Lower Back Pain

[Manfred_Man]

the following is a MUST READ that was originally posted by Adonis:

What is low back pain?

Almost everyone has back pain at one time or another. The pain may be in the center of the back or to one side, or even move down the leg. Symptoms may also include pain in the back and the buttocks or legs, stiffness, limited motion and spasm.

What are the risk factors?
Things like obesity, lack of exercise, heavy physical work, accidents, vibration (i.e., driving a truck), smoking, and family history may add to the chance of having low back pain.

Being overweight may increase risk for low back pain because of the added stress on the back.

How does it occur?
We don't know a lot about just what does cause low back pain. Pulled muscles, strained ligaments, tight joints or small tears in the disks (shock absorbers which are stacked between the spine bones) are all likely causes. The problem is that these tears and pulls don't show up well on x-rays.

Should I have an x-ray?
As a rule, most people with low-back pain do not need an x-ray. X-rays do not provide any useful information that has an effect on treatment. Your doctor may order x-rays or other studies if your specific symptoms indicate a need for these tests or if your back pain does not go away in 4-6 weeks.

How is it treated?
The good news is that 90% of people with acute low back pain recover within 4 - 6 weeks.


Basic points of a program for treating low back pain include:
Stay active. Lying in bed or cutting back on activity is not helpful. People get better faster if they stay active at home and work. Common exercise such as walking, swimming or riding a stationary bike can be helpful in many cases. Your doctor may limit your activity if your job or the sports you play are very physical.

Stretching. A healthcare provider will suggest doing stretches 2-3 times daily in most cases. Hold the stretch for 20-30 seconds, take a break and do it again. If a stretch seems to make things worse, or if it causes pain to go down your leg, seek further advice from a healthcare provider or your doctor.

Ice packs (plastic bag with ice cubes and water, wrapped in a towel) applied for 20-30 minutes at a time may feel cold at first, but they actually may decrease pain, spasm and inflammation in the back. There's nothing wrong with trying heat if it works, but ice may be better.

Exercise. Common aerobic and conditioning exercises, such as brisk walking, swimming or riding a stationary bicycle can be very helpful.

Medications may be prescribed by your doctor. It's much more helpful to take them regularly as opposed to only when you hurt.


When to call your doctor?
Call your doctor right away if you have:
- trouble controlling your bladder or bowels
- numbness or weakness in the feet legs, groin or rectal area
- the pain gets worse or extends into your leg and below the knees
- pain limits your normal activities for more than 4 weeks
- shooting pain down the leg


What can I do to help prevent low back pain?
You can reduce the strain on your back by doing the following:
- Don't push with your arms when you move a heavy object.
- Turn around and push backwards so the strain is taken by your legs.
- Participating regularly in an exercise program will help your back, plus it will keep you healthy, overall. Before starting any exercise program you should inform your doctor and see a professional trainer or physical therapist for exercise advice that fits your needs. For aerobic exercise such as walking, bicycling or swimming, start with low intensity exercise about 5 - 10 minutes of exercise a day, three days a week, and slowly work up to 30 minutes of exercise a day for five days a week. If you can't start with 5 - 10 minutes of exercise, do 2-3 minutes, or whatever you can. Strength training is also good for your body and back. You can start with leg strengthening exercises that will help your back when it comes to lifting heavy objects. Use strength training machines if you can. Start with lighter weights, completing 10 to 15 repetitions before increasing the weight at your next workout. Keep in mind that, stronger muscles will allow you to do more work and help reduce the risk of back injury.
- When lifting a heavy object keep the object close to your body and bend your knees. The stronger your legs are, the easier it will be to lift.
- When you sit, sit in a straight-backed chair and hold your spine against the back of the chair.
- Bend your knees and hips and keep your back straight when you lift a heavy object.
- Avoid lifting heavy objects higher than your waist.
- Hold objects you carry close to your body, with your arms bent.
- Avoid sitting in one place or in one position for a long time. Get up and stretch, walk about and change positions.
- Use a footrest for one foot when you stand or sit in one spot for a long time. This keeps your back straight.
- Sit close to the pedals when you drive and use your seat belt and a hard backrest or pillow.
- Lie on your side with your knees bent when you sleep or rest. It may help to put a pillow between your knees.
- Put a pillow under your knees when you sleep on your back.
- If you smoke, ask your doctor for help on how to quit. Smoking limits blood flow to the discs and muscles in your back and slows their healing.


How do I rest my back?
To rest your back, hold each of these positions for 5 minutes or longer:
- Lie on your back, bend your knees, and put pillows under your knees.
- Lie on your back, put a pillow under your neck, bend your knees to a 90-degree angle, and put your lower legs and feet on a chair.
- Lie on your back, bend your knees, and bring one knee up to your chest and hold it there. Repeat with the other knee, and then bring both knees to your chest. When holding your knee to your chest, grab your thigh rather than your lower leg to avoid over-flexing your knee.


