<>One of the most common reasons people develop low back pain is posture. Postural problems, including spinal abnormalities, along with muscular compensations or inactivity put added pressure on the back. Although people of all ages experience low back pain — including both athletes and those who are sedentary — middle-aged to older adults (especially when they’re overweight) are most likely to develop severe symptoms and therefore can benefit from lower back pain relief treatments like chiropractic care, soft tissue therapy and regular exercise.
<>Mechanical pain. By far the most common cause of lower back pain, mechanical pain (axial pain) is pain primarily from the muscles, ligaments, joints (facet joints, sacroiliac joints), or bones in and around the spine. This type of pain tends to be localized to the lower back, buttocks, and sometimes the top of the legs. It is usually influenced by loading the spine and may feel different based on motion (forward/backward/twisting), activity, standing, sitting, or resting.
<>This stretch is designed to help lengthen the piriformis muscle over time. This muscle is often the source of sciatica, or radiating leg pain. Sitting with a straight back, cross your left leg over your right leg placing your foot next to your thigh and tuck your right leg in towards your buttocks. Place your right arm on your leg as pictured and slowly ease into a stretch. Be sure to keep your back straight and chest lifted. Hold for 20 seconds and alternative sides, three times.
<>Steroids: Oral steroids can be of benefit in treating acute sciatica. Steroid injections into the epidural space have not been found to decrease duration of symptoms or improve function and are not currently recommended for the treatment of acute back pain without sciatica. Benefit in chronic pain with sciatica remains controversial. Injections into the posterior joint spaces, the facets, may be beneficial for people with pain associated with sciatica. Trigger point injections have not been proven helpful in acute back pain. Trigger point injections with a steroid and a local anesthetic may be helpful in chronic back pain. Their use remains controversial.
<>This material is presented for informational and educational purposes only. This information does not constitute medical advice and is not intended to be a substitute for professional medical advice. You should always seek the advice of a physician or other qualified health care provider before beginning any exercise program. If you experience any pain or difficulty with these exercises, stop and consult your health care provider. ADVANCED PAIN MANAGEMENT MAKES NO WARRANTIES, EXPRESS OR IMPLIED, THAT THE INFORMATION CONTAINED IN THESE MATERIALS WILL MEET YOUR NEEDS.
<>The available science includes a 2011 study published in Arthritis Care & Research, which found that a 10-week tai chi program reduced pain and improved functioning in people with long-term low back pain symptoms. The study involved 160 adults with chronic low back pain, half of whom participated in 40-minute-long tai chi sessions 18 times over the 10-week period.
<>High-quality evidence shows that individual patient education of greater than two hours is more effective than no education or less-intense education for pain that persists for four weeks or more.23 Moderate-quality evidence shows that less-intense individual education and advice to stay active have small benefits and are at least as effective as other back pain interventions.23,24 It is unclear whether patient education and advice for patients with acute low back pain are cost-effective.25
<>When structural problems are exaggerated, you also get a plague of bogus explanations and solutions based on that. Spines do degenerate, but not for the reasons most people think they do: genetics is by far the biggest factor in degeneration,27 not your posture, your office chair or mattress, your core stability, or anything else that low back pain sufferers have taught to blame their pain on.
<>Also referred to as "hypnosis," hypnotherapy is a mind-body technique that involves entering a trance-like state of deep relaxation and concentration. When undergoing hypnotherapy, patients are thought to be more open to suggestion. As such, hypnotherapy is often used to effect change in behaviors thought to contribute to health problems (including chronic pain).
<>“Opioid medications generally shouldn’t be used as the first, the only or the long-term line of treatment for chronic back pain,” recommends Nava. Many of them are addictive and don’t address the underlying cause of your pain. Opioids should be prescribed only after a thorough exam by a specialist and if other drugs have failed to provide relief. If you find yourself relying on opioids to get through the day, it may be time to seek a second opinion.
