Tips For Dealing With Lower Back Pain
By Robert Greenleaf, MD, Spine Surgeon
Lower back pain is extremely common and one of the top reasons for missed workdays. Thats because the lower back supports the weight of the upper body and is subject to a lot of stress and strainespecially during everyday movements like lifting and twisting.
One of two things typically causes lower back pain: a sudden injury or the wear and tear of aging, arthritis and physical activity. No matter the cause of your lower back pain, here are 10 recommendations that can help you relieve it and prevent future problems.
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.
Lower Back Pain: Is It In Your Genes
One of the main reasons a person develops low back pain and another doesn’t may lie in their genes. With disc degeneration, Andersson says, âIf you take twins — one who is doing heavy physical work and one who is doing desk work — and you compare their MRI exams, they are essentially identical. This tells you that genetic factors are very important.â
If you have chronic low back pain, you’ve likely inherited the tendency, and you’re probably hardwired for it. The lower back contains sensitive receptors called nociceptive fibers, which send pain signals to the brain. “Some people have a lot of nociceptive fibers — for example, in their discs — while others have relatively few,” Wisneski tells WebMD. That may be why one person can lift heavy weights many times and never experience low back pain, while another who barely lifts anything is in constant agony.
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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.
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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Ways To Ease Low Back Pain
Just because it’s possible to inherit low back pain doesn’t mean the matter is completely out of your control. “It’s how we’re born and how we take care of ourselves,” Wisneski says.
If you sit in an uncomfortable chair all day, work a jackhammer, or regularly twist your body into uncomfortable positions, your lower back will suffer for it. Smoking — the bad habit that increases the risk of dozens of diseases — can also lead to backaches. One study found that smokers are nearly a third more likely to have low back pain compared to nonsmokers.
Try these five tips to prevent or ease lower back pain:
- If you smoke, get help to kick the habit.
- Practice good posture whenever you sit or stand. When lifting something, lift with your knees, not with your back.
- Do exercises to strengthen the muscles that support your back — especially the abdominals, hips, back, and pelvic area. Developing strong core muscles can make a big difference in how you feel. “When my abs are in good shape and I’m well worked out, I’m the least susceptible,” Snyder says.
- Fight the urge to crawl into bed whenever your lower back acts up. “Our bodies are meant to be used,” Wisneski says. “If you have pain, sometimes you develop a âdisease of disuse.â”
- See your doctor and get treated for low back pain early on, so you can stay moving and keep active.
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Gunnar Andersson, MD, PhD, professor and chairman emeritus, Department of Orthopedic Surgery, Rush University Medical Center, Chicago.
How To Prevent Lower Back Pain For Avid Runners
Lower back pain is an unfortunately all-too-common problem for avid runners. It can be debilitating, interfere with ones ability to train, and ultimately prevent them from competing at the highest level. Despite the high prevalence of lower back pain among runners, its important to remember that it doesnt have to be a permanent issue.
There are several ways that runners can prevent lower back pain in the first place by running smarter instead of harder.
One of the most important steps that runners can take to prevent lower back pain is to make sure they are properly warmed up before they begin their run. This includes doing dynamic stretches as well as some light jogging or walking in order to get the muscles loosened up and ready for activity.
Additionally, runners should focus on strengthening their core muscles, which will help protect their spine during long runs. Core exercises such as planks and crunches are great for this purpose and should be incorporated into any runners regular training routine.
Finally, its essential for all runners pay attention to proper form while running in order to reduce any additional stress on the lower back. This means focusing on keeping your shoulders relaxed, leaning slightly forward from the hips, and striking with your feet beneath your body rather than out in front of you.
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Target The Quadratus Lumborum For Extra Pain Relief
Outside of the traditional stretches, you may want to consider stretching and releasing your quadratus lumborum muscle.
The Quadratus Lumborum are muscles positioned around the lower back either side of the spine.
