<>A neurologist, a doctor specializing in treatment of the nervous system. "Back pain is commonly associated with lower-extremity symptoms, such as numbness and tingling. These symptoms can also be caused by neurological conditions that are not spine-related, such as multiple sclerosis. Neurologists are great at sorting this out and offering solutions," says Dr. Kowalski.
<>Thirty-five randomized controlled trials did not allow firm conclusions for the effectiveness of acupuncture for acute low back pain.25 For chronic low back pain, acupuncture is more effective for pain relief and functional improvement than no treatment or sham treatment in the short term only. Acupuncture is not more effective than other conventional or alternative treatments.25
<>Acute low back pain can be defined as six to 12 weeks of pain between the costal angles and gluteal folds that may radiate down one or both legs (sciatica). Acute low back pain is often nonspecific and therefore cannot be attributed to a definite cause. However, possible causes of acute low back pain (e.g., infection, tumor, osteoporosis, fracture, inflammatory arthritis) need to be considered based on the patient's history and physical examination. Table 1 presents the differential diagnosis of acute low back pain.5,6
<>These powerful painkillers may not be all that: In a study published in JAMA, fast-acting opioids like morphine and oxycodone were no better than non-opioid medications (like Tylenol or an NSAID) in improving function in moderate to severe back pain. Talk to your doctor about the option that’s best for you. Don’t miss these 24 things pain doctors won’t tell you.
<>A rub down can deliver real lower back pain relief. In a 2017 study, more than half of participants told researchers that a series of massage therapy sessions eased their backache. “The study can give primary care providers the confidence to tell patients with chronic low back pain to try massage if the patients can afford to do so,” co-author of the study Niki Munk, PhD, said in a press release. Here are 10 more things you should do if you wake up with back pain.
<>After your initial visit for back pain, it is recommended that you follow your doctor's instructions as carefully as possible. This includes taking the medications and performing activities as directed. Back pain will, in all likelihood, improve within several days. Do not be discouraged if you don't achieve immediate improvement. Nearly everyone improves within a month of onset of the pain.
<>Injections. If other measures don't relieve your pain, and if your pain radiates down your leg, your doctor may inject cortisone — an anti-inflammatory medication — or numbing medication into the space around your spinal cord (epidural space). A cortisone injection helps decrease inflammation around the nerve roots, but the pain relief usually lasts less than a few months.
<>If your purse or briefcase tips the scales at more than 10% of your weight, it’s too heavy. And you need to carry it right. Your best bet is a model with a long strap that lets you position it across your chest like a messenger bag. Our pick: the Ellington Leather Moroccan Shoulder Bag ($169.90). Can’t part with your shorter-strapped number? Switch shoulders every 20 minutes.
<>When we stand, the lower back is functioning to support the weight of the upper body. When we bend, extend, or rotate at the waist, the lower back is involved in the movement. Therefore, injury to the structures important for weight bearing, such as the bony spine, muscles, tendons, and ligaments, often can be detected when the body is standing erect or used in various movements.
<>30. Gellhorn AC, Chan L, Martin B, Friedly J. Management patterns in acute low back pain: the role of physical therapy [published ahead of print November 19, 2010]. Spine (Phila Pa 1976). http://journals.lww.com/spinejournal/Abstract/publishahead/Management_Patterns_in_Acute_Low_Back_Pain__The.99251.aspx (subscription required). Accessed May 2, 2011.
<>Levator scapula stretch. Rest one arm against a wall or doorjamb with the elbow slightly above the shoulder, then turn the head to face the opposite direction. Bring the chin down toward the collarbone to feel a stretch in the back of the neck. It may be helpful to gently pull the head forward with the other hand to hold the stretch for the desired time.
<>Acupuncture: Both the American Pain Society and the American College of Physicians released guidelines stating that acupuncture may help patients with chronic low-back pain when other treatments have failed. It can be used alone or as part of a comprehensive treatment plan that includes medications and other therapies. However, there is not enough evidence yet to recommend it for acute back pain.
<>In addition to chiropractic care and naturopathic solutions including acupuncture, we also provide physical therapy and soft tissue work, including clinical massage and myofascial release—even personal strength training. That's because we’re a comprehensive care team in one place dedicated to freeing you of your pain, restoring your flexiblity, stability, mobility, and lower back health. 
<>That’s a huge topic, but here’s one simple example of an extremely common problem with back pain science: control groups that don’t control. Rather than comparing a treatment to a good, carefully selected placebo, most studies use a comparison to a treatment that is allegedly neutral, underwhelming, or placebo-ish. That makes the results hard to interpret: if each works about the same, it could mean that the treatments are equally effective … or equally ineffective! So much back pain science has this problem — or any one of a dozen other weak points — that you can effectively ignore at least 80% of all back pain research, because it’s so far from the last word on anything. Good science is essential to solving these problems, but really good studies are also difficult to design and rare. BACK TO TEXT
<>Since I first started treating low back pain in 2000, there’s been an explosion of free online information about it — countless poor quality articles. Back in the day, we actually had to go to a doctor or buy a book to get shoddy back pain information — now it’s just a Google search away.234 Even many better articles still have serious “attitude” problems.5 But it’s worse than that: even professional back pain guidelines are often misleading.6 For instance, despite overwhelming scientific evidence to the contrary, it’s extremely common to incorrectly portray back pain as a “mechanical” problem, as if the spine is a fragile structure which breaks down and causes pain.7 This is based on decades old misconceptions about how backs work, and how pain works, which the medical world is only gradually learning to leave behind.
<>Herniated discs develop 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 one-third of adults older than 20 years of age. Only 3% of these, however, produce symptoms of nerve impingement.
<>Spines haven’t changed in the last century,21 and yet modern civilization suffers from a great plague of low back pain.2223 Yet the real causes of most back pain are obscured by medical mythology and misunderstanding.24 Before I discuss what does cause most low back pain, it’s important to talk about what does not cause it. In this section, I will challenge the mythology in just a few paragraphs, supported by over thirty references to the best scientific information available — references you can check for yourself. This is quite different than most sources of patient-focused low back pain information, which tend to avoid discussing the evidence.
<>Research is being conducted on certain treatments that stimulate nerves to reduce chronic back pain. Your doctor may consider adding acupuncture to your treatment plan if you aren't finding relief with more conservative care. Another method your doctor might suggest is transcutaneous electrical nerve stimulation (TENS), during which mild electric pulses are delivered to the nerves to block incoming pain signals.

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