<>A recent double-blind randomized placebo-controlled study of 546 patients with acute low back pain (less than 4 weeks) with radiculopathy compared LLLT and nimesulide to nimesulide alone to sham LLLT. Treatment with LLLT and nimesulide improved movement, with more significant reduction in pain intensity and disability and with improvement in quality of life, compared with patients treated only with drugs or placebo LLLT.38
<>Chill it. Ice is best in the first 24 to 48 hours after an injury because it reduces inflammation, says E. Anne Reicherter, PhD, PT, DPT, associate professor of Physical Therapy at the University of Maryland School of Medicine. "Even though the warmth feels good because it helps cover up the pain and it does help relax the muscles, the heat actually inflames the inflammatory processes," she says. After 48 hours, you can switch to heat if you prefer. Whether you use heat or ice -- take it off after about 20 minutes to give your skin a rest. If pain persists, talk with a doctor.
<>The discs are pads that serve as "cushions" between the individual vertebral bodies. They help to minimize the impact of stress forces on the spinal column. Each disc is designed like a jelly donut with a central, softer component (nucleus pulposus) and a surrounding, firm outer ring (annulus fibrosus). The central portion of the disc is capable of rupturing (herniating as in a herniated disc) through the outer ring, causing irritation of adjacent nervous tissue and sciatica as described below. Ligaments are strong fibrous soft tissues that firmly attach bones to bones. Ligaments attach each of the vertebrae to each other and surround each of the discs.
<>Back pain can have many underlying reasons, but often no specific cause will be found and the pain will stop. This chapter will review many of the causes of back pain and proper evaluation and diagnosis. Please be sure to discuss your individual symptoms as well as the suggested treatments with your health-care professional to determine the appropriate diagnostic and treatment plan for your circumstances.
<>I like to kick off a topic with an example of a terrible website about it, just for the chuckle and a teachable moment. ThePain.net is one of the worst I’ve seen: a large, stale, ugly thing by Pekka Palin, MD. There are hours of terrible reading there! Dozens of blandly composed, shallow, rambling, and frequently irrational mini-articles on every imaginable pain subject, all 100% unreferenced, laid out in huge blocks of text without a subheading for many screens (a typographic travesty). There’s soooo much badness, but I really got a chuckle out of this perfectly pointless phrase: “The most common term used for general, temporary low back pain is lumbago.” Now “lumbago” means “back pain” (see the definition of lumbago on Wikipedia), so Dr. Obvious has helpfully explained that the cause of back pain is, er, back pain. The Internet, at your service!
<>"Having excess weight pulling on your back all day (except when you're lying down) is just bad news for your back," says Lauri Grossman, DT, a licensed chiropractor in private practice in New York City. "Often times, when people who wrestle with back pain for a lifetime lose a few pounds, they find that the pain that they've taken a million medications for and a million vitamins for just goes away." If you're having trouble shedding extra pounds, consider consulting with a registered dietitian or personal trainer.
<>Turns out that the committees that write these things do not necessarily know the science! One of the best reviews of back pain research ever published — Machado 2009, more on this one later — found something really interesting: “treatment recommendations from recent clinical guidelines do not align with the results of this meta-analysis.” In fact, quite a few disproven pain treatments are still cheerfully recommended in otherwise sensible professional guidelines. Eek. BACK TO TEXT
<>Three small higher quality trials found that systemic corticosteroids were not clinically beneficial compared with placebo when given parenterally or as a short oral taper for acute or chronic sciatica.21,28,49 With acute low back pain and a negative straight-leg raise test, no difference in pain relief through 1 month was found between a single intramuscular injection of methylprednisolone (160 mg) or placebo.23 Glucocorticosteroids are banned by the World Anti-doping Association.70
<>An essential nutrient available in certain foods (such as fortified milk and fish with small bones), vitamin D is produced naturally by the body during exposure to the sun's ultraviolet rays. But since it's difficult to obtain your recommended daily intake of D solely through dietary sources and sun exposure, many medical experts recommend increasing your vitamin D levels by taking a dietary supplement.
<>Pregnancy symptoms can vary from woman to woman, and not all women experience the same symptoms. When women do experience pregnancy symptoms they may include symptoms include missed menstrual period, mood changes, headaches, lower back pain, fatigue, nausea, breast tenderness, and heartburn. Signs and symptoms in late pregnancy include leg swelling and shortness of breath. Options for relief of pregnancy symptoms include exercise, diet, and other lifestyle changes.
