What Do You Do About Trigger Points And Fibromyalgia
Those are both big, separate topics, but there are many resources on PainScience.com where you can get started. Self-massage and heating are by far the best ways to start working on muscle knots. Fibromyalgia is much more complicated, but the basics are sleep improvements, lots of light but thorough exercise, and learning about sensitization and the weirdness of pain.
The Worst Back Pain Is Rarely The Scariest
People understandably assume that the worst back pain is the scariest. In fact, pain intensity is a poor indicator of back pain ominousness,10 and some of the worst causes are actually the least painful . For instance, someone could experience the symptoms of cauda equinae syndrome, and be in real danger of a serious and permanent injury to their spine, but have surprisingly little pain even none at all in some cases!
Meanwhile, many non-dangerous problems can cause amazingly severe back pain. A muscle cramp is a good analogy just think about how painful a Charley horse is! Regardless of whats actually going on in there, muscle pain is probably the main thing that back pain patients are feeling. The phenomenon of trigger points tiny muscle cramps, basically11 could be the entire problem, or a complication thats more painful and persistent than the original problem. Its hard to overstate how painful trigger points can be, but they are not dangerous to anything but your comfort.
Treatments For Back Pain From A Specialist
A GP, specialist or physiotherapist may recommend extra treatments if they do not think your pain will improve with self-help measures alone.
These may include:
- group exercise classes where you’re taught exercises to strengthen your muscles and improve your posture
- manual therapy treatments, such as manipulating the spine and massage, which are usually done by a physiotherapist, chiropractor or osteopath
- psychological support, such as cognitive behavioural therapy , which can be a useful part of treatment if you’re struggling to cope with pain
Some people choose to see a therapist for manual therapy without seeing a GP first. If you want to do this, you’ll usually need to pay for private treatment.
Surgery is generally only considered in the small number of cases where back pain is caused by a specific medical condition.
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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
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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I Didnt Need Exercise Before And I Dont Now
The problems with your symptoms are not obvious until long after some injury has occurred to you. There is a good chance that earlier warning signs such as sudden spasm, stiffness, soreness, tightness and aches are sometimes seen as unrelated or to be treated simply with rest or medication.
But when you are not able to care for yourself because of these warning signs, they may progress into the morning. Sudden and gradual changes to your level of activity or lifestyle do have an impact on any changes to the overall health of your back.
Dont regard exercise as something new to add to your recovery. Rather, it should be seen as what your body naturally requires to maintain optimal health and protection of your spine. The type of exercises for your relief that are beneficial are actually composed of movements and stretches to improve your mobility and eliminate weaknesses.
Medical Conditions That Cause Back Pain
Conditions that can cause back pain include:
- a slipped disc this can cause back pain and numbness, tingling and weakness in other parts of the body
- sciatica this can cause pain, numbness, tingling and weakness in the lower back, buttocks, legs and feet
- ankylosing spondylitis this causes pain and stiffness that’s usually worse in the morning and improves with movement
- spondylolisthesis this can cause lower back pain and stiffness, as well as numbness and a tingling sensation
These conditions are treated differently to non-specific back pain.
Very rarely, back pain can be a sign of a serious problem such as:
- a broken bone in the spine
- an infection
- cauda equina syndrome
- some types of cancer, such as multiple myeloma
If you see a GP with back pain, they’ll look for signs of these.
Page last reviewed: 14 January 2020 Next review due: 14 January 2023
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How To Sit On A Chair
To sit on a chair safely:
To help your back and make sitting more comfortable:
- Try to get up and change position regularly
- Try to sit right back in the chair
- Put a rolled up towel in the small curve at the bottom of your spine
Articles Like This Dont Write Themselves
Suggested price to continue reading is $6 USD.? Dont want to pay? Just keep on scrollin by! Like passing a street busker.
You do not have to pay to continue reading. The suggested price really is just a suggestion. I refuse to clutter my pages with typical internet advertising so instead you get a strongly worded suggestion to support my work. But only in a few of the most substantive and popular articles.
And why six bucks? I would rather suggest $3 for this, honestly, but my hands are tied. Its weird, but $5 online purchases are rejected by credit card companies at an extraordinary rate, because that price point is strongly associated with fraud . And under $5, the fees start to defeat the purpose of the donation. So $6 is the minimum viable price point for a micro-transaction.