A tight QL can also be the cause of lower back pain so its a good idea to investigate whether you have issues with your QL.
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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Treatment Options For Acute Lower Back Pain
Most low back pain is due to muscle strain and spasm and does not require surgery. To treat the pain, medications such as acetaminophen , nonsteroidal anti-inflammatory agents , gabapentin or pregabalin can be used. NSAIDs suppress inflammation, pain and fever by inhibiting certain inflammation-causing chemicals in the body. Acetaminophen reduces pain and fever, but does not inhibit inflammation. Gabapentin and pregabalin, medications that have been used for antiseizure activity, also have the ability to block pain. Opioids provide pain relief and may at times be prescribed to manage severe back pain. However, opioids have many problems, such as habituation, constipation and lightheadedness, and are avoided when possible and used for the shortest possible duration. Epidural injection is an option if the back pain does not respond to these treatments. Each person is different in terms of response to medication.
Other nonsurgical treatments for lower back pain include Intradiscal electrothermal therapy , nucleoplasty, and radiofrequency lesioning.
How To Stop Lower Back Pain
Back pain has now reached epidemic levels in the UK and is now the single cause of disability according to NHS England.
With most people resorting to painkillers, I spoke with leading GP Dr Dawn Harper and Physiotherapist Sammy Margo to pull together the top exercises to help ease back pain through stretching and strengthening core muscles.
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How To Give A Back Massage
With just a few tools and some basic massage techniques, you can give a back message to a friend or family member or even show them how to give you one. Heres a video about giving a lower back massage:
Keep in mind that you should never apply pressure directly to the spine. Only use gentle pressure to avoid injury and discomfort.
Try Easy Mobility Routines Before You Go To Bed And When You Wake Up
Today, theres a lack of separation between work and home for many due to COVID-19, so its easy for people to go right from the computer to bed. This is why its important to build in behaviors and habits, like a gentle mobility routine, into an intentional nighttime wind-down routine, says Dr. Grimes. The motion is lotion concept means youre bringing nutrition and blood flow to the tissues in your spine when you move. Here are simple stretches and exercises that you can do before bed to loosen up your back.
When you wake up in the morning, if youre lying on your back, squeeze your abdomen down into the bed to engage those core muscles. This is called abdominal bracing, says Dr. Smith. Or bring your knees to your chest to loosen up your hips a little bit. If you can tolerate it, try some supine knee twists, where you lie on your back and turn your knees to one side. Like the Tin Man with no oil, the spine and other joints can feel stiff and creaky after a period of immobility when you get up, so just giving yourself a little bit of extra time in the morning can also help. Often symptoms will improve once you get moving.
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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.
How To Relieve Lower Back Pain: 7 Easy Ways To Reduce Back Pain
Does your low back hurt? You’re not alone.
Low-back pain is a nagging problem for many people. Almost 65 million Americans report a recent episode of back pain, according to the Health Policy Institute at Georgetown University. One study cited by the CDC found that “it was the most common type of pain reported by patients, with 25% of U.S. adults reporting low back pain in the prior 3 months.”
Some more serious issues that can cause back pain like a disk injury or structural problem require attention from a doctor or chiropractor. So always check with your doctor about any pain youre feeling. But oftentimes pain in the low back is caused by strained muscles or tendons, weak abdominal muscles and poor posture. The good news? These are all things within our control.
There are some everyday tricks that you can implement to avoid and reduce low-back pain. For many of us, being stuck at a desk all day without moving causes an uncomfortable tightness in the hamstrings, erector muscles of the spine and hip flexors. Strengthening the core, loosening up tight muscles and training the body to hold itself with better posture can all help.
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Get Enough Restorative Sleep
Pain is a leading cause of insomniadifficulty with falling asleep and/or staying asleep. Inadequate sleep can also make your back pain worse. This vicious cycle makes it more difficult for you to get restorative sleep.