When can I return to my activity or sport?
The goal of rehabilitation is to return you as soon as is safely possible to your normal activity. This includes strenuous activity and sports. If you return too soon you may worsen your injury, which could lead to permanent damage. People recover from injury different rates. When you can return to your activity will depend on how soon your back gets better. It does not depend on how many days or weeks it has been since you were injured. Most of the time, the longer you have symptoms before you start treatment, the longer it will take to get better.

It is important that you have fully recovered from your low back pain before you return to any strenuous activity, which includes sports. You must be able to have the same range of motion that you had before your injury. For sports you must be able to run, jump and twist without pain.


Check out this link: Low Back Exercises

[Manfred_Man]

BASIC BACK BIOMECHANICS

Movement of the body is described by the term, "Biomechanics." In order to better understand the biomechanics of the spine it is important to understand the anatomy of the spine. Please read the section on basic spine anatomy before reading this section. It discusses the bones, ligaments, muscles and other structures that make up and support the spine.

The spine is one of the most complex parts of the body. The spine can be divided into five sections: the cervical section (the neck), the thoracic section (the upper back), the lumbar section (the lower back), the sacrum (part of the pelvis) and the coccyx (the tailbone). Each section of the spine has unique features that allow it to move certain ways and do different things.

Vertebrae in the cervical, thoracic and lumbar sections of the spine are separated by a structure called the "intervertebral disc". This disc forms part of the joint that connects the "bodies" of two vertebrae. This joint allows very little movement between two vertebrae. The facets are paired, flat areas of the vertebrae that form joints (facet joints) with the facets of the vertebrae above and below (see diagram). The majority of spine movement occurs at these joints.

The main movements of the spine are to bend forward (flex), bend backward (extend), side-bend (side-flex), and rotate.

In the cervical section of the spine there are 7 "cervical" vertebrae. The joints between the vertebrae in the upper part of the neck (above the second cervical vertebra) allow primarily neck flexion, extension and rotation. The joints between the vertebrae in the lower part of the neck allow flexion, extension, side-flexion and rotation to occur.

In the thoracic section of the spine there are 12 "thoracic" vertebrae. The joints between the vertebrae in the thoracic section of the spine allow flexion, extension, side-flexion and rotation to occur. In the thoracic spine the individual ribs attach to the vertebrae. The ribs provide stability to the thoracic spine and help to control motion.

In the lumbar section of the spine there are 5 "lumbar" vertebrae. The joints between the vertebrae in the lumbar section of the spine allow small amounts of flexion, extension, side-flexion and rotation to occur. The lumbar spine has the least amount of movement when compared to the thoracic and cervical sections of the spine.

The sacrum is a single bone that forms part of the pelvis. This triangular shaped bone is made up of 5 fused vertebrae. The coccyx is also a single bone that is made up of 4 small fused vertebrae. It attaches to the bottom of the sacrum.

There is no movement between the fused vertebrae in the sacrum but there is a small amount of movement in the joints that connect the sacrum to the left and right pelvic bones. These joints are called the sacroiliac joints. The sacroiliac joints play a role in transferring the weight of the spine and upper body to the pelvis and legs.

Finally, normal spine biomechanics is required to maintain a healthy spine. Abnormal biomechanics can be classified as hypomobile (decreased) movement between vertebrae, hypermobile (increased) movement between vertebrae or instability (severe loss of stability). Muscle weakness, ligament injury, broken bones or damage to the intervertebral disc can all lead to abnormal biomechanics, a major factor in the development of neck and back pain.

[Manfred_Man]

BASIC BACK ANATOMY

Each section of the spine contains a number of bones called vertebrae. A typical vertebra has a "body": two laminae, two transverse processes, a spinous process and four facets. The body is the main part of the vertebrae and it is designed to carry weight. The laminae form the bony tunnel that allows the spinal cord to pass down the spine. The paired transverse processes and the spinous process are bony extensions of the spine and act as attachment sites for muscles and ligaments. The facets are paired, flat areas of the vertebrae that form joints (facet joints) with the facets of the vertebrae above and below.

Vertebrae in the cervical, thoracic and lumbar sections of the spine are separated by a structure called the "intervertebral disc". The discs act as spacers between the vertebrae and they also function as shock absorbers. Each disc consists of a spongy center called the "nucleus pulposis", and a tough outer layer called the "annulus fibrosis".

Although the vertebrae in the spine are similar, each section of the spine has vertebrae with unique structural features. The smallest moving vertebrae in the spine are located in the cervical section. There are 7 cervical vertebrae. These vertebrae are designed for motion rather than weight bearing (the first cervical vertebrae is not a typical vertebrae in that it does not have a vertebral body or a disk above it). In the thoracic section of the spine there are 12 vertebrae. These vertebrae are larger than the cervical vertebrae. Each thoracic vertebra has attachment sites for the left and right ribs. In the lumbar section of the spine there are 5 vertebrae. These vertebrae are the largest in the spine and are primarily designed for supporting the weight of the body.

