tear over time. When this happens, the soft inner disc tissue may push through the outer layer. A disc that bulges or slips out of place is known as a herniated disc, bulging disc, or slipped disc. The herniation may press on nerve roots, leading to symptoms such as pain, tingling, numbness or weakness in the area that the nerve serves
Your Back Isnt The Problem
Heres the irony: In most cases, lower back pain isnt actually coming from the low back but an entirely different muscle.
But which one? Is it your abdominal core muscle, hamstring muscles, or tight muscles in general?
To be sure, the first thing we need to do is identify what is truly causing your low back pain. Im going to teach you how below.
But for my money, Im willing to bet that the gluteus medius could be the real cause of your back pain.
The glute medius is sandwiched between the glute maximus and minimus Its actually underneath the glute maximus.
It attaches on the inside of the bony area that is called the posterior superior iliac spine, or PSIS. This attachment point is going to make your job of pinpointing the pain a hell of a lot easier. More on this below.
The glute medius has two main functions:
The first is hip abduction, which means lifting your hip up, and out to the side.
The other thing thats even more important is that it keeps your pelvis level.
You can see this in action every time you lift one leg. Naturally, when you lift the leg, the entire body wants to fall in that direction.
But when your gluteus medius is working right and doing its job, the position of your pelvis level will stay stable.
When you have a weak or underactive gluteus medius, you can develop a postural gait called the Trendelenburg Gait.
This posture is when your hips drop on every step. You dont want that to happen!
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When Is Not Helpful
Back pain is one of the most common reasons why people visit a health care provider. The good news is that the pain often goes away on its own, and people usually recover in a week or two. Many people want to stay in bed when their back hurts. For many years, getting bed rest was the normal advice. But current studies recommend no bed rest at all and stress that staying in bed longer than 48 hours not only wont help but it may, in fact, actually delay your recovery. Heres why:
Staying in bed wont help you get better faster.If youre in terrible pain, lying down for a day to help ease the distress may seem like a good idea, but moderating your activities and staying active in a limited way is a more effective way to control your symptoms. Research suggests that if you can find comfortable positions and keep moving, you may not need bed rest at all.Research shows that:
- Lying down longer than a day or two day isnt helpful for relieving back pain.
- People can recover more quickly without any bed rest.
- The sooner you start moving, even a little bit, or return to activities such as walking, the faster you are likely to improve.
Rub On Medicated Creams
Skin creams, salves, ointments, or patches may help when your back feels stiff, sore, and tense. Many of these products contain ingredients such as menthol, camphor, or lidocaine that can cool, heat, or numb the affected area.
Put on creams right where you hurt. Ask someone to apply it if you have trouble reaching the spot.
âIt’s not going to be a mainstay at providing significant relief, but it can calm things down,â Ray says.
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To Fix Back Pain You Must Think About Your Whole Body Not Just One Part
One of the biggest misconceptions about back pain is that all your attention needs to be on what you do to protect your spine. “Brace your abs! Do more spine stretching! Do less spine stretching! Do more spine strengthening!”
Some of these tactics can workfor SOME people in some situations. But these approaches often fail because they don’t take into account the rest of your body.
To put it simply, a happy back is about more than just spinal muscles or abdominal muscles. You can beat back pain if and only if you train your entire body to function well as a unit.
If your hips are out of whack, your spine will pay a price.
If your shoulders are out of whack, your spine will pay a price.
And if your spine is out of whack, well, your spine will pay a price then too.
The key is to understand the relationships between segments of your body so you can address issues systematicallyall over the body.
If you had a car tire that was constantly wearing out, you wouldn’t keep patching and replacing the tire. You’d look at the rest of the car to see why so much stress was going to the one tire.
Conventional approaches to back pain are obsessed with the tire, rather than looking at the busted axle or bent frame.
Once you realize how interconnected segments of your body are, traditional approaches to back pain look downright ridiculous.
Less Common Causes Of Low Back Pain
Inflammation of the joints of the spine sometimes causes back pain. Osteoarthritis is the common form of arthritis and usually occurs in older people. Ankylosing spondylitis is another form of arthritis that can occur in young adults and which causes pain and stiffness in the lower back. Rheumatoid arthritis may affect the spine but you are likely to have other joints affected too.
Various uncommon bone disorders, tumours, infection and pressure from structures near to the spine occasionally cause low back pain .
The rest of this leaflet is mainly about nonspecific low back pain – the common type of low back pain.
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When Should I See My Healthcare Provider About Lower Back Pain
Lower back pain usually gets better with rest and pain relievers. Back pain that doesnt go away may be a sign of a more serious condition.
See your provider if you have:
- Pain that doesnt get better after about a week of at-home care.
