Back pain in the lower back or low back pain is a common concern, affecting up to 90% of Americans at some point in their lifetime. Up to 50% will have more than one episode. Low back pain is not a specific disease. Rather, it is a symptom that may occur from a variety of different processes. In up to 85% of people with low back pain, despite a thorough medical examination, no specific cause of the pain can be identified.
Low back pain is second only to the common cold as a cause of lost days at work. It is also one of the most common reasons to visit a doctor's office or a hospital's emergency department.
For 90% of people, even those with nerve root irritation, their symptoms will improve within 2 months, no matter what treatment is used-even if no treatment is given.
Doctors usually refer to back pain as acute if it has been present for less than a month and chronic if it lasts for a longer period of time.
Back Pain Causes
Back pain is a symptom. Pain arising from other organs may be felt in the back. This is called referred pain. Many intra-abdominal disorders-such as appendicitis, aneurysms, kidney diseases, bladder infections, pelvic infections, and ovarian disorders, among others-can cause pain referred to the back. Your doctor will have this in mind when evaluating your pain.
Nerve root syndromes are those that produce symptoms of nerve impingement (a nerve is touched), often due to a herniation (or bulging) of the disc between the lower back bones. Sciatica is an example of nerve root impingement. Impingement pain tends to be sharp, in one spot, and associated with numbness in the area of the leg that the affected nerve supplies.
Herniated discs are produced as the spinal discs degenerate or grow thinner. The jellylike central portion of the disc bulges out of the central cavity and pushes against a nerve root. Intervertebral discs begin to degenerate by the third decade of life. Herniated discs are found in a third of adults older than 20. Only 3% of these, however, produce symptoms of nerve impingement.
Spinal stenosis occurs as intervertebral discs lose moisture and volume with age, which decreases the disc spaces. Even minor trauma under these circumstances can cause inflammation and nerve root impingement, which can produce classic sciatica without disc rupture.
Spinal degeneration is caused by alterations in the disc that progress to degeneration. This, coupled with disease in joints of the low back, causes spinal canal narrowing. These changes in the disc and the joints produce symptoms and can be seen on an x-ray. A person with spinal degeneration may have morning stiffness or pain while standing for a long time or walking even short distances.
Cauda equina syndrome is a medical emergency. Disc material expands into the spinal canal, which compresses the nerves. A person would experience pain, possible loss of sensation, and bowel or bladder dysfunction. This could include inability to control urination causing incontinence, or the inability to begin urination.
Musculoskeletal pain syndromes that produce low back pain include myofascial pain syndromes and fibromyalgia.
Myofascial pain is characterized by pain and tenderness over localized areas (trigger points), loss of range of motion in the involved muscle groups, and pain radiating in a characteristic distribution but restricted to a peripheral nerve. Relief of pain is often reported when the involved muscle group is stretched.
Fibromyalgia results in pain and tenderness on 11 of 18 trigger points when touched, one of which is the low back area, as classified by the American College of Rheumatology. Generalized stiffness, fatigue, and muscle ache are reported.
Other skeletal causes of low back pain include osteomyelitis or sacroiliitis (infections of the bones of the spine). This pain is usually worse at night and is worse when sitting or standing for a long time.
Tumors, possibly cancerous, can be a source of skeletal pain
Back Pain Symptoms
Pain in the lumbosacral area (lower part of the back) is the primary symptom of low back pain.
The pain may radiate down the front, side, or back of your leg, or it may be confined to the low back.
The pain may become worse with activity.
Occasionally, the pain may be worse at night or with prolonged sitting such as on a long car trip.
You may have numbness or weakness in the part of the leg that receives its nerve supply from a compressed nerve.
An example of this would be an inability to plantar flex the foot. This means you would be unable to stand on your toes or bring your foot downward. This occurs when the first sacral nerve is compressed or injured.
Another example would be the inability to raise your big toe upward. This results when the fifth lumbar nerve is compromised
When to Seek Medical Care
The Agency for Healthcare Research and Quality has identified 11 "red flags" that doctors should look for when evaluating a person with back pain. The focus of these red flags is to detect fractures (broken bones), infections, or tumors of the spine. Presence of any of the following "red flags" with low back pain should prompt a visit to your doctor as soon as possible for complete evaluation.
