<>In addition to strengthening the core muscles, it's also important to address any mobility problems, says Jacque Crockford, M.S., C.S.C.S., exercise physiology content manager at American Council on Exercise, which can sometimes be what's causing pain. If specific movements like twisting or bending or extending your spine feel uncomfortable, there may be mobility (flexibility) issues at play. Doing some gentle stretching (like these yoga poses) might help. (If it gets worse with those stretches, stop and see a doctor.)
<>I have had life-altering low back pain for more than 8 years. I’ve had the fusions at L5-S1. Prior to my first surgery I spent 18 months seeking relief through physical therapy, intense massage therapy, myofascial “release” therapy, a visit to Dr. Sarno himself, injections, dry needling of trigger points and massage from a physiatrist, chiropractic work and more. For years between surgeries I tried core strengthening, acupuncture, PT, more massage, two rhizotomies, and visits to the Mayo clinic and Johns Hopkins’ pain management in-patient programs. So I’ve been through a lot. And your book is the first thing I’ve read that dispassionately and entertainingly dissects all of the options and offers some realistic, pragmatic suggestions. It’s a gift to all back pain sufferers.
<>Adherence to exercise is one of the most important factors for long term pain relief. However, maintaining exercise can be difficult for a variety of reasons, including worsened pain with activity, economic constraints, and low motivation.1 In one study, the most common reason for lack of adherence to exercise was increased pain caused by activity.1 When this is the case, an exercise professional can incorporate pain reduction and management as primary parts of the exercise program.
<>“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.”
<>Three systemic reviews3,6,13 analyzed spinal manipulation therapy (SMT) for low back pain, including (1) high-velocity, low-amplitude manipulation of the spinal joints slightly beyond their passive range of motion; (2) high-velocity, low-amplitude technique rotating the thigh and leg; (3) mobilization within passive range of motion; and (4) instrument-based manipulations. There is moderate evidence of short-term pain relief with acute low back pain treated with SMT.6 Chronic low back pain showed moderate improvement with SMT, which is as effective as NSAIDs and more effective than physical therapy in the long term.6 Patients with mixed acute and chronic low back pain had better pain outcomes in the short and long terms compared with McKenzie therapy, medical care, management by physical therapists, soft tissue treatment, and back school.6 SMT was more effective in reducing pain and improving daily activities when compared with sham therapy.3 Dagenais13 found SMT effective in pain reduction in the short-, intermediate-, and long-term management of acute low back pain. However, a Cochrane review in 2004 on SMT in acute and chronic low back pain concluded that there was no difference in pain reduction or ability to perform daily activities with SMT or standard treatments (medications, physical therapy, exercises, back school, or the care of a general practitioner).3
<>Preliminary research suggests that hypnotherapy may be of some use in the treatment of low back pain. For instance, a pilot study published in the International Journal of Clinical and Experimental Hypnosis found that a four-session hypnosis program (combined with a psychological education program) significantly reduced pain intensity and led to improvements in mood among patients with chronic low back pain.
<>Many researchers seem to believe that low back pain is a modern problem. For instance, Waddell writes, “Observations of natural history and epidemiology suggest that low-back pain should be a benign, self-limiting condition, that low back-disability as opposed to pain is a relatively recent Western epidemic … .” In 2008, Martin et al found that, “The estimated proportion of persons with back or neck problems who self-reported physical functioning limitations increased from 20.7%… to 24.7% … 1997 to 2005,” which certainly shows that it is a growing problem and therefore likely to be worse now than in the past. A Spanish study (Jiménez-Sánchez et al) showed that “serious” musculoskeletal complaints (including a great deal of back pain, presumably) increased significantly from 1993 to 2001. Finally, Harkness et al did a nice job in 2005 of comparing rates of musculoskeletal pain (including low back pain) 40 years apart in the northwest of England, and found a large increase. In his books, Sarno also strongly portrays low back pain as a modern problem — though he doesn’t defend it . It’s hard to say if back pain actually is a modern problem, or whether it just tends to be described as such. Remember that human beings have a strong tendency to sensationalize and dramatize! Harkness pointed out in her study that the appearance of an increase “could be partly explained by the ‘worried well’. The ‘worried well’ are those patients who are concerned about their health, and attend their GP to seek reassurance about their well-being.” This is a great example of how hard it is to really be sure of anything! BACK TO TEXT
<>I have had life-altering low back pain for more than 8 years. I’ve had the fusions at L5-S1. Prior to my first surgery I spent 18 months seeking relief through physical therapy, intense massage therapy, myofascial “release” therapy, a visit to Dr. Sarno himself, injections, dry needling of trigger points and massage from a physiatrist, chiropractic work and more. For years between surgeries I tried core strengthening, acupuncture, PT, more massage, two rhizotomies, and visits to the Mayo clinic and Johns Hopkins’ pain management in-patient programs. So I’ve been through a lot. And your book is the first thing I’ve read that dispassionately and entertainingly dissects all of the options and offers some realistic, pragmatic suggestions. It’s a gift to all back pain sufferers.
