How Physical Therapy Can Help You
Sudden severe lower back pain can be debilitating and have a significant effect on your quality of life. Fortunately, physical therapy is considered one of the most effective treatments for this condition and can help you recover quickly and effectively.
It helps to strengthen the muscles that support your spine, improve flexibility, and reduce inflammation. This can also help you learn proper posture and body mechanics to prevent further episodes of sudden severe lower back pain. Some common techniques used in physical therapy for sudden severe lower back pain include:
Sensations That Might Indicate A Medical Emergency
1. Sharp pain rather than a dull ache: This could indicate a torn muscle or ligament, or a problem with an internal organ in the back or side.2. Radiating pain: This pain “moves” or shoots to the glutes or legs, which could indicate a nerve compression condition.
3. Sudden weakness in the legs: Limb weakness can be caused by compressed nerves in the spine due to conditions like sciatica or spinal stenosis. However, sudden leg weakness could also indicate a stroke.4. Incontinence: Back pain paired with inability to control the bowels or bladder might be a sign of serious nerve compression or a spine infection, such as discitis or meningitis.5. Numbness or pins and needles in the groin or glutes: This is known as saddle anesthesia and is also a sign of a serious nerve or spine condition.
If you have leg weakness, incontinence, and numbness together, you might have cauda equina syndrome, a serious illness characterized by spinal cord nerve damage. This is a medical emergency, and patients usually need surgery immediately to decompress the nerves and reduce permanent damage.
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Surgery For Lower Back Pain
Because the vast majority of patients recover from their low back pain with little help from a doctor, the rationale behind choosing surgery must be convincing. Eighty percent of patients with sciatica recover eventually without surgery.
Severe progressive nerve problems, bowel or bladder dysfunction and the cauda equina syndrome make up the most clear-cut indications for back surgery. Back surgery will also be considered if the patients signs and symptoms correlate well with studies such as MRI or electromyogram .
In the most serious cases, when the condition does not respond to other therapies, surgery may well be necessary to relieve pain caused by back problems. Some common procedures include:
- , such as a or removal of a portion of a
- a bone graft that promotes the vertebrae to fuse together
- removal of the lamina to create more space and reduce irritation and inflammation
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You Have Numbness Tingling Or Weakness
Back pain accompanied by sensations of numbness, tingling or weakness could be a sign of nerve irritation or damage. This is especially true if the pain persists after taking over-the-counter pain relievers. Nerve pain is serious and can result in permanent damage or disability if left untreated.
Learn More: Listen to a podcast on pinched nerves.
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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Why Is Lower Back Pain Such A Common Problem
The bottom part of your back typically has just five vertebrae fewer than your neck and mid-back. And these vertebrae do a lot of heavy lifting! Your lower back is where your spine connects to your pelvis, bearing the weight of your upper body. This area experiences a lot of movement and stress, which may lead to wear, tear and injuries.
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.
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What Is The Treatment For Chronic Nonspecific Low Back Pain
Initial treatment is similar to sudden-onset attacks. That is, aim to keep as active as possible. Also, painkillers can help. In addition to the painkillers listed above, your doctor may advise a course of an antidepressant medicine in the tricyclic group – for example, amitriptyline. Tricyclic antidepressants have other actions separate to their action on depression. They are used in a variety of painful conditions, including back pain.
Also, a national guideline , referenced below) recommends one or more of the following treatments should be considered. Each of these treatments has some evidence from research trials to suggest that they will help to ease symptoms in some people :
- Structured exercise programme. This means a programme of exercise supervised by a professional such as a physiotherapist. This is likely to be in a group setting. Exercises may include aerobic activity, movement instruction, muscle strengthening, posture control and stretching. It typically consists of up to eight supervised sessions over 8-12 weeks with encouragement to keep on doing the exercises at home between sessions.
- Manual therapy. Typically this includes several sessions of massage, spinal mobilisation and/or spinal manipulation. With spinal mobilisation the therapist moves the joints of the spine around in their normal movement range. In spinal manipulation, the therapist moves joints beyond the usual range of movement.
- A course of acupuncture. It is not clear how this may work.
Your Pain Is Worse At Certain Times Or In Certain Positions
If your back pain wakes you up in the middle of the night or appears when you’re in certain positions, such as lying down, then this could be a sign of a more serious problem. It could be a sign of a more systematic problem such as an infection, fracture, severe nerve compression or even cancer.