The sacrum is a single bone that also forms part of the pelvis. This triangular shaped bone is actually 5 fused vertebrae. It plays a role in transferring the weight of the spine and upper body to the hips. The coccyx is also a single bone that consists of 4 small fused vertebrae. It attaches to the bottom of the sacrum.

Ligaments are like strong ropes that help connect bones and provide stability to joints. Six major ligament groups run down the spine. These ligaments attach to each vertebra and form a strong support system for the spinal column.

The complex anatomy of the spine allows it to perform various functions. The spine supports the weight of the body, protects the spinal cord and it allows the body to move by providing attachment sites for muscles. The muscles located closest to the vertebrae help to provide stability to the spine. The muscles located further from the vertebrae play a role in movement of the spine.

Finally, the spine protects the spinal cord and allows the spinal nerves to exit the spinal column. The spinal nerves exit through openings in the spinal column called the intervertebral foramen. There is a left and right intervertebral foramen between vertebrae. These openings allow the nerves to pass through them and transfer information between the spinal cord and the specific tissues and organs they supply.

[Manfred_Man]

Lower back pain symptoms and treatment options

Types of low back pain
In the US, low back pain is one of the most common conditions and one of the leading causes of physician visits. In fact, at least four out of five adults will experience low back pain at some point in their lives.

Ironically, the severity of the pain is often unrelated to the extent of physical damage. Muscle spasm from a simple back strain can cause excruciating back pain that can make it difficult to walk or even stand, whereas a large herniated disc or completely degenerated disc can be completely painless.

The causes of low back pain can be very complex, and there are many structures in the low back that can cause pain. The following parts of spinal anatomy can cause pain:

• The large nerve roots in the low back that go to the legs and arms may be irritated
• The smaller nerves that innervate the spine in the low back may be irritated
• The large paired lower back muscles (erector spinae) may be strained
• The bones, ligaments or joints may be injured
• The intervertebral disc may be injured

It is important to note that many types of low back pain have no known anatomical cause, but the pain is still real and needs to be treated. However, usually low back pain can be linked to a general cause (such as muscle strain) or a specific and diagnosable condition (such as degenerative disc disease or a lumbar herniated disc).

This article provides a review of the most common types of low back pain and related symptoms. The vast majority of lower back pain conditions will get better with time and can be addressed with conservative treatments, such as osteopathic or chiropractic manipulation, physical therapy, pain medications, etc. However, it is important to note that there are a few symptoms that indicate the need for emergency surgery.

Types of lower back pain that indicate a surgical emergency
There are a few symptoms that are possible indications of a serious medical condition requiring surgery, and patients with these symptoms should seek medical attention immediately. These symptoms include:

• Sudden bowel and/or bladder incontinence (cauda equina syndrome)
• Progressive weakness in the legs (cauda equina syndrome)
• Severe, continuous abdominal and low back pain (see abdominal aortic aneurysm)

People with fever and chills, history of cancer with recent weight loss, or who have just suffered a severe trauma should also seek immediate medical attention.

• Acute low back pain caused by muscle strain
• Common conditions that cause low back pain (e.g. herniated disc)

[Manfred_Man]

Muscle strain & low back pain

The majority of incidences & occurences of acute lower back pain are caused by a muscular strain (such as from lifting a heavy object, a sudden movement or a fall). Even though this doesn’t sound like a serious injury, the low back pain can be very severe and last for several hours, several days or even a couple of weeks.

When the muscles in the back are strained or torn, the area around the muscles can become inflamed. With inflammation the muscles in the back can spasm and cause both severe lower back pain and difficulty moving.

Healing from acute low back pain
Fortunately, muscle strains usually heal with time (a couple of days or weeks) because muscles in the low back have a good blood supply to bring the necessary nutrients and proteins for healing to take place.

However, an episode of low back pain that lasts for more than two weeks can lead to muscle weakness (since using the muscles hurts, the tendency is to avoid using them). This process leads to disuse atrophy (muscle wasting), and subsequent weakening, which in turn causes more low back pain because the muscles are less able to help hold up the spine.

Exercise helps prevent acute low back pain
As a general rule, people who are active and well-conditioned are much less likely to suffer from low back pain due to muscle strain, as regular exercise stretches the muscles so they are less likely to strain, tear or spasm.

There are three types of muscles that support the spine:

• Extensors (back muscles and gluteal muscles)
• Flexors (abdominal muscles and iliopsoas muscles)
• Obliques or Rotators (side muscles)

While some of these muscles are used in everyday life, most do not get adequate exercise from daily activities and tend to weaken with age unless they are specifically exercised. A complete exercise program for the low back should consist of a combination of stretching, strengthening, and aerobic conditioning.