<>Despite the high prevalence of low back pain and the significant burden to the athletes, there are few clearly superior treatment modalities. Superficial heat and spinal manipulation therapy are the most strongly supported evidence-based therapies. Nonsteroidal anti-inflammatory medications and skeletal muscle relaxants have benefit in the initial management of low back pain; however, both have considerable side effects that must be considered. Athletes can return to play once they have recovered full range of motion and have the strength to prevent further injury.
<>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.
<>Few people need surgery for back pain. If you have unrelenting pain associated with radiating leg pain or progressive muscle weakness caused by nerve compression, you might benefit from surgery. Otherwise, surgery usually is reserved for pain related to structural problems, such as narrowing of the spine (spinal stenosis) or a herniated disk, that hasn't responded to other therapy.
<>It may sound funny to massage your own back, but it is easy to have someone massage your back for you. In fact, having a loved one or friend use Ben Gay to massage the cream into your back is a great way to naturally help your back pain. Don’t massage directly over the spine, as this can cause harm to that delicate collection of anatomical structures. Long, smooth strokes over the entirety of the back are the best. These are called gliding movements, and they help to relax the muscles under the skin. Work the muscles up and down the back to either side of the spine, allowing the hands to glide over the problem area and work the cream into the muscle to provide maximum, natural healing. Next, find out the 15 everyday habits that are causing back pain and damaging your spine. 
<>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.
<>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
<>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).
<>It may be tempting to quit exercising when you're suffering from back pain, but it's essential to keep yourself moving. Pilates is one great option. In a 2014 European Journal of Physical Rehabilitation Medicine study, researchers found an improvement in pain, disability, and psychological health in chronic low-back pain patients who took five hourlong Pilates classes a week for six months. Meanwhile, people who remained inactive experienced further worsening of their pain. Similarly, a Medicine and Science in Sport and Exercise study revealed that taking either Pilates or a general exercise class twice a week for six weeks both improved pain and quality of life.
<>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.
<>When you have chronic pain, it’s important to accept your limitations and adapt. “Listen to your body and learn to pace yourself,” suggests Nava. Take a break when mowing the lawn, or make several trips when carrying groceries. Take note of the activities that worsen your pain and avoid them if possible. Not only could this help your back feel better, it could also prevent the underlying condition from advancing. 
<>Topical treatments: One potential concern with dietary supplements is that some may interfere with medications you’ve been prescribed to treat back pain or other health conditions. For this reason, Grossman suggests topical treatments: “Gels and creams can be very helpful and won't interfere with supplements or medications,” she explains. “They're generally inexpensive, too.”
<>Most people will experience lower back pain at some point in their life, it is very common. In the old days bed rest was prescribed if your back was “playing-up,” whereas today it is recommended to keep exercising. Of course the exercises you do have to be appropriate, we are not suggesting to go for a run or lift heavy weights, that wouldn’t be smart. However, there are some great exercises you can do which should help alleviate lower back pain. These exercises are extremely gentle, but of course, listen to your body and stop if you experience any pain.
<>Get some exercise. You may be tempted to stay in bed when your back acts up, but exercise and activity can actually help you heal faster and reduce pain. A study of 240 men and women found that regular exercise reduced pain by 28 percent and disability by 36 percent. Low impact, moderate intensity exercise is the safest option. Avoid movements that trigger pain or require excessive jumping or squatting, which can exacerbate injuries. Take two to three minutes at the end of your workout to stretch your back thoroughly. Lie flat on your back and hug your knees to release any tension that developed during your workout.
<>Use this movement to stretch the paraspinal muscles and strengthen the abdominal muscles. Lie on your back with your legs extended straight out. Bend the right knee up and cross it over the left side of your body. Hold in a position that allows you to feel a gentle stretch through the back and buttocks muscles for 20 seconds. Tighten your core muscles and rotate back to center. Repeat three times on each side.
<>To relieve pain all over instead of just in one problem area, Dr. Mark Liponis, the chief medical officer at Canyon Ranch in Tucson, Arizona, recommended an inversion table that provides massage. While it may be expensive for some, he said it could be worth it for managing a chronic pain issue. "Over time can help relieve chronic neck and back pain,” Liponis added.
<>Chiropractors use posture exercises and hands-on spinal manipulation to relieve back pain, improve function, and help the body heal itself. They often work in conjunction with other doctors, and they can prescribe diet, exercise, and stretching programs. "A well-trained chiropractor will sort out whether you should be in their care or the care of a physical therapist or medical doctor," Dr. Kowalski explains.
<>As part of your exercise routine, you may want to consider doing yoga regularly for lower back pain relief. One study of over 960 people with low back pain found that those who completed a 12-week yoga program experienced greater improvements in back function and reduced pain compared to controls who did not participate. (4) There’s even evidence that mindfulness meditation, often practiced in some form with yoga, can also help people deal with chronic back pain more effectively. (5)
<>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.
<>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.
