<>Physical activity. Exercise helps build strong, flexible muscles that will be less prone to injury. It can also help the healing process for an aching back, prevent problems in the future, and improve function. Work with your doctor to develop an exercise program, or seek a referral to another health professional who can. A good program typically includes the three major forms of exercise: aerobic activity, strength training, and flexibility exercises.
<>Another way to get lower back pain relief is to hook up with an expert in physical therapy, who will guide you in safe exercises that can strengthen and stretch the muscles. “This will prevent symptoms from worsening and further damage to the spine,” says Strassberg. She says that PTs address symptoms and target the underlying cause so that you can prevent future discomfort.
<>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
<>“For most people, it means their back hurts,” says Richard A. Deyo, MD, MPH,the Kaiser-Permanente Endowed Professor of Evidence-Based Medicine in the department of family medicine at Oregon Health & Science University in Portland. “But it’s often impossible to know the precise anatomical cause of back pain because the back has so many sources of pain.”
<>Chronic back pain is straining both physically and emotionally. To manage the frustration, irritability, depression and other psychological aspects of dealing with chronic pain, you may get referred to a rehabilitation psychologist. This specialist may recommend meditation, yoga, tai chi and other cognitive and relaxation strategies to keep your mind from focusing on pain.
<>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.
<>There are numerous reasons why you may be saddled with lower back pain, says Melanie Strassberg, PT, DPT, clinical director of Professional Physical Therapy in New Rochelle, New York: Muscle strains and spasms, a herniated disc, degenerative disc disease, spinal stenosis, and osteoarthritis are just a handful. Given the wide range of causes, your doctor will need to uncover the source during a medical examination before you can find the best lower back pain relief. These are 10 other common reasons your back is hurting.
<>Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
<>"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.
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<>Degenerative bone and joint conditions: As we age, the water and protein content of the body's cartilage changes. This change results in weaker, thinner, and more fragile cartilage. Because both the discs and the joints that stack the vertebrae (facet joints) are partly composed of cartilage, these areas are subject to wear and tear over time (degenerative changes). Degeneration of the disc is called spondylosis. Spondylosis can be noted on X-rays of the spine as a narrowing of the normal "disc space" between the vertebrae. It is the deterioration of the disc tissue that predisposes the disc to herniation and localized lumbar pain ("lumbago") in older patients. Degenerative arthritis (osteoarthritis) of the facet joints is also a cause of localized lumbar pain that can be detected with plain X-ray testing. These causes of degenerative back pain are usually treated conservatively with intermittent heat, rest, rehabilitative exercises, and medications to relieve pain, muscle spasm, and inflammation.
<>Massage: There's an upside to your discomfort: It's a legit excuse to get a weekly massage. One study found that people who did had less lower back pain and disability after 10 weeks, compared with the control group—and general relaxation rubdowns worked just as well as structural massage targeted at specific parts of the body. Osteopathic and chiropractic therapies—in which joints and muscles get stretched and repositioned—have been shown to work, too. In a study published in the Annals of Family Medicine
<>Stretching. Almost everyone can benefit from stretching muscles in the low back, buttocks, hips, and legs (especially the hamstring muscles). These muscles support the weight of the upper body. The more mobile these muscles are the more the back can move without injury. It is typically advised to start small—stretch for 20 to 30 seconds and stop a stretch if it causes pain.
<>“Stretching of the back and legs can help maintain or improve movement for everyday functions. For example, being limber will help you lift objects off the floor or put on shoes without increased stress to the back,” says Jiang. “Additionally, physical activity [like stretching] can help increase back resilience, so that one can perform more activities without increased pain.”
<>Paget's disease of the bone is a condition of unknown cause in which the bone formation is out of synchrony with normal bone remodeling. This condition results in abnormally weakened bone and deformity and can cause localized bone pain, though it often causes no symptoms. Paget's disease is more common in people over the age of 50. Heredity (genetic background) and certain unusual virus infections have been suggested as causes. Thickening of involved bony areas of the lumbar spine can cause the radiating lower extremity pain of sciatica.
<>Situated between the bones of the spine, intervertebral disks act as cushions and shock absorbers. If they become damaged and start to bulge out between the bones of your lower back (a condition known as a slipped or herniated disk), they can press on your sciatic nerve roots and cause sciatica. Herniated disks are the most common cause of sciatica, according to the American Academy of Orthopaedic Surgeons.
<>Does massage really ease back pain once you leave the table? A recent study found that one weekly massage over a 10 week period improved pain and functioning for people with chronic back pain. Benefits lasted about six months but dwindled after a year. Another hands-on approach is spinal manipulation. Performed by a licensed specialist, this treatment can help relieve structural problems of the spine and restore lost mobility.

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