[Manfred_Man]

from Men's Health

The Back-Saving Workout
7 minutes to a healthier back
by Mark Anders; photos by Beth Bischoff

Cat-Camel
Although this plan is designed to improve the endurance of your stabilizing muscles, it's important to begin your workout by slowly flexing and extending your spine in small ranges of motion to prepare it for the moves that follow. Keep in mind, this exercise isn't a stretch. So don't push at the end of each movement.



How to do it: Get down on your hands and knees with your hands shoulder-width apart. Slowly lower your head between your arms as you push up as high as you can with your back, rounding your spine. When you reach the top of the movement, slowly lower your back as you lift your head up, extend your neck forward and up, and arch your lower back by moving your belly button toward the floor. That's one repetition. Remember, move back and forth slowly without pushing at either end of the movement. Do five to eight repetitions.


Curl-Up
This exercise forces you to work your entire abdominal muscle complex while keeping your lower back in its naturally arched position. The move minimizes stress on your spine while increasing the endurance of the muscles.



How to do it: Lie faceup on the floor with your left leg straight and flat on the floor. Your right knee should be bent and your right foot flat. Place your hands palms down on the floor underneath the natural arch in your lower back. (Don't flatten your back.) Slowly raise your head and shoulders off the floor without bending your lower back or spine, and hold this position for 7 to 8 seconds, breathing deeply the entire time. That's one repetition. Do four repetitions, then switch legs so that your right leg is straight and your left is bent.

Advanced move: Try raising your elbows off the floor as you curl up. For an even greater challenge, start by contracting your abs, and then curl up against that force.


Side Bridge
You'll work your lateral stabilizers-muscles that are crucial in ensuring that your spine is fully supported-by assuming a body position that puts them at a disadvantage and forces them to work harder than normal.



How to do it: Lie on your left side with your knees straight and your upper body propped up on your left elbow and forearm. Place your right hand on your left shoulder and slowly raise your hips until your body forms a straight line from your shoulders to your knees. Hold this position for 7 to 8 seconds, breathing deeply the entire time. Do four or five repetitions, then switch to your right side.


Bird Dog
This exercise works your lower- and middle-back extensors-the muscles that help you bend backward-while producing half the stress on your spine that conventional back-extensor exercises such as the "Superman" (simultaneous leg and arm lifting) create.



How to do it: Get down on your hands and knees with your palms flat on the floor, shoulder-width apart. Slowly raise and straighten your right leg and left arm at the same time. Hold that position for 7 to 8 seconds, breathing deeply throughout the exercise. Lower your arm and leg straight down, and then sweep them along the floor back into the starting position. That's one repetition. Perform four repetitions, then switch sides.

[goozler]

That was very helpful

[Saurian]

Very interesting, I'll have to give some of those exercises a try.

I used to have pretty bad lower back pain. I found out it was just my body telling me "Hey, get back to working those abs." I had gotten lazy and let abs slip out of workout. I make it a note to encourage all of my coworkers who suffer from the lower back pain to consider what they are doing for their abdominal maintenance. Of course, none of them are doing abs. I got one back at my old store to start working out his abs every night, and in 2 and a half weeks his back was golden again.

That siad, there are alot of legitimate back-pain-sufferers around, many of whom these may further benefit.

[Carnitas]

i have had lower back pain for quite a while now, and im going to try some of those exercises. im also going to try to ice my back at night to see if that helps at all. if its still there in a few weeks, then maybe going to see the doctor would be the next best thing

[gYmgIrL]

bumpp

[johnny_on_the_spot]

i actually herniated my lowest disc on my spine over the coarse of 2 years and about 4 lower back injuries (and im only 25)... it was not fun to say the least... but while going to therapy for it, those were the types of excercises my doc had me doing

- i might have missed it, but she had me always keeping my abs tight while doing everything, even walking, to stregnthen the abs to take pressure off my back

-but i also found that loosing weight helped it too, especially from my stomach

-once i started doing that i added in hyper extensions, starting with just body weight, and moving up

-bent over rows with a bench bar and light weight to start

my back feels great now and havent had problems since (but i also remember to always lift with my legs now too, so that might help also)

[wildstang]

ive been down this path life through at me and manfred hit it on the head with this info posted. ive had 3 spinal surgery procedures in my life and am doing everything possible to avoid a 4th. mine were a result of a injury sustained in the line of duty not from bad form for the record.

[gorka]

Many thank's. I've got t4, t7, l5 disks problem in my body for 3 years. Constant pain, forgot when last time slept well? but never took any tablets! Using stretches and lot of exersizes, some of them seen at this page. Thank's again!