What Are The Risks
Long bed rest can lead to slower recovery.Staying in bed for any prolonged period can make you stiff and increase pain. When you dont move and bend, you lose muscle strength and flexibility. With bed rest, you lose about 1 percent of your muscle strength each day. And you can lose 20 to 30 percent in a week. It becomes more difficult to return to any activity. As you become weaker and stiffer your recovery takes longer.
Who needs bed rest?Almost no one! The only people who might require time in bed are those with unstable spinal fractures awaiting surgery.
What can I do for the pain?Hot or cold packs often help. Some people can get pain relief from non-prescription analgesics or anti-inflammatory drugs such as ibuprofen or naproxen . But no medication should be taken for an extended period of time.
When should I see a health care provider?You should see your health care provider right away if:
- You have severe continuous back pain that lasts longer than 48 hours.
- You have severe continuous back pain and fever.
- You have back pain with accompanying pain, numbness or weakness in one or both legs or feet. Your leg symptoms are more disabling than your back symptoms.
- You have back pain and the onset of numbness in your private/genital region or changes in your ability to control your bladder and bowel function.
Upper Back Pain When Sitting
Many people experience pain in their necks and upper backs as a result of craning forward while sitting to look at a computer monitor or phone display. Although its tempting to sprawl out and watch television for hours, this can also easily throw your back out of alignment.
That uncomfortable feeling of stiffness when you finally do move or stand up is telling you something.
Better posture makes a difference.
Its likely your parents or teachers cautioned you to sit up straight when you were a child, and with good reason.
Sitting in one position too long isnt healthy. Doing it with your back rounded forward, slumped to one side, or leaning too far back can put stress on parts of your spine for an extended period. This can lead to pain, as well as other issues.
To help you sit straighter, position your body along an imaginary straight line extending the length of your back, out of your head, and up to the ceiling. Keep your shoulders level and dont let your pelvis rotate forward. Doing so causes a curve in your lower back.
If you sit up perfectly straight, youll feel the small of your back stretch and lengthen.
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
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Heat And Cold Therapy
For temporary relief from back pain, try using a heating pad or cold compress. Cold reduces inflammation and constricts blood flow, while heat relaxes muscles and dilates blood vessels. Both can treat back pain depending on the cause. A good rule of thumb to remember is that heat works best for soreness and cold works best for injuries.
TENS units like the Omron Avail can temporarily relieve chronic pain.
Transcutaneous electrical nerve stimulation is a type of therapy that stimulates nerves at pain sites. Using electrodes placed on your skin, a TENS device emits gentle electric signals that mask or intercept the pain signals your body sends to your brain.
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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
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When To Call The Doctor
Most back pain gets better after a few weeks. But you should call the doctor if:
- Your pain is constant or intense, especially at night or when you lie down.
- Your pain spreads down one or both legs.
- You feel numbness or tingling in one or both legs.
- Youâre losing weight without trying.
Go to the emergency room right away if you have any of these symptoms:
- Pain after a fall, car crash or sports injury
- Fever
Whats New In This Article
Fourteen updates have been logged for this article since publication . All PainScience.com updates are logged to show a long term commitment to quality, accuracy, and currency. moreWhens the last time you read a blog post and found a list of many changes made to that page since publication? Like good footnotes, this sets PainScience.com apart from other health websites and blogs. Although footnotes are more useful, the update logs are important. They are fine print, but more meaningful than most of the comments that most Internet pages waste pixels on. I log any change to articles that might be of interest to a keen reader. Complete update logging of all noteworthy improvements to all articles started in 2016. Prior to that, I only logged major updates for the most popular and controversial articles.See the Whats New? page for updates to all recent site updates.
2020 Minor science update, added a citation to a cancer case study.
2020 Added information about back pain as a symptom of COVID-19.
2018 Cited Premkumar et al on red flag reliability .
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What Can I Do For Low Back Pain At Home
If your lower back pain has just started, the best thing you can do is start a log. Record your symptoms, times, dates and which activities trigger the pain or make it worse or better. Take this information to your family physician if the pain doesnt resolve on its own. It will make diagnosing the cause much easier.
Once you know which motion or position causes your lower back pain, try to avoid it and see if you get better. Icing the painful spot can also help. And so can over-the-counter pain relievers that help reduce inflammation. Just remember that pain killers treat only the symptom pain and not its cause.
Prop Onto Your Elbows
While lying on your stomach, slowly prop yourself up onto your elbows. This maneuver should cause your low back to bend back slightly. Take a few deep breaths and try to relax in this position.
While propping on your elbows, again try to monitor your symptoms for any changes. A decrease in your symptoms or centralization of your pain is a good sign here.
If your low back pain or sciatica worsens in the propped up position, simply return to lying face down and relax for a few more minutes, and then try to prop up again. Sometimes the pain is simply too intense to get into the propped up position. If this is the case, wait a few hours and try again.
Remain in the propped up position for a few minutes, and then slowly return to the prone lying position. Repeat this cycle for three to five repetitions, and then move on to the next exercise.
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Symptoms Of Low Back Pain
These might range from a dull ache to a stabbing or shooting sensation. The pain may make it hard to move or stand up straight. Pain that comes on suddenly is âacute.â It might happen during sports or heavy lifting. Pain that lasts more than 3 months is considered âchronic.â If your pain is not better within 72 hours, you should consult a doctor.
How To Tell If Your Lower Back Pain Is Muscle
by Dr. Don DuffAug 20, 2019
The low back is a fairly complicated structure, so its no wonder the majority of peopleexperts estimate up to 80% of usexperience pain in this area of our bodies at some point in our lives. In fact, back pain is one of the most common reasons for visits to the doctors office.