<>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
<>Another muscle which can be tight when you have lower back pain is the piriformis, a muscle in your butt. The stretch below is really effective in stretching this muscle, and very easy to do. To carry out the exercise, lie on your back and cross the right ankle over the left knee. Grip the thigh of your left leg and take a deep breath in. As you breathe out pull the knee in towards you. Hold the stretch for 20-30 seconds. Repeat two times for each side.
<>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.
<>I apply a MythBusters approach to health care (without explosives): I have fun questioning everything. I don’t claim to have The Answer for low back pain. When I don’t know, I admit it. I read scientific journals, I explain the science behind key points (there are more than 460 footnotes here, drawn from a huge bibliography), and I always link to my sources.
<>Rest: The basic treatment for relieving acute back pain from strain or minor injury is a limited period of rest for 24 to 72 hours. An ice pack can be helpful, as can aspirin or another nonsteroidal anti-inflammatory drug (NSAID) to reduce pain and inflammation. Do not give aspirin to a child aged 18 years or younger because of the increased risk of Reye syndrome. After the inflammation subsides, applying heat can soothe cramped muscles and strained connective tissue.
<>A 2007 Cochrane review of opioids for chronic low back pain found that tramadol was more effective than placebo for pain relief and improving function.16 The 2 most common side effects of tramadol were headaches and nausea. One trial comparing opioids to naproxen found that opioids were significantly better for relieving pain but not improving function. Despite the frequent use of opioids for long-term management of chronic LBP, there are few high-quality trials assessing efficacy. The benefits of opioids for chronic LBP remain questionable. There is no evidence that sustained-release opioid formulations are superior to immediate-release formulations for low back pain. Long-acting opioids did not differ in head-to-head trials.9 Opioids are banned by the World Anti-doping Association.70
<>For example, ginger is a natural anti-inflammatory agent. It may help reduce inflammation associated with back pain, especially helpful after strenuous activities. Consider simmering fresh ginger root slices in hot water for about 30 minutes to prepare a spicy but soothing cup of tea. Capsaicin has also shown some promise for reducing pain. It’s the active ingredient in chili peppers. You can find it in both topical cream and oral supplement forms.
<>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.
<>Did you know that aside from coughs and respiratory infections, back pain is the most common reason for seeing a doctor in the United States? More than 85 percent of Americans will experience back pain at some point in their life, and back pain is the leading cause of disability worldwide. Yet surgery is rarely needed to treat back pain. So, what’s the answer? Why is it such a problem and, more importantly, how can you prevent it from becoming a problem for you? This article will help answer some of those questions as well as give you some of the best exercises to beat back pain.
<>In all other cases, you can safely read this tutorial first. For instance, even if you have severe pain or numbness and tingling down your leg, you can safely read this first. Or, even if you have an obviously severe muscle tear from trying to lift your car or something, you can safely start here — rest and read. Your back is not as fragile as you probably think, and understanding why is a great starting place for healing in nearly all cases of low back pain.
<>Perhaps you bent the wrong way while lifting something heavy. Or you're dealing with a degenerative condition like arthritis. Whatever the cause, once you have low back pain, it can be hard to shake. About one in four Americans say they've had a recent bout of low back pain. And almost everyone can expect to experience back pain at some point in their lives.
<>Surgery for nonspecific back pain is a last resort as spinal problems are unlikely to be the cause of chronic non-specific back pain in the absence of loss of movement and sensation or other findings such as loss of muscle bulk and reflexes. In cases where the pain spreads into the extremities and imaging studies reveal compression or damage to nerve tissue in the spine, surgery remains a consideration if loss of function as well as pain continues after a trial of conservative treatment with medications and activity modification including a home exercise program and physical therapy.
<>Opioids are commonly prescribed for patients with severe acute low back pain; however, there is little evidence of benefit. Three studies showed no difference in pain relief or time to return to work between oral opioids and NSAIDs or acetaminophen, and there is risk of harmful dose escalation over time with opioids, especially with purer formulations.16,21 Although epidural steroid injections are not beneficial for isolated acute low back pain, they may be helpful for radicular pain that does not respond to two to six weeks of noninvasive treatment. Transforaminal injections appear to have more favorable short- and long-term benefit than traditional interlaminar injections.22
<>Learning to keep your cool is as good for your back as it is for your mental health. When you're anxious, your body sets off the "fight or flight" response, which involves tensing your muscles so you're ready to spring into action. One European study revealed that people prone to negative thoughts and anxiety are more likely to suffer from back pain. Get calm now with these stress-busting solutions.