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Lower Back Pain: What Could It Be
Do you have lower back pain? You are not alone. Anyone can experience lower back pain at any time, even if you dont have a prior injury or any of the risk factors. It is not always serious and can often get better on its own. But in some cases pain is your bodys way of telling you that something isnt right.
Learn more about lower back pain and what causes it from rehabilitation physician Akhil Chhatre, M.D., who specializes in back pain in the Johns Hopkins Department of Physical Medicine and Rehabilitation.
When Is Surgery A Good Idea For Back Pain
These red flags can be indicators for surgery, if theyre found to berelated to your spine condition:
- New or progressing bowel/bladder issues
- Weakness in limbs
- Gait and balance problems
- Evidence of increased reflexes
Surgery can also be an option for chronic back pain if there is a knowncause confirmed by imaging and if other treatments didnt help. Getopinions from at least two surgeons, suggests Nava, as pain can stillcome back after the surgery.
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What Type Of Doctor Should I See For Back Pain
This depends on your condition or symptoms. If you have no obvious injury that would explain your pain, you may want to start by seeing a . This is a specialist in physical medicine who can diagnose back pain and determine whether nonsurgical treatments such as physical therapy may help. Depending on those findings, a physiatrist may also refer you to a , doctor or other type of back specialist, , for additional discussion.
When Are Diagnostic Tests For Lower Back Pain Necessary
Many patients do not need X-rays in the first few weeks of pain because their pain will end up resolving. Many more do not need CT scans or MRI imaging, which are overly sensitive and often reveal abnormalities not related to the patients pain. These forms of imaging can be extremely useful, however, if a person has chronic or severe pain, and/or neurological symptoms. Blood tests may be ordered if an infection or tumor is suspected.
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Which Asana Should Not Do In Back Pain
Big Toe Pose. If youve performed big toe pose before, youll understand why I say this is not the pose to do if you have any kind of back problem or pain. This pose compresses your side body and can cause your pelvis to tilt backwards, both of which puts a lot of strain and pressure on your lumbar spine.
Is Frog pose good for you?
Frog pose is an advanced move with many benefits, including: Strengthens the back muscles. Consistently practicing frog pose can build back strength, which helps support your spine and improves posture.
Lower Back Pain Symptoms Diagnosis And Treatment
The lumbar spine, or low back, is a remarkably well-engineered structure of interconnecting bones, joints, nerves, ligaments, and muscles all working together to provide support, strength, and flexibility. However, this complex structure also leaves the low back susceptible to injury and pain.
Watch:Lumbar Spine Anatomy Video
This article presents a model for understanding symptoms, physical findings, imaging studies, and injection techniques to come to a precise diagnosis.
Once an accurate diagnosis of the cause of the lower back pain is attained, treatment options can be selected based on todays best medical practices.
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Is Dhanurasana Good For Lower Back Pain
Benefits: Dhanurasana is very effective in eradicating back pain. It bends the back and provides a strong stretch, which is very healing for back pain. Other benefits are that it helps in menstrual cramps, strengthening leg muscles and abdominal muscles.
Is pigeon pose good for lower back pain?
Thread the Needle, also called a Reclined Pigeon Pose, is a great yoga pose for not only lower back pain in addition to relieving sciatic nerve pain. Laying down on your back, bend your knees and keep your feet flat on the floor.
What happens if you do cobra stretch everyday?
Cobra Pose might help relieve chronic back pain. Its a fab counteraction stretch for your spine and chest. It can help take pressure off the lower back and encourages better spinal alignment. Another small study found that practicing yoga for 12 weeks helped improve lower back pain.
Who should not do dhanurasana?
Do not practice Dhanurasana or bow pose if you have any of the following condition:
What Are The Causes Of Lower Back Pain
The vast majority of patients experience back pain because of mechanical reasons. They strain a muscle from heavy lifting or twisting, suffer a sudden jolt in a car accident, experience stress on spinal bones and tissues resulting in a , or suffer from , a potentially painful degeneration of one or more spinal joints. Common causes for low back pain are:
- mechanical or functional injury
- active infection
To choose the safest and most effective therapy, doctors need to consider the full spectrum of possible underlying issues, such as inflammatory conditions, fracture, infection, as well as some serious conditions unrelated to the back that radiate pain to the back.