Recent significant trauma such as a fall from a height, motor vehicle accident, or similar incident
Recent mild trauma in those older than 50: A fall down a few steps or slipping and landing on the buttocks may be considered mild trauma.
History of prolonged steroid use: People with asthma, COPD, and rheumatologic disorders are frequently on this type of medication.
Anyone with a history of osteoporosis: An elderly woman with a history of a hip fracture, for example, would be considered high risk.
Any person older than 70: There is an increased incidence of cancer, infections, and abdominal causes of the pain.
Prior history of cancer
History of a recent infection
Temperature over 100° F
IV drug use: Such behavior markedly increases risk of an infectious cause.
Low back pain worse at rest: This is thought to be associated with an infectious or malignant cause of pain.
Unexplained weight loss
The presence of any of the "red flags" would justify a visit to a hospital's emergency department, particularly if your family doctor is unable to evaluate you within the next 24 hours.
The presence of any acute nerve dysfunction should also prompt an immediate visit. These would include inability to walk or inability to raise or lower your foot at the ankle. Also included would be the inability to raise the big toe upward or walk on your heels or stand on your toes. These might indicate an acute nerve injury or compression. Under certain circumstances, this may be an acute neurosurgical emergency.
Loss of bowel or bladder control including difficulty starting or stopping a stream of urine or incontinence can be a sign of an acute emergency and requires urgent evaluation in an emergency department.
If you cannot manage the pain using the medicine you are currently prescribed, this may be an indication to go to an emergency department. Generally, this problem is best addressed with the doctor writing the prescription who is following you for this problem.
Back Pain Treatment
Self-Care at Home
General recommendations are to resume normal, or near normal, activity as soon as possible. Stretching or activities that place additional strain on the back are discouraged, however.
Sleeping with a pillow between the knees while lying on one side may increase comfort. Some doctors recommend lying on your back with a pillow under your knees.
No specific back exercises were found that improved pain or increased functional ability in people with acute back pain. Exercise, however, may be useful for people with chronic back pain to help them return to normal activities and work.
Nonprescription medications may provide relief from pain.
Ibuprofen (such as Advil, Nuprin, or Motrin), available over-the-counter, is an excellent medication for the short-term treatment of low back pain. Because of the risk of ulcers and gastrointestinal bleeding, talk with your doctor about using this medication for a long time.
Acetaminophen (such as Tylenol) has been shown to be as effective as ibuprofen in relieving pain.
Topical agents such as "deep heating rubs" have not been shown to be effective.
Some people seem to benefit from the use of ice or heat. Their use, although not proven effective, is not considered to be harmful. Take care: Do not use a heating pad on "high" or place ice directly on the skin.
Most experts agree that prolonged bed rest is associated with a longer recovery period. Further, people on bed rest are more likely to develop depression, blood clots in the leg, and decreased muscle tone. Very few experts recommend more than a 48-hour period of decreased activity or bed rest. In other words, get up and get moving to the extent you can.
Much has been written about lower back pain exercises and the preventive and rehabilitative aspects of specific back exercise for back pain sufferers. In fact, over the last two decades, more than a thousand books and magazines have featured an X-minutes-a-day exercise program, each one promoted as the lower back pain exercises plan to for you.
Since most people with activity-limiting back pain do back exercises on a regular basis - and still have limitations - it is obvious that the whole story about back pain exercises hasn’t been told. So let’s try to sort out the misconceptions from the facts by examining some commonly held but erroneous beliefs about exercises for back pain.
If you are athletic and fit you won’t have back pain. False. The physical fitness boom that took hold in the USA in the 1970s, galvanizing some 55 million Americans into regular fitness activities, did not banish back problems by any means.
Incapacitating back pain among weekend athletes is common. According to the US Health Insurance Association, an estimated 20 million sports injuries, including back injuries, occur each year. And, according to survey participants, racket sports such as tennis and squash, with their sudden lunges, starts and stops, seem to be especially risky for back pain sufferers.
Any reputable book, magazine article or printed sheet handed to you by a doctor can teach you the upper and lower back pain exercises you need. This is only half true. Roughly half the US back pain sufferers who got advice this way were not helped much by it - and about 10 per cent were injured by it.
