<>2010 — Updated: Added a very beefy footnote about some new research showing that muscle imbalance does not result in higher rates of injury. This almost should have been a new section, but I decided to just make it a ginormous footnote — footnotes are there for delving if you want to, that’s the idea! You can read a summary of the research in the bibliography (see Hides et al), but the relevance to back pain is spelled out in detail here. And it’s interesting. [Section: Diagnosis: Your low back is not fragile!]
<>Sports that have higher rates of back pain include gymnastics, diving, weight lifting, golf, American football, and rowing.61 In gymnastics, the incidence of back injuries is 11%. In football linemen, it may be as high as 50%.18 Ninety percent of all injuries of professional golfers involve the neck or back.19 Injury rates for 15- and 16-year-old girls in gymnastics, dance, or gym training are higher than the general population, while cross-country skiing and aerobics are associated with a lower prevalence of low back pain.4 For boys, volleyball, gymnastics, weight lifting, downhill skiing, and snowboarding are associated with higher prevalence of low back pain, while cross-country skiing and aerobics show a lower prevalence.
<>Lower back pain can be mild to very severe depending on its underlying causes, how long it’s been left untreated and the state of someone’s overall health. The University of Maryland Medical Center states that several important risk factors for lower back problems include family history of back pain, smoking or using tobacco, being overweight or obese, being female, being anxious or depressed, and either doing too much physical work or living a sedentary lifestyle.
<>Taking NSAIDs like ibuprofen will help decrease inflammation in the short term. Couple that with heat and ice therapy to stop spasms, recommends Laser Spine Institute chiropractor, Robert Koser, DC. He adds that what you eat also makes a difference. A healthy, anti-inflammatory diet will turn down pain and help you lose weight, as excess pounds put a strain on your spine.
<>Another great exercise for mobilizing the lower back is the bridge, as shown in the image below. To carry out this exercise lie on your back with knees bent and your feet placed hip distance apart on the floor. Take a deep breath in and as you breathe out lift your hips off the floor until shoulders hips and knees are in a straight line. As you breathe in lower your hips to the floor. Repeat eight to twelve times.
<>To diagnose back pain -- unless you are totally immobilized from a back injury -- your doctor probably will test your range of motion and nerve function and touch your body to locate the area of discomfort. Sometimes blood and urine tests are performed to make sure that the back pain is not caused by an infection or other more widespread medical problem.
<>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
<>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.
<>Radicular pain. This type of pain can occur if a spinal nerve root becomes impinged or inflamed. Radicular pain may follow a nerve root pattern or dermatome down into the buttock and/or leg. Its specific sensation is sharp, electric, burning-type pain and can be associated with numbness or weakness (sciatica). It is typically felt on only one side of the body.
<>Lower back pain and vaginal discharge: What to know Lower back pain and vaginal discharge are common on their own. When they occur together, this can point to specific medical issues. In this article, learn about seven possible causes of both lower back pain and vaginal discharge. We also describe risk factors, diagnostic methods, and treatment options. Read now
<>Articles and information on this website may only be copied, reprinted, or redistributed with written permission (but please ask, we like to give written permission!) The purpose of this Blog is to encourage the free exchange of ideas. The entire contents of this website is based upon the opinions of Dave Asprey, unless otherwise noted. Individual articles are based upon the opinions of the respective authors, who may retain copyright as marked. The information on this website is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. It is intended as a sharing of knowledge and information from the personal research and experience of Dave Asprey and the community. We will attempt to keep all objectionable messages off this site; however, it is impossible to review all messages immediately. All messages expressed on The Bulletproof Forum or the Blog, including comments posted to Blog entries, represent the views of the author exclusively and we are not responsible for the content of any message.
<>A common pose in yoga, the restful child’s pose can help you relax your body. Position yourself on the floor on hands and knees with your knees just wider than hip distance apart. Turn your toes in to touch and push your hips backwards bending your knees. Once you reach a comfortable seated position, extend your arms forward fully and allow your head to fall forward into a relaxation position. Hold this pose for 20 seconds and slowly return to starting position. Repeat three times. For modification if you have shoulder pain, place your arms on either side of your body, extending towards your feet.