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Treatment Of Nonspecific Pain
Many treatments are available for acute low back pain, but strong evidence for their benefit is lacking. Based on the evidence, a reasonable approach to treatment is described in Table 4.
| First visit |
| Patient education |
| Reassure the patient that the prognosis is often good, with most cases resolving with little intervention |
| Advise the patient to stay active, avoiding bed rest as much as possible, and to return to normal activities as soon as possible |
| Advise the patient to avoid twisting and bending |
| Initiate trial of a nonsteroidal anti-inflammatory drug or acetaminophen |
| Consider a muscle relaxant based on pain severity |
| Consider a short course of opioid therapy if pain is severe |
| Consider referral for physical therapy if it is not the first episode |
| Second visit* |
| Consider changing to a different nonsteroidal anti-inflammatory drug |
| Consider referral for physical therapy if not done at initial visit |
| Consider referral to a spine subspecialist if pain is severe or limits function |
Common Causes Of Chronic Lower Back Pain
“Chronic lower back pain is less likely to be caused by injury to your muscles and ligaments and more likely to be due to issues with the lumbar disks, nerves, joints or vertebrae,” says Dr. Palmer. “There are several potential causes of chronic pain in the lower back.”
In general, osteoarthritis and degenerative disk disease are the underlying cause of many types of chronic lower back pain. However, lower back pain can also be caused by accident-related trauma and acute stress.
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Causes Of Lower Back Pain
Mechanical abnormalities and soft tissue injuries are among the most common causes of lower back pain. Lets review some of the conditions that frequently lead to this uncomfortable symptom:
Sprains and strains
Muscle strains and ligament sprains are the most common causes of lower back pain and fortunately for us all, they also tend to improve and rarely lead to chronic pain. Strains and strains occur when muscles, tendons, or ligaments are stretched beyond their capacity and develop partial tears or microtears as a result.
Sprains and strains can occur as acute injuries, or they can develop progressively over a period of time. Different movements can lead to these types of injuries, including:
- Lifting a heavy object using an inadequate technique
- Engaging in poor posture over a prolonged period of time
- Falling or twisting your lower back suddenly
Ligament sprains and muscle strains cause symptoms that are essentially indistinguishable from each other, and they often receive the same treatment. Symptoms of sprains and strains can include:
- Lower back pain that can irradiate to the buttocks, but not the legs.
- Pain that intensifies with specific movements or positions.
- Muscle spasms or cramping.
Symptoms caused by these injuries typically improve on their own within 10 to 14 days. However, they can cause moderate to severe pain at first.
How Common Is Lower Back Pain
Around four out of five people have lower back pain at some point in their lives. Its one of the most common reasons people visit healthcare providers.
Some people are more likely to have lower back pain than others. Risk factors for lower back pain include:
- Age: People over 30 have more back pain. Disks wear away with age. As the disks weaken and wear down, pain and stiffness can result.
- Weight: People have overweight/obesity or carry extra weight are more likely to have back pain. Excess weight puts pressure on joints and disks.
- Overall health: Weakened abdominal muscles cant support the spine, which can lead to back strains and sprains. People who smoke, drink alcohol excessively or live a sedentary lifestyle have a higher risk of back pain.
- Occupation and lifestyle: Jobs and activities that require heavy lifting or bending can increase the risk of a back injury.
- Structural problems: Severe back pain can result from conditions, such as scoliosis, that change spine alignment.
- Disease: People who have a family history of osteoarthritis, certain types of cancer and other disease have a higher risk of low back pain.
- Mental health: Back pain can result from depression and anxiety.
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Understanding The Lower Back
The lower back is also called the lumbosacral area of the back. It is the part of the back between the bottom of the ribs and the top of the legs.
Most of the lower back is made up from muscles that attach to, and surround, the spine. The spine is made up of many bones called vertebrae. The vertebrae are roughly circular and between each vertebra is a disc. The discs between the vertebrae are a combination of a strong fibrous outer layer and a softer, gel-like centre. The discs act as shock absorbers and allow the spine to be flexible.
Benefits Of Good Posture
Good posture isnât just about how you present yourself. Having poor posture can actually affect your physical and mental health.â
Better mood and energy. One of the best benefits of good posture is the way that you feel about yourself. Improving your posture can help you stay focused and more energized throughout the day. This can help improve your mood, too.â
Research also suggests that good posture can lead to more self-confidence. When you carry yourself well and feel good about yourself, youâre less likely to experience depressive thoughts. This can give you more self-esteem and a better feeling of pride and confidence in yourself.â
Bone, joint, and muscle health. As mentioned, your posture depends on your muscles and bones. When you align your spine correctly, you put less stress on your joints and bones. This can lead to less overall pain or reduced chances of developing problems like osteoarthritis.â
Even though there are tons of exercises out there to help you improve your core muscle strength, doctors say that practicing proper posture is one of the best ways to help tone this muscle group.â
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