- Tingling, numbness, weakness or pain in your buttocks or legs.
- Severe pain or muscle spasms that interfere with your normal activities.
- Fever, weight loss, bowel or bladder problems or other unexplained symptoms.
A note from Cleveland Clinic
Millions of people live with low back pain. Stiffness, pain and limited movement can have a major impact on quality of life. But you may be able to avoid lower back pain by maintaining a healthy weight and staying active. Talk to your provider if back pain doesnt go away or if youre unable to do the activities you enjoy. Several treatments can relieve pain, help you move better and get more out of life.
Last reviewed by a Cleveland Clinic medical professional on 01/18/2021.
References
What Are The Treatments For Lower Back Pain
Lower back pain usually gets better with rest, ice and over-the-counter pain relievers. After a few days of rest, you can start to get back to your normal activities. Staying active increases blood flow to the area and helps you heal.
Other treatments for lower back pain depend on the cause. They include:
- Medications: Your provider may recommend nonsteroidal anti-inflammatory drugs or prescription drugs to relieve pain. Other medications relax muscles and prevent back spasms.
- Physical therapy : PT can strengthen muscles so they can support your spine. PT also improves flexibility and helps you avoid another injury.
- Hands-on manipulation: Several hands-on treatments can relax tight muscles, reduce pain and improve posture and alignment. Depending on the cause of pain, you may need osteopathic manipulation or chiropractic adjustments. Massage therapy can also help with back pain relief and restore function.
- Injections: Your provider uses a needle to inject medication into the area thats causing pain. Steroid injections relieve pain and reduce inflammation.
- Surgery: Some injuries and conditions need surgical repair. There are several types of surgery for low back pain, including many minimally invasive techniques.
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When To See A Spine Specialist For Chronic Back Pain
Sometimes back pain comes on quick, and you know exactly what caused it. After some stretching, resting and pain relievers, you’ll remember to bend with your knees next time.
But, other times, people experiencing back pain are often left thinking: I don’t even remember when the pain started or what I did to cause it. The reality is that the source of you back pain may not always be evident which can also make it hard to know when it’s time to see an expert.
Dr. Hwang says the following five signs likely indicate that it’s time to see a spine specialist for your back pain:
1. Your pain is severe. While some back pain is only mild to moderate, severe back pain is when your pain is constant, intense or gets worse when you’re resting or at night.
2. Your pain is persistent. If your back pain lasts longer than three months, it’s considered chronic and may require a tailored treatment plan.
3. Your pain isn’t isolated to your back. If your pain is traveling down your leg, you have numbness or weakness in your hips or legs, or you’re experiencing tingling in your legs and feet, it may be a sign that there’s pressure on your spine.
4. Everyday activities have become difficult. If your back pain is already affecting routine activities, don’t let it get so debilitating that it keeps you from doing things you enjoy.
Next Steps:
- Find a Houston Methodist spine specialist that can treat your back pain at a location convenient for you
Complementary And Alternative Techniques Include:
- Acupuncture is moderately effective for chronic low back pain. It involves inserting thin needles into precise points throughout the body and stimulating them , which may cause the body to release naturally occurring painkilling chemicals such as endorphins, serotonin, and acetylcholine.
- Behavioral approaches include:
- Biofeedback involves attaching electrodes to the skin and using an electromyography machine that allows people to become aware of and control their breathing, muscle tension, heart rate, and skin temperature people regulate their response to pain by using relaxation techniques
- Cognitive therapy involves using relaxation and coping techniques to ease back pain
Spinal injections include:Trigger point injections can relax knotted muscles that may contribute to back pain. An injection or series of injections of a local anesthetic and often a corticosteroid drug into the trigger point can lessen or relieve pain.
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More Advanced Care Options
Surgery When other therapies fail, surgery may be considered to relieve pain caused by worsening nerve damage, serious musculoskeletal injuries, or nerve compression. Specific surgeries are selected for specific conditions/indications. However, surgery is not always successful. It may be months following surgery before the person is fully healed and there may be permanent loss of flexibility. Surgical options include:
Implanted nerve stimulators
- Spinal cord stimulation uses low-voltage electrical impulses from a small implanted device that is connected to a wire that runs along the spinal cord. The impulses are designed to block pain signals that are normally sent to the brain.
- Dorsal root ganglion stimulation also involves electrical signals sent along a wire connected to a small device that is implanted into the lower back. It specifically targets the nerve fibers that transmit pain signals. The impulses are designed to replace pain signals with a less painful numbing or tingling sensation.
- Peripheral nerve stimulation also uses a small implanted device and an electrode to generate and send electrical pulses that create a tingling sensation to provide pain relief.