The key to relieving back pain is understanding the cause. But diagnosing the of a patients pain isnt always a straightforward exercise. It could be muscle, joint, or disc-related in some cases, it may even arise from issues unrelated to the back. So how can you tell if your back pain is muscle- or disc-related, or attributable to something else entirely? Well cover all the possibilities in this post.
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If You Have Low Back Pain Try These Steps First
- By Monique Tello, MD, MPH, Contributor
Low back pain, the scourge of mankind: it is the second leading cause of disability here in the United States, and the fourth worldwide. Its also one of the top five medical problems for which people see doctors. Almost every day that I see patients, I see someone with back pain. Its one of the top reasons for lost wages due to missed work, as well as for healthcare dollars spent, hence, a very expensive problem.
When Should I See My Doctor
If you have back pain and have lost feeling or movement in your limbs or are having problems controlling your bowels or bladder, call triple 000 immediately and ask for an ambulance.
You should see your doctor or other health care professional for further advice if:
- your pain bothers you
- your back pain doesnt improve after a few weeks or worsens
- you have symptoms such as weight loss, tingling or numbness in the legs, or problems with bladder and/or bowel control
- you have osteoporosis
You should see your doctor as soon as possible, if you have a history of cancer, are prone to infection, or use intravenous drugs.
For most people, back pain will resolve in a few weeks with appropriate self-care. After 2 months, 9 out of 10 people will recover from back pain.
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Treatment Options For Lower Back Pain
If your GP thinks there may be a specific cause for your back pain, they may refer you to a specialist to treat that specific condition.Usually, lower back pain gets better in a few days or weeks and often you can manage it yourself at home. For some advice about when to seek medical help, see our section on Symptoms.
Your physiotherapist or GP will probably encourage you to try self-help measures. They can also advise you on what exercises you can do to help your back. If the pain doesnt improve, then your GP can help with other options or may refer you to a specialist.
Drugs Are Not Part Of The Latest Recommendations For Treating Mechanical Back Pain
What the researchers found was surprising: for acute and subacute low back pain, the best and safest treatments are not medicines. The ACP made the following strong recommendation:
Most patients with acute or subacute low back pain improve over time regardless of treatment and can avoid potentially harmful and costly treatments and tests. First-line therapy should include nondrug therapy, such as superficial heat, massage, acupuncture, or spinal manipulation. When nondrug therapy fails, consider NSAIDs or skeletal muscle relaxants.
Because most mechanical back pain improves no matter what, we dont want to prescribe treatment that can cause harm. Because some medications carry significant risks, we really shouldnt be recommending these right off the bat. Rather, we should be providing guidance on heating pad or hot water bottle use, and recommendations or referrals to acupuncturists, massage therapists, and chiropractors. These therapies were somewhat effective, and are very unlikely to cause harm.
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How Is Back Pain Treated
Acute back pain usually gets better on its own. Acute back pain is usually treated with:
- Medications designed to relieve pain and/or inflammation
- analgesics such as acetaminophen and aspirin
- non-steroidal anti-inflammatory drugs such as ibuprofen and naproxen may be sold over the counter some NSAIDS are prescribed by a physician
- muscle relaxants are prescription drugs that are used on a short-term basis to relax tight muscles
- topical pain relief such as creams, gels, patches, or sprays applied to the skin stimulate the nerves in the skin to provide feelings of warmth or cold in order to dull the sensation of pain. Common topical medications include capsaicin and lidocaine.
Exercising, bed rest, and surgery are typically not recommended for acute back pain.Chronic back pain is most often treated with a stepped care approach, moving from simple low-cost treatments to more aggressive approaches. Specific treatments may depend on the identified cause of the back pain.
What Are The Most Common Lower Back Surgery Procedures
Spine surgery is not necessary for most people who have lower back pain. If you do need it, your doctor will recommend an appropriate procedure to address your specific symptoms and medical situation. Common spine surgeries include:
Spinal Fusion. Two or more vertebrae are permanently fused together to limit excess spinal motion. Your surgeon will use a combination of bone, bonelike material, screws, plates and rods to hold the vertebrae together so they can heal into a single unit. Spinal fusion may be done to correct spinal deformities or to increase the spines stability in severe cases of spinal osteoarthritis or herniated discs.
Laminectomy and laminotomy. Laminectomy is a surgery in which your surgeon removes the back portion of one or more vertebrae to create more space for the spinal cord or other nerves. In people with severe arthritis, bone spurs within the spinal canal can grow large enough to press on the spinal cord, causing pain and limiting mobility. In a similar surgery known as laminotomy, your surgeon will remove a small piece of bone called the lamina from the back of the vertebra.
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Key Points About Low Back Pain
- Specific treatment for low back pain depends on the cause of the pain and the severity. But it often includes pain medicines and muscle relaxers, physical therapy, and assistive devices such as a back support. It also may include lifestyle changes such as stress reduction, weight loss, and increased physical activity.
- A back rehab program may be used as part of the treatment for low back pain.
- Measures to prevent back pain include using safe lifting techniques, maintaining correct posture, staying at a healthy weight, not smoking, and reducing stress.
What Is Low Back Pain
The low back, also called the lumbar region, is the area of the back that starts below the ribcage. Almost everyone has low back pain at some point in life. Itâs one of the top causes of missed work in the U.S. Fortunately, it often gets better on its own. When it doesn’t, your doctor may be able to help with several effective treatments.
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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.
How Do I Stop My Lower Back From Hurting When I Walk
The posture you have when walking matters more than you think. Walking places a tremendous amount of weight on the spine, which can affect the support structure of the rest of the body. If you experience back pain when you walk, your posture may be the underlying cause.
So how do you stop your lower back from hurting when you walk? While the overarching answer can be different depending on the individual, improvements to your gait and general posture is an excellent start.
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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.