<>Low-level laser therapy (LLLT) is a noninvasive light source treatment that generates a single wavelength of light without generating heat, sound, or vibration. Also called photobiology or biostimulation, LLLT may accelerate connective tissue repair and serve as an anti-inflammatory agent. Wavelengths from 632 to 904 nm are used in the treatment of musculoskeletal disorders. A Cochrane review of 7 small studies with a total of 384 patients with nonspecific low back pain of varying durations found insufficient data to either support or refute the effectiveness of LLLT for the treatment of low back pain. Because of the varied length of treatment, LLLT dose, application techniques, and different populations, it was not possible to determine optimal administration of LLLT.71 No side effects were reported.
<>Pain in the lower back or low back pain is a common concern, affecting up to 80% of Americans at some point in their lifetime. Many will have more than one episode. Low back pain is not a specific disease, rather it is a symptom that may occur from a variety of different processes. In up to 85% of people with low back pain, despite a thorough medical examination, no specific cause of the pain can be identified.
<>Music therapy is a low-cost natural therapy that may reduce some of the stress of chronic pain in conjunction with other treatments. Studies find that it may reduce the disability, anxiety, and depression associated with chronic pain. It is thought to help because it can shift attention away from the unpleasant sensations of pain, and it may cause the release of endorphins or changes in catecholamine levels.
<>For short-term pain relief, over-the-counter pain relievers including acetaminophen and NSAIDs (non-steroidal anti-inflammatory drugs) are sometimes suggested. The most common NSAIDs include aspirin, ibuprofen (Advil, Motrin), and naproxen (Aleve). Potential side effects of NSAIDs include stomach and liver problems. Talk to your doctor if you don't find relief after taking the recommended dose.
<>Activity modification. One variant of resting is to stay active but avoid activities and positions that aggravate the pain. For example, if long periods of sitting in a car or at a desk make the pain worse, then set a timer to get up every 20 minutes and walk around or gently stretch. If standing makes the pain worse, avoid chores that require standing such as washing dishes at the sink. Avoiding, or minimizing, activities and positions that worsen the pain will help prevent or reduce painful back spasms and allow for a better healing environment.
<>To understand various causes of low back pain, it is important to appreciate the normal design (anatomy) of the tissues of this area of the body. Important structures of the low back that can be related to symptoms in this region include the bony lumbar spine (vertebrae, singular = vertebra), discs between the vertebrae, ligaments around the spine and discs, spinal cord and nerves, muscles of the low back, internal organs of the pelvis and abdomen, and the skin covering the lumbar area.
<>If your back pain hasn't resolved itself within four to six weeks, you'll want to make an appointment with your doctor. Your doc will examine your back and ask you to sit, stand, bend, walk, and lift your legs to see how your pain is affecting your mobility. You'll likely be asked to rate your pain on a scale of one to 10, and you may be sent for imaging tests like an x-ray or MRI. You might be asked to try one of these therapies:
<>That being said, the best medicine for dealing with back pain is (drum roll please)…. EXERCISE! And before you jump to the conclusion that the fitness professional is turning to exercise yet again, there are just a few other professionals who would agree, namely Harvard Medical School, The American Academy of Orthopedic Surgeons and the Mayo Clinic. All three organizations list exercise as their number one solution for low back pain prevention. In addition, the American Council on Exercise recommends specific dos and don'ts for exercising with low back pain. Yes, the recommendations for exercise seem to be overwhelming when it comes to dealing with back pain. However, the type of exercise you perform is going to make a difference and when it comes to exercising to relieve back pain there are two important goals:
<>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.
<>When you're working to strengthen the core, you'll want to focus on exercises that don't exacerbate lower back issues. "It's important to find out which movements (flexion, extension, rotation) cause pain or discomfort and to avoid those movements, while continuing to work into ranges that are not provoking," Dircksen says. Crockford suggests focusing on exercises that keep the core stable and avoiding twisting movements to avoid exacerbating pain.
<>Braces are not effective in preventing back pain.64 However, there is conflicting evidence to whether braces are effective supplements to other preventive interventions.64 Bracing, in combination with activity restriction, is effective in the treatment of spondylolysis in adolescents.33,42,46,53 A meta-analysis of 15 observational spondylolysis and grade 1 spondylolisthesis treatment studies did not find a significant improvement in rates of healing with bracing when compared with conservative treatment without bracing.37 Most experts recommend surgical consultation for spondylolisthesis with 50% slippage or more (grade 3 and higher).46
<>A common culprit in lower back pain due to sitting are tight or shortened hip flexors, which connect to your iliopsoas muscle, and often result in weak or compromised lower back and glute muscles. The following effective static stretches will help stretch out those muscles and deliver lower back relief. Regular practice of these stretches will also aid in bettering your posture long term.
