<>A Cochrane review of 10 antidepressant and placebo trials showed no difference in pain relief or depression severity.62 The qualitative analyses found conflicting evidence on the effect of antidepressants on pain intensity in chronic low back pain and no clear evidence that antidepressants reduce depression in chronic low-back-pain patients. Two pooled analyses showed no difference in pain relief between different types of antidepressants and placebo. Another systemic review found different results: Antidepressants were more effective than placebo,9 but the effects were not consistent with all antidepressants. Tricyclic antidepressants were moderately more effective than placebo, but paroxetine and trazodone were not.9 Antidepressants were associated with significantly higher risk for adverse events compared with placebo, with drowsiness, dry mouth, dizziness, and constipation the most commonly reported.54 Duloxetine has recently been approved by the Food and Drug Administration for treatment of chronic low back pain and osteoarthritis,63 and evidence suggests effectiveness in chronic low back pain.58,57
<>A 2008 study published in the journal Spine found "strong evidence that acupuncture can be a useful supplement to other forms of conventional therapy" for low back pain. After analyzing 23 clinical trials with a total of 6,359 patients, the study authors also found "moderate evidence that acupuncture is more effective than no treatment" in relief of back pain.
<>Cold can be applied to the low back with towels, gel packs, ice packs, and ice massage. Heat methods include water bottles and baths, soft packs, saunas, steam, wraps, and electric pads. There are few high-quality randomized controlled trials supporting superficial cold or heat therapy for the treatment of acute or subacute low back pain. A Cochrane review cited moderate evidence supporting superficial heat therapy as reducing pain and disability in patients with acute and subacute low back pain, with the addition of exercise further reducing pain and improved function.22 The effects of superficial heat seem strongest for the first week following injury.44
<>This myth of “mechanical” failure of the low back has many unfortunate consequences, such as unnecessary fusion surgeries — a common and routinely ineffective procedure — and low back pain that lasts for years instead of months or weeks. The seriousness of chronic low back pain is often emphasized in terms of the hair-raising economic costs of work absenteeism, but it may well be far worse than that — a recent Swedish study shows that it probably even shortens people lives.8 The stakes are high. “Tragedy” is not hyperbole.
<>But how do you kow if you’re the exception? Can you recognize the early warning sign of cancer, infection, autoimmune disease, or spinal cord injury? These things often cause other distinctive signs and symptoms, and so they are usually diagnosed promptly. If you are aware of these red flags, you can get checked out when the time is right — but please avoid excessive worry before that.
<>Pain from spine structures, such as musculature, ligaments, facet joints, and disks, can refer to the thigh region, but rarely to areas below the knee. Pain related to the sacroiliac joint often refers to the thigh, but can also radiate below the knee. Irritation, impingement, or compression of the lumbar root often results in more leg pain than back pain. Pain from the L1-L3 nerve roots will radiate to the hip and/or thigh, whereas pain from the L4-S1 nerve roots will radiate below the knee.
<>There is a significant overlap of nerve supply to many of the discs, muscles, ligaments, and other spinal structures, and it can be difficult for the brain to accurately sense which is the cause of the pain. For example, a degenerated or torn lumbar disc can feel the same as a pulled muscle – both creating inflammation and painful muscle spasm in the same area. Muscles and ligaments heal rapidly, while a torn disc may or may not. The time course of pain helps determine the cause.
<>THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for general informational purposes only and does not address individual circumstances. It is not a substitute for professional medical advice, diagnosis or treatment and should not be relied on to make decisions about your health. Never ignore professional medical advice in seeking treatment because of something you have read on the WebMD Site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
<>This traditional treatment scores well in research for its pain-relieving properties—and you can add lower back pain relief to the list. In a review published in the journal Evidence-based Complementary and Alternative Medicine, researchers concluded that for chronic low back pain, acupuncture alone or in conjunction with other treatments could provide short-term improvements in pain and function compared to no treatment at all.
<>A 2008 Cochrane review of randomized controlled trials for subacute and chronic low back pain included 18 trials of 1179 participants.59 Studies that compared intradiscal injections, prolotherapy, ozone, sacroiliac joint injections, or epidural steroids for radicular pain were excluded unless injection therapy with another pharmaceutical agent was part of one of the treatment arms. Corticosteroids, local anesthetics, indomethacin, sodium hyaluronate, and B12 were used. Of 18 trials, 10 were rated for high methodological quality. Statistical pooling was not possible because of clinical heterogeneity in the trials yielding no strong evidence for or against the use of injection therapy.59
<>Before you dive into the best exercises for lower back pain, it’s important to understand that there are a multitude of reasons why an individual would experience muscle soreness. In the case of this article, we’ll focus on the most common one: sitting. Over time, prolonged periods of sitting can manipulate our posture, resulting in specific muscles becoming weaker.
<>This movement is helpful to stretch tight abdominal muscles and the lower back. Start by lying on your stomach with your legs extended and with palms planted on either side of your head with your forearms and elbows flat on the ground. Slowly, push your body upwards, so your weight is resting on your forearms. Be sure to keep your hips on the ground. Once you reach a comfortable position that gently stretches your abdominal muscles and lower back, hold for 10 seconds. Slowly return to starting position and repeat five times. If you have more flexibility in your lower back, try straightening your arms.
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<>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 suggests that topical medications may be just as effective as oral ones. Many of them worked significantly better than placebo. These medications can come in the form of gels, creams, patches, and more. One study also saw decrease in pain when people applied lavender essential oil or ointments prepared with cayenne peppers with acupressure.
<>This final stretch is great at stretching out your spine and it feels good to do, too. Lie on your back and place a small cushion under your head. Keep your knees bent and together. Keep your upper body relaxed and your chin gently tucked in. Take a big deep breath in and as you breathe out roll your knees to one side, followed by your pelvis, keeping both shoulders on the floor. Take a big deep breathe in as you return to the starting position. Repeat six to eight times, alternating sides.
<>Regular applications of ice to the painful areas on your back may help reduce pain and inflammation from an injury. Try this several times a day for up to 20 minutes each time. Wrap the ice pack in a thin towel to protect your skin. After a few days, switch to heat. Apply a heating pad or warm pack to help relax your muscles and increase blood flowing to the affected area. You also can try warm baths to help with relaxation. To avoid burns and tissue damage, never sleep on a heating pad.

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Medical Disclaimer: The material on this site is provided for informational purposes only and is not medical advice. Always consult your physician before beginning any exercise program.

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These back pain movements really did help me with my chronic back pain.
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