<>A diagnosis of sciatica is usually made during a history and physical examination. Your doctor will ask you about your pain. During the physical exam, you may be asked to lift your leg while lying on your back — shooting pain down the back of your leg while in this position is a common sign of sciatica. Your doctor will also check the strength and reflexes in your leg.
<>Your core muscles—not just your abdominals, but the muscles that wrap around your midsection—support your spine and lower back. And your core, hips, glutes, and hamstrings together form one big stability machine, so weakness in any one of those muscles forces the others to take up the slack. If you have weak hip and gluteal muscles, for example, as they become fatigued during a run, your lower back is forced to work harder to keep you upright and stable, and you become vulnerable to injury.
<>**Please get an accurate diagnosis of your back pain.  If you want to know WHAT is causing your back pain we are experts at explaining what is causing your pain based on a thorough movement examination.  Then we can explain what exercises will help and what will make it worse!  We can help guide you with how to get in and out of bed and how to move around without making your back pain worse.    If you want peace of mind of what is causing the pain and what you can do about it we would love to help!
<>Shingles (herpes zoster) is an acute infection of the nerves that supply sensation to the skin, generally at one or several spinal levels and on one side of the body (right or left). Patients with shingles usually have had chickenpox earlier in life. The herpes virus that causes chickenpox is believed to exist in a dormant state within the spinal nerve roots long after the chickenpox resolves. In people with shingles, this virus reactivates to cause infection along the sensory nerve, leading to nerve pain and usually an outbreak of shingles (tiny blisters on the same side of the body and at the same nerve level). The back pain in patients with shingles of the lumbar area can precede the skin rash by days. Successive crops of tiny blisters can appear for several days and clear with crusty inflammation in one to two weeks. Patients occasionally are left with a more chronic nerve pain (postherpetic neuralgia). Treatment can involve symptomatic relief with lotions, such as calamine, or medications, such as acyclovir (Zovirax), for the infection and pregabalin (Lyrica) or lidocaine (Lidoderm) patches for the pain.
<>Prolotherapy has been used to treat back pain for more than 50 years, according to a report by the Cochrane Database of Systematic Reviews. (6) Prolotherapy, including the specific type called PRP or dextrose/glucose prolotherapy treatments, use platelet-rich plasma and sometimes stem cells taken from your own body that contain growth factors that help heal damaged tissues.
<>A pinched nerve causes pain, numbness, or tingling in the affected area due to pressure on a nerve. Caral tunnel and sciatica are two examples of conditions caused by a pinched nerve. A pinched nerve is diagnosed by taking a patient history and performing a physical examination. Electromyography may be performed. Treatment for a pinched nerve depends on the underlying cause.
<>Spinal disc degeneration coupled with disease in joints of the low back can lead to spinal-canal narrowing (spinal stenosis). These changes in the disc and the joints produce symptoms and can be seen on an X-ray. A person with spinal stenosis may have pain radiating down both lower extremities while standing for a long time or walking even short distances.
<>Nonsteroidal anti-inflammatory medications (NSAIDs) are the mainstay of medical treatment for the relief of back pain. Ibuprofen, naproxen, ketoprofen, and many others are available. No particular NSAID has been shown to be more effective for the control of pain than another. However, your doctor may switch you from one NSAID to another to find one that works best for you.
<>Learning to keep your cool is as good for your back as it is for your mental health. When you're anxious, your body sets off the "fight or flight" response, which involves tensing your muscles so you're ready to spring into action. One European study revealed that people prone to negative thoughts and anxiety are more likely to suffer from back pain. Get calm now with these stress-busting solutions.
<>When the first 24 hours are over, you can turn to heat to cure back pain fast at home. Heat helps to ease the strained muscle and reduce tension. It can help to increase range of motion and reduce pain. In this case, you want to bring the healing blood to the site, and heat will do that, dilating the blood vessels and encouraging blood flow. Don’t let the heating pad get too hot and don’t use it for more than an hour or so at a time. The heat can hurt your skin, leading to more problems. Here’s how heat therapy works to make you feel better.
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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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