See Restorative Sleep Brings Back Pain Relief
Getting enough restorative sleep is needed for the bodys tissues to heal and recharge energy levels. If you have trouble sleeping, it is important to address pain or other factors that are causing it. Your doctor might recommend lifestyle changes, medications, or other treatments depending on what is disrupting your sleep.
Tips And Stretches For Lower Back Pain
If you are reading this, you are probably experiencing lower back pain or know someone who is.
Back pain is one of the most common medical complaints in the world. Studies show that up to 70% of adults will experience some kind of back pain during their lives. Worldwide, back pain is the main reason for missed work days and the second most common reason to visit a doctor.
Back pain may be caused by a sprain you suffered at work or from doing chores around the house. Or, the pain may result from an injury or a chronic condition, like arthritis.
If your pain is sudden or severe, you should get checked by your doctor. But, if you are experiencing a nagging pain or discomfort, there are things you can do to relieve the pain. Here are a few things to try.
1. Move. It may be uncomfortable, but one of the best things you can do to deal with lower back pain is to move around. Get on your feet and take a walk. Whether its a brisk walk around the block or a slow stroll, walking can help to strengthen back muscles, which will improve support for the spine.
2. Stretch. Often, lower back pain results from tight muscles. Stretching can increase flexibility and loosen muscles. Yoga is excellent to keep the body limber. Stretching exercises may also help.
3. Exercise. Beyond stretching, you should exercise to strengthen your core, which provides important support for your back. Pilates and tai chi are useful for strengthening the core.
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How Is Lower Back Pain Diagnosed
Your provider will ask about your symptoms and do a physical exam. To check for broken bones or other damage, your provider may order imaging studies. These studies help your provider see clear pictures of your vertebrae, disks, muscles, ligaments and tendons.
Your provider may order:
- Spine X-ray, which uses radiation to produce images of bones.
- MRI, which uses a magnet and radio waves to create pictures of bones, muscles, tendons and other soft tissues.
- CT scan, which uses X-rays and a computer to create 3D images of bones and soft tissues.
-
Electromyography to test nerves and muscles and check for neuropathy , which can cause tingling or numbness in your legs.
Depending on the cause of pain, your provider may also order blood tests or urine tests. Blood tests can detect genetic markers for some conditions that cause back pain . Urine tests check for kidney stones, which cause pain in the flank .
Common Causes Of Lower Right Back Pain
Now, lets turn to common musculoskeletal causes of lower right back pain. By learning more about these causes, youll be better prepared to get quick pain relief.
1. Sprains and Strains
Sprains and strains are the number one cause of lower right back pain.
Whats the difference between a sprain and a strain? In essence, they are similar injuries. Sprains happen when you overextend or tear ligaments strains happen when you tear muscles or tendons . Typically, youll feel swelling, stiffness, bruising, cramping and/or spasms in your lower right back.
You usually know when you have a sprain or strain because you did something to trigger it. This could be an everyday activity, such as a sports injury, lifting something heavy, household falls or overexercising. Any sudden movements, or unnatural twisting and turning can also injure your muscles.
While both sprains and strains can heal on their own, you can help speed up the recovery process. Generally, the R.I.C.E. formula is recommended, which stands for Rest, Ice, Compression and Elevation. The idea is to limit the use of your back muscles, ice them and apply any compression bandages. By following this formula, your lower right back should feel better in no time.
2. Disc Degeneration
In extreme cases, you may even consider steroid injections or surgery. However, most people with disc degeneration will focus on getting relief at home.
3. Osteoarthritis
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Lower Back Pain Caused By Infection
Infections of the spine are not common, but they do occur. The doctor will ask about the usual signs and symptoms of infection, especially when back pain is accompanied by fever and/or chills. Dialysis patients, IV drug users, and patients who have recently had surgery, trauma, or skin infections are at risk for infections of the spine. Infections of the spine can be caused by a number of agents, most commonly bacteria. Doctors will first test for the presence of bacteria, then give antibiotics.