But, if youve come this far with me, you can see that this is a super deep dive into the topic of morning back pain, like a small ebook that I could easily be selling to Kindle users . Certainly its more than a mere article: its an actively maintained resource, heavily referenced, and ad-free for millions of readers over the years. Please help it exist.
Or support PainScience with a premium newsletter subscription, and get 13 mostly short posts of pain science news per week, plus some extra posts, plus members-only content scattered around the site. See the membership page.
Vancouver, Canada
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Low Back Pain Fact Sheet
If you have had lower back pain, you are not alone. Back pain is one of most common reasons people see a doctor or miss days at work. Even school-age children can have back pain.
Back pain can range in intensity from a dull, constant ache to a sudden, sharp or shooting pain. It can begin suddenly as a result of an accident or by lifting something heavy, or it can develop over time as we age. Getting too little exercise followed by a strenuous workout also can cause back pain.
There are two types of back pain:
- Acute, or short-term back pain lasts a few days to a few weeks. Most low back pain is acute. It tends to resolve on its own within a few days with self-care and there is no residual loss of function. In some cases a few months are required for the symptoms to disappear.
- Chronic back pain is defined as pain that continues for 12 weeks or longer, even after an initial injury or underlying cause of acute low back pain has been treated. About 20 percent of people affected by acute low back pain develop chronic low back pain with persistent symptoms at one year. Even if pain persists, it does not always mean there is a medically serious underlying cause or one that can be easily identified and treated. In some cases, treatment successfully relieves chronic low back pain, but in other cases pain continues despite medical and surgical treatment.
Inflammation Sleep Stress And Pain
The link between sleep and pain is based on some superficially simple inflammatory biology: bad sleep is inflammatory and inflammation makes it harder to sleep, which is not widely appreciated. That means that sleeping badly can actually make it harder to sleep well!17 This is a vicious cycle every extremely frustrated insomniac is familiar with: being exhausted from a sleepless is not a guarantee that you will sleep well the next night.
And that vicious cycle is relevant to night and morning pain, which is known to be significantly mediated by the immune system signalling molecule interleukin-6. IL-6 and inflammation are almost synonymous more of one means more of the other. Everyone knows that stress makes it harder to sleep, but how? Its not just because your mind is racing its because stress makes us produce IL-6, which is inflammatory, and inflammation in turn makes it harder to sleep! And then the bad sleep also makes us pump more IL-6
And thats why its important to get your sleep!
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When To Call A Professional
Contact your doctor if:
- Severe back pain makes it impossible for you to do your normal daily activities.
- Your back pain follows significant trauma.
- Mild back pain gets worse after a few days or persists more than a week or two.
- Back pain is accompanied by weight loss, fever, chills or urinary symptoms.
- You develop sudden weakness, numbness or tingling in a leg.
- You develop numbness in the groin or rectum or difficulty controlling bladder or bowel function.
- You have had cancer previously and you develop persistent back pain.
What Structures Make Up The Back
The lower backwhere most back pain occursincludes the five vertebrae in the lumbar region, which supports much of the weight of the upper body. The spaces between the vertebrae are maintained by round, rubbery pads called intervertebral discs that act like shock absorbers throughout the spinal column to cushion the bones as the body moves. Bands of tissue known as ligaments hold the vertebrae in place, and tendons attach the muscles to the spinal column. Thirty-one pairs of nerves are rooted to the spinal cord and they control body movements and transmit signals from the body to the brain.
Other regions of vertebrate are cervical , thoracic , and sacral and coccygeal segments.
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Unexplained Acute Low Back Pain
Unexplained low back pain means chronic pain that comes on gradually, over time, with no specific injury, event, or illness causing it.
Common causes:
- Prolonged sitting and lack of fitness can weaken back muscles and cause pain from lack of support.
- Ankylosing spondylitis, a form of arthritis.
- Spinal stenosis, a narrowing of the spinal column that puts pressure on the spinal cord.
- Certain types of cancer, in rare cases.
Those most susceptible are over 30, overweight and/or pregnant, and not physically fit. Smoking interferes with healing after any sort of stress to the back.
