The Universal Guide To Lower Back Pain: Everything You Ever Wanted To Know Straight From The Experts
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If youve ever had lower back pain stop you from doing what you want, youre not alone. Lower back pain is one of the most common medical problems in the world. It is a leading reason why people visit a doctor, affecting more than 80% of adults at some point in their lives. According to the Global Burden of Diseasea significant study published in the Lancet medical journallower back pain is also a leading cause of disability.
While severe lower back pain can cause worry, pain severity is not always an indication something is seriously wrong. Photo Source: Shutterstock.
You may not be able to prevent lower back pain, especially as you age and your back loses some strength and resilience. Fortunately, there are many ways you can get relief, no matter the cause of your back pain.
Who Gets Back Pain
Anyone can have back pain. You may be more likely to have back pain because of the following:
- Fitness level: Back pain is more common among people who are out of shape. You may also get back pain if you exercise too hard after not being active for a while.
- Obesity: If you are overweight or obese, it can put stress on the back and cause pain.
- Job-related risk factors: Jobs that require heavy lifting, pushing, pulling, or twisting can injure the back. A desk job may also play a role, especially if you slouch or sit all day in an uncomfortable chair.
- Age: You may have more back pain as you get older, particularly after you turn 45.
- Family history: Your genes play a role in some disorders that cause back pain.
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.
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Can Back Pain Be Prevented
Recurring back pain resulting from improper body mechanics may be prevented by avoiding movements that jolt or strain the back, maintaining correct posture, and lifting objects properly. Many work-related injuries are caused or aggravated by stressors such as heavy lifting, contact stress , vibration, repetitive motion, and awkward posture.Recommendations for keeping ones back healthy
When You May Need Medicine
If non-drug interventions dont help, the ACP recommends first trying non-steroidal anti-inflammatory drugs such as ibuprofen, naproxen, indomethacin or meloxicam. While NSAIDs provide some pain relief, they may put you at risk for GI bleeding or kidney damage.
As second-line drugs, the ACP recommends duloxetine or tramadol .
Due to their serious side effects and addictive nature, opioid medications should be used only as a last resort when patients fail all other therapies, the ACP advises. The rule of thumb: Use the lowest possible dose of opioid for the least amount of time.
If youve been suffering with long-term low back pain, its worth exploring these non-drug treatment options before resorting to pills. Youre likely to find your quality of life improving.
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Sleep On A Quality Mattress
Lower back pain sufferers usually benefit from sleeping on a medium-firm mattress. However, your preferred sleep position also should influence your mattress selection. To maintain good posture, side sleepers should select a softer mattress. Back and stomach sleepers should choose a firmer mattress. If you have lower back pain, its a good idea to avoid sleeping on your stomach altogether.
If your lower back pain doesnt improve after 4 to 6 weeks of home care using these suggestions, you should see your doctor. You also should contact your doctor right away if you have any red flags, including:
- A history of cancer or a recent infection
- A recent fall or other accident
- Extreme fatigue
- Signs of infection, such as fever, chills, sweats
- Nerve problems, such as shooting pain, numbness or tingling
- Changes in bowel or bladder function
Other options for treating lower back pain may include physical therapy, pain management with cortisone injections or, in certain cases, surgery. Although lower back surgery can be beneficial for patients who are experiencing nerve problems and injured discs, its not typically recommended for patients with other types of lower back pain.
Download the Virtua Health Guide to Back Pain, or call to request a consultation with a Virtua back pain specialist.
Know Your Otc Medications
Nonprescription pain relievers can help with muscle aches and stiffness. The two main types of over-the-counter options are nonsteroidal anti-inflammatory drugs and acetaminophen. NSAIDs include aspirin, ibuprofen, and naproxen.
True to their name, NSAIDs help lower inflammation that can lead to swelling and tenderness. But acetaminophen does not relieve inflammation. You can reach for either type of pain reliever for occasional back pain. NSAIDs may work a bit better, Hemani says, if you have arthritis of the spine or other inflammatory conditions.
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When Do You Need A Doctor For Back Pain
if you have any of the following symptoms along with your back pain, see a doctor immediately:
- Numbness in an arm or leg
- Trouble with bowel or bladder control
- Weakness in an arm or leg
When the team assesses patients with severe back pain, we often recommend physical therapy and pain medication then we dont see the patients again because their back pain got better on its own. Staying or getting active with guidance from your doctor can provide ample relief for severe back pain.
Try To Boost Your Mood
No, the lower back pain isnt in your head, but obsessing over it could be making it worse. Fear, anxiety, and catastrophizing can amplify pain, says Dr. Mackey. Because brain circuits that process pain overlap dramatically with circuits involved with emotions, panic can translate into actual pain. Start by accepting that you have pain, Dr. Mackey says. Then say to yourself, it will get better. If you struggle with overall mental wellbeingsay, you have anxiety or depressionin addition to your physical aches, it could be worth seeing a therapist to manage negative thought processes while exploring other lower back pain treatments.
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How Do I Know If My Back Pain Is Serious
Back pain can be a sign of severe damage and should be looked into immediately. If your back pain is partnered with any of the following symptoms, its time to go to the emergency room.
- A sudden spike in pain, discomfort, weakness, or numbness
- A loss of bladder or bowel function
- A high fever
- Severe stomach pain
- Unexplained weight loss
If your back pain was caused by a fall or a blow to your back, go to the hospital to ensure there is no significant or lasting damage done to your spine.
If your pain levels remain the same or increase after a week of rest, you may also want to consult a physician.
How Hamstring Flexibility Can Help Your Lower Back Problems
When my hamstrings are tight, I get pain and stiffness in the lower back. Most folks are familiar with the toe touch as a hamstring exercise. It is, but its also very stressful on the lower back.