<>Infection of the discs (septic discitis) and bone (osteomyelitis) is extremely rare. These conditions lead to localized pain associated with fever. The bacteria found when these tissues are tested with laboratory cultures include Staphylococcus aureus and Mycobacterium tuberculosis (TB bacteria). TB infection in the spine is called Pott's disease. These are each very serious conditions requiring long courses of antibiotics. The sacroiliac joints rarely become infected with bacteria. Brucellosis is a bacterial infection that can involve the sacroiliac joints and is usually transmitted in raw goat's milk.
<>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.
<>It is very common for your hamstring muscles, which are found on the back of your legs, to be very tight when you experience lower back pain. For this reason it is recommended to stretch them out. You can see a great stretch for the hamstrings below. To carry out this exercise, lie on your back with both feet on the floor and knees raised up. Loop a towel under the ball of one foot. Straighten your knee and slowly pull back on the towel. You should feel a gentle stretch down the back of your leg, try not to overdo it. Hold for 20 to 30 seconds. Repeat two times for each leg.
<>Rosenzweig, S., Greeson, J. M., Reibel, D. K., Green, J. S., Jasser, S. A., & Beasley, D. (2010, January). Mindfulness-based stress reduction for chronic pain conditions: Variation in treatment outcomes and role of home meditation practice. Journal of Psychosomatic Research, 68(1), 29–36. Retrieved from https://www.sciencedirect.com/science/article/pii/S0022399909000944
<>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
<>2010 — Upgraded: Section now includes discussion of that bizarre and already infamous paper in the New England Journal of Medicine (see Berman). I also make an important new point: exactly why acupuncture placebos are such a problem for low back pain patients in particular. [Section: The fascinating case of acupuncture, formerly a contender in low back pain therapy, but which has now miserably failed well-designed scientific tests.]
<>A physiatrist or interventional pain management doctor may help you avoid more invasive treatments. “These can include medications delivered to the spine such as epidural steroid injections to reduce inflammation, or radiofrequency nerve ablations to reduce transmission of neck or back pain,” explains Koser. The expert you meet with will go over all of the options available to you.
<>Imaging is not warranted for most patients with acute low back pain. Without signs and symptoms indicating a serious underlying condition, imaging does not improve clinical outcomes in these patients.9–11 Even with a few weaker red flags, four to six weeks of treatment is appropriate before consideration of imaging studies.8–10 If a serious condition is suspected, magnetic resonance imaging (MRI) is usually most appropriate. Computed tomography is an alternative if MRI is contraindicated or unavailable.10 Clinical correlation of MRI or computed tomography findings is essential because the likelihood of false-positive results increases with age.12–14 Radiography may be helpful to screen for serious conditions, but usually has little diagnostic value because of its low sensitivity and specificity.10
<>Low-level laser therapy (LLLT) is a noninvasive light source treatment that generates a single wavelength of light without generating heat, sound, or vibration. Also called photobiology or biostimulation, LLLT may accelerate connective tissue repair and serve as an anti-inflammatory agent. Wavelengths from 632 to 904 nm are used in the treatment of musculoskeletal disorders. A Cochrane review of 7 small studies with a total of 384 patients with nonspecific low back pain of varying durations found insufficient data to either support or refute the effectiveness of LLLT for the treatment of low back pain. Because of the varied length of treatment, LLLT dose, application techniques, and different populations, it was not possible to determine optimal administration of LLLT.71 No side effects were reported.
<>You know that calcium is key for strong bones, but Japanese researchers have identified something else you need: vitamin K. It’s believed that the vitamin, found in broccoli, spinach, and other dark leafy greens, helps calcium deposit in the bones, making them denser. The stronger your bones, the stronger your whole body—and the lower your chances of an injury that could cause back pain.
<>For a 2006 report published in Rheumatology, investigators analyzed the available research on the use of balneotherapy in treatment of low back pain. Looking at five clinical trials, the report's authors found "encouraging evidence" suggesting that balneotherapy may be effective for treating patients with low back pain. Noting that supporting data are scarce, the authors call for larger-scale trials on balneotherapy and low back pain.

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