If you have low back pain that is more annoying than incapacitating, and if you are in relatively good shape, the chances are that a conservative back pain exercise plan that progresses slowly may help you a great deal. But if you have activity-limiting episodes of back pain, or chronic back pain, you probably need an exercise plan prescribed specifically for you, lest you risk serious injury, or fail to make progress.
For the vast majority of back sufferers, appropriate exercises for back pain are essential to lessening or ending back pain. People with debilitating back pain have far more success with individually prescribed exercise programs than with back pain exercise routines in self-help books and articles or in health dub classes.
As for specific back pain exercise advice, experiences show that there are two very simple ‘non-back’ exercises that help just about everyone with back pain - walking and swimming.
Even back sufferers who can’t lead normal lives because of back pain usually improve in the long run by following their practitioners’ advice to walk or swim regularly. At least half an hour of brisk walking every other day is recommended, or building up to 15 minutes of non-stop swimming three times a week.
Results from a large international survey were remarkably similar for both swimming and walking, with around 70 per cent of participants getting back pain relief from these activities. One respondent, Jane, had this advice for others: ‘Keep active. Consider back pain exercise that keeps you mobile and flexible such as walking, swimming, dance, use simple stretching and flexibility exercises, plan a short simple routine to do each day.’
And another, Michelle, advised: ‘Walking or swimming often relieves back pain. Don’t do high-impact sports like running. Avoid anything that demands jerky movements.’
Personally tailored back pain exercise advice is most likely to be forthcoming from one of the following exercise experts:
• Physiotherapist (practitioner trained in natural means of rehabilitation, who usually requires a doctor’s authorization to treat you)
• Sports medicine specialist (medical doctor trained to prevent and repair sports injuries, including back problems)
• Kinesiologists (expert in the principles and mechanics of movement)
• Yoga teacher
• Physical fitness instructor.
Not all yoga teachers and physical fitness instructors have the experience or the desire to work with back problems. On the other hand, some physical fitness instructors have advanced degrees in back pain exercises physiology or kinesiology, and may be especially qualified to prescribe exercises for back pain
topbackpainrelieftips.com/back-pain-exercises
Low back pain: Exercises to reduce pain
Key points
• Low back pain is very common among adults and is often caused by overuse and muscle strain or injury. Treatment can help you stay as active as possible, and it will help you understand that some continued or repeated back pain is not surprising or dangerous.
• Most low back pain can get better if you stay active, avoid positions and activities that may increase or cause back pain, use ice, and take nonprescription pain relievers when you need them.
• When you no longer have acute pain, you may be ready for gentle strengthening exercises for your stomach, back, and legs, and perhaps for some stretching exercises. Exercise may not only help decrease low back pain, but it may also help you recover faster, prevent reinjury to your back, and reduce the risk of disability from back pain.
• Exercises to reduce low back pain are not complicated and can be done at home without any special equipment.
• It's important that you don't let fear of pain keep you from trying gentle activity. You should try to be active soon after noticing pain, and gradually increase your activity level. 1 Too little activity can lead to loss of flexibility, strength, and endurance, and then to more pain.
Exercises that may help reduce or prevent low back pain include:
• Aerobic exercise, to condition your heart and other muscles, maintain health, and speed recovery.
• Strengthening exercises, focusing on your back, stomach, and leg muscles.
• Stretching exercises, to keep your muscles and other supporting tissues flexible and less prone to injury.
Some exercises can aggravate back pain. If you have low back pain, avoid:
• What exercises are important for low back pain
•
• Straight leg sit-ups.
• Bent leg sit-ups or partial sit-ups (curl-ups) when you have acute back pain.
• Lifting both legs while lying on your back (leg lifts).
• Lifting heavy weights above the waist (standing military press or bicep curls).
• Toe touches while standing.
Exercise and staying active may relieve low back pain and can help speed your recovery. 2 3 Stretching and strengthening your stomach, back, and leg muscles helps make them less susceptible to injury that can cause back pain. Strong stomach, back, and leg muscles also better support your spine, reducing pressure on your spinal discs. This may help prevent disc injury.
Aerobic exercises-such as walking, swimming, or walking in waist-deep water-also help you maintain a healthy back. Aerobic exercise makes your heart and other muscles use oxygen more efficiently. Muscles that frequently receive oxygen-rich blood stay healthier.
Source ; http://www.emedicinehealth.com/
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