A much better option is done lying on your back, on the bed or the floor. Bend your right leg, wrap your fingers around your leg just above the knee, and pull the knee toward your chest. Now, still pulling the knee toward your chest, gradually and gently straighten your knee. As you straighten your knee, you will feel an intense hamstring stretch. Go as far as you comfortably can and hold this for 15-30 seconds, then switch legs.
Another option is to hold two seconds, then return to the starting position and repeat 10 times or more. Oftentimes, stretching the hamstrings can provide instant relief to the lower back.
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Can I Prevent Lower Back Pain
You cant prevent lower back pain that results from disease or structural problems in the spine. But you can avoid injuries that cause back pain.
To reduce your risk of a back injury, you should:
- Maintain a healthy weight: Excess weight puts pressure on vertebrae and disks.
- Strengthen your abdominal muscles: Pilates and other exercise programs strengthen core muscles that support the spine.
- Lift the right way: To avoid injuries, lift with your legs . Hold heavy items close to your body. Try not to twist your torso while youre lifting.
How Excess Belly Fat Places Stress On Lower Back Muscles
A protruding midsection and lack of strong, flexible muscles can be manifested in what I call the paper clip syndrome.
Heres how it works: a person walks into a room and sees a paper clip on the floor. He bends to retrieve it and his lower back explodes in pain. A paper clip is used to signify that no heavy lifting was involved and the only event was bending over. The key is, the person was poised for disaster and all that was required was a minor effort to trigger it.
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Excess belly fat places considerable and relentless stress on the lower back muscles. Why? The bodys anatomy and upright posture results in a natural tendency to lean forward, and its the job of lower back muscles to resist the forward lean and keep the body upright. Thus, even under the best conditions, the lower back muscles are constantly being challenged.
A protruding midsection adds to the challenge because additional weight in the front of the body pulls it forward, and the lower back muscles must work harder to keep the body upright.
Whats more, leverage works against the lower back muscles. An increase in abdominal fat of just a few pounds can exert a stress of many times that amount on the lower back muscles to keep the body upright.
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Check With Your Doctor About Over
Stephens recommends that people with back pain reach out to their primary care physician to discuss how to safely take NSAID medications such as ibuprofen or naproxen to relieve back pain.
Were very aware of some of the long-term health risks associated with excessive use of . They have a place when it comes to helping manage pain, but a patient needs to follow the advice of their doctor to minimize any negative effects of that medication, says Stephens.
NSAID use can increase the risk for severe or life-threatening bleeding and in some people, and taking too much of these drugs can also lead to liver or kidney injury or failure.
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
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How Does The My Back Pain Coach Program Work
This program is based on the scientific principles of human anatomy, which encourage overall balance among the muscles of the human body. This body balance theory can be achieved with Ian Harts specific 8-step routine. All you will need is 16 minutes of your day, a chair, and a pillow or towel.
The 8 movements recommended by the program include the following.
- Activating muscles that are out of alignment
The first step focuses on activating muscles that are out of alignment as a result of daily life habits or inactivity. This will usually come with slight pain, but it is nothing to worry about. Once they are activated, the pain goes away, leaving room for other more complex routines.
- Hip muscle activation
The base of the spine is connected to the hips by bone joints, strong ligaments, and muscles. This second step activates your dormant hip muscle, which in effect, activates the back muscles from the base of the spine.
- Blood flow improvement
This movement is specifically targeted at the soft tissues in the back. It improves the flow of blood and necessary nutrients to the back. This encourages healing and reduces stiffness.
- Improving the lower back bones and muscles
The state of your lower back is quite significant to the alignment of your back muscles and bones. Movement number four further improves blood flow to that area to facilitate better results.
- Alignment restoration
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Back Exercises And Stretches
Simple back exercises and stretches can often help reduce back pain. These can be done at home as often as you need to.
For information about exercises and stretches that can help, see:
A GP may be able to provide information about back exercises if you’re unsure what to try, or you may want to consider seeing a physiotherapist for advice. Read about how to get access to physiotherapy.
Doing regular exercise alongside these stretches can also help keep your back strong and healthy. Activities such as walking, swimming, yoga and pilates are popular choices.
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What Home Remedies For Lower Back Pain Actually Work
Unless youve had a major injury, such as a fall or car accident, you probably dont need to rush to the doctor for back pain. You may want to try these simple self-care strategies first.
Avoid bed rest. When lower back pain strikes, people often think complete rest will relieve back pain. However, a review of many clinical studies found that patients who retreated to bed actually experienced more pain and recovered more slowly than patients who stayed fairly active
Use ice and/or heat. Many people find that using ice or cold packs for periods of up to 20 minutes at a time helps reduce pain and swelling. Always wrap ice or a cold pack in a thin towel before putting it on your body so you dont injure your skin. You may also find that heat, such as a heating pad or warm bath, eases pain. Ice is recommended in the first 48 hours after injury then you can try a combo of ice and heat.
Try over-the-counter remedies. Short-term use of OTC pain relievers, such as the nonsteroidal anti-inflammatory drugs ibuprofen and naproxen, may ease your lower back pain. Also consider OTC creams, gels, patches, or sprays applied to the skin. They stimulate the nerves in the skin to provide feelings of warmth or cold in order to dull the sensation of pain.
Maintain Correct Posture When Sitting
You can avoid lower back pain by maintaining proper posture when sitting. If you have a desk job, keep your feet planted on the floor and use a chair that provides lower back support. Also, avoid hunching forward to see your computer screen and reaching far in front of you to use your mouse or keyboard.
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