If there are additional symptoms, medical care should be sought: fever, unexplained weight loss, leg weakness or numbness, or trouble urinating.
An exact diagnosis is made through blood tests and through imaging such as x-rays, CT scan, or MRI.
Once more serious causes are ruled out, treatment may include medications to ease pain, swelling, and inflammation. Steroid injections are useful in some cases.
Overall, exercise and maintaining a healthy weight can be very helpful with easing chronic low back pain.
Rarity: Common
Top Symptoms: lower back pain, back pain that shoots to the butt, fever, back pain
Symptoms that always occur with unexplained acute low back pain:lower back pain
Symptoms that never occur with unexplained acute low back pain:buttocks numbness, thigh numbness, involuntary defecation, fever
Urgency: Self-treatment
Yoga Works When There Are Strong Ligaments Yoga Will Not Help When Ligament Instability Prevents Muscles From Getting Needed Resistance
Some patients with lower back pain have seen great results with yoga. Some patients have seen poor, none, or worse, results that caused greater injury to the low back. Why do some get benefits and others didnt? How do some hurt themselves worse? The answer is ligaments.
Lets first paint a picture by way of a comparison between yoga and physical therapy and the ligament problem.
- If ligament damage and weakness are the problems, a patient trying yoga and physical therapy will find in most cases, neither will help.
- If the patients ligaments are still strong enough and can provide the spinal and core muscles resistance, the spine will be stable enough for yoga and physical therapy to work and provide great relief.
Research that was published in the July 2017 edition of the Annals of Internal Medicine helps us shed some light on realistic expectations for Yoga and Physical Therapy.
Coming from some of the best research universities in the United States, doctors from Boston University School of Medicine, Harvard Medical School, the University of Pittsburgh School of Health and Rehabilitation Sciences, and the University of Washington found:
The portions of the above in quotations come from the Annals of Internal Medicine, patient information recap of the study.
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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
The Popular Understanding Of Back Pain Is Disc Herniation As A Frequent Cause But To A Much Greater Extent Ligament Injury Forms The Underlying Basis
Caring Medical research: Our paper A Systematic Review of Dextrose Prolotherapy for Chronic Musculoskeletal Pain, published in the journal Clinical Medicine Insights. Arthritis and Musculoskeletal Disorders made these observations supported by accompanying citations:
- In approximately 90% of patients, low back pain is mechanical in nature, typically originating from overuse, straining, lifting, or bending that results in ligament sprains, muscle pulls, or disk herniation.
- The popular understanding of back pain is disc herniation as a frequent cause, but to a much greater extent, ligament injury forms the underlying basis.
- Ligaments hold the disc in place, and with ligament weakness, the disc is more likely to herniate.
- Low back pain patients who remain symptomatic despite tailored physiotherapy are believed to possess deficient ligament strength in the rear elements of the sacroiliac joint, resulting in insufficient stability to permit effective muscle recruiting strategies.
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Other Types Of Diagnosis
- A chiropractor will diagnose through touch, or palpation, and a visual examination. Chiropractic is known as a direct approach, with a strong focus on adjusting the spinal joints. A chiropractor may also want to see the results of imaging scans and any blood and urine tests.
- An osteopath also diagnoses through palpation and visual inspection. Osteopathy involves slow and rhythmic stretching, known as mobilization, pressure or indirect techniques, and manipulation of joints and muscles.
- A physical therapist focuses on diagnosing problems in the joints and soft tissues of the body.
Muscle Strain And Ligament Sprain
A low back sprain or strain can happen suddenly, or can develop slowly over time from repetitive movements.
- Strains occur when a muscle is stretched too far and tears, damaging the muscle itself.
- Sprains happen when over-stretching and tearing affects ligaments, which connect the bones together.
For practical purposes, it does not matter whether the muscle or ligament is damaged, as the symptoms and treatment are the same.
Common causes of sprain and strain include:
- Lifting a heavy object, or twisting the spine while lifting
- Sudden movements that place too much stress on the low back, such as a fall
- Poor posture over time
- Sports injuries, especially in sports that involve twisting or large forces of impact
While sprains and strains do not sound serious and do not typically cause long-lasting pain, the acute pain can be quite severe.
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