<>Doctors lack the skills and knowledge needed to care for most common aches, pains, and injury problems, especially the chronic cases, and even the best are poor substitutes for physical therapists. This has been proven in a number of studies, like Stockard et al, who found that 82% of medical graduates “failed to demonstrate basic competency in musculoskeletal medicine.” It’s just not their thing, and people with joint or meaty body pain should take their family doctor’s advice with a grain of salt. See The Medical Blind Spot for Aches, Pains & Injuries: Most physicians are unqualified to care for many common pain and injury problems, especially the more stubborn and tricky ones.
<>Other back pain remedies that work fast at home is over-the-counter pain medications. Tylenol, or acetaminophen, is really not recommended for muscular strains and sprains. If you’ve hurt your back, the best back pain remedy is a non-steroidal anti-inflammatory medication, or NSAID. These are popularly known as Advil (ibuprofen) and Aleve (naproxen). Once again, these medications help to stem the tide of the blood flow to the area to reduce pain. By keeping inflammation low, your pain is decreased, and you are better able to move. Be careful to follow the bottle’s instructions, though, because these medications can cause stomach ulcers.
<>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!]
<>One of the new back pain remedies is a muscle stimulation machine. In the past, you would need to visit a chiropractor or physical therapist to receive the benefit of one of these machines, but they now sell them over the counter. However, they are expensive. They make the muscles of the back “twitch,” and this helps to strengthen them. After several sessions with the stimulation machine, your muscles are better able to handle the stress and strain of everyday life again. When a back muscle is hurt, it loses some of its primary strength, and the stimulation machine can restore that to a point. The over-the-counter versions are limited, though, and you may need to see a professional if your back pain persists.
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<>Mobilising your lower back is important to aid it’s recovery. The bird dog exercise is shown in the image below and is great for mobilising the lower back. To carry out this exercise get onto all fours, make sure your hands are directly under your shoulders, and knees directly under your hips. Your spine is in a neutral position and you need to keep your head in line with your spine. Take a deep breath in and as you breathe out extend one leg and the opposite arm to inline with your spine. You need to keep your spine in a neutral position at all times, so don’t let your lower back sag down. Hold for 5-10 seconds and as you breathe out lower both your leg and arm to the ground. Repeat this exercise eight to twelve times alternating sides.
<>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.
<>Your doctor will first ask you many questions regarding the onset of the pain. (Were you lifting a heavy object and felt an immediate pain? Did the pain come on gradually?) He or she will want to know what makes the pain better or worse. The doctor will ask you questions referring to the red flag symptoms. He or she will ask if you have had the pain before. Your doctor will ask about recent illnesses and associated symptoms such as coughs, fevers, urinary difficulties, or stomach illnesses. In females, the doctor will want to know about vaginal bleeding, cramping, or discharge. Pain from the pelvis, in these cases, is frequently felt in the back.
<>2010 — Like new: Rewritten. I’ve lost track and can’t be bothered to go back into the archives to figure it out for sure, but I think that this section was brand new (but never announced) late in 2009, and then this past week I gave it a substantial upgrade: it is now one of the best-referenced chapters in the book, and it says as much as probably needs to be said on the subject — or more! [Section: Core strengthening has failed to live up to the hopes and dreams of therapists and patients.]
<>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
<>Back pain is a symptom. Common causes of back pain involve disease or injury to the muscles, bones, and/or nerves of the spine. Pain arising from abnormalities of organs within the abdomen, pelvis, or chest may also be felt in the back. This is called referred pain. Many disorders within the abdomen, such as appendicitis, aneurysms, kidney diseases, kidney infection, bladder infections, pelvic infections, and ovarian disorders, among others, can cause pain referred to the back. Normal pregnancy can cause back pain in many ways, including stretching ligaments within the pelvis, irritating nerves, and straining the low back. Your doctor will have this in mind when evaluating your pain.
<>Subacute low back pain. Lasting between 6 weeks and 3 months, this type of pain is usually mechanical in nature (such as a muscle strain or joint pain) but is prolonged. At this point, a medical workup may be considered, and is advisable if the pain is severe and limits one’s ability to participate in activities of daily living, sleeping, and working.
<>“I went in not knowing what the problem was, I hurt and I figured I was out of place. I was seeing another chiropractor but they were only adjusting me and there was no improvement - I was worsening. I went to see Dr. Riley and in one visit he found that I was weak in my left glute and my body was overcompensating and causing me pain. It took four visits working on strengthening that side and I'm pain free.”
<>Although it may not sound like a back pain remedy, rest is vital when you are trying to relieve back pain naturally. Your muscles are in a state of shock and injury. Further insult will only make the pain worse and can lead to further injury of the musculature of the back. You shouldn’t go on complete bed rest, though. Yes, take it easy, but it is easy to lock up your back by not moving enough. Don’t engage in strenuous activity, but gentle stretching and light walking should be okay. Take time to sit or lay down regularly until your back pain remedies start to improve your situation. Don’t miss these lower back pain relief treatments that really work.
<>If you've ever groaned, "Oh, my aching back!", you are not alone. Back pain is one of the most common medical problems, affecting 8 out of 10 people at some point during their lives. Back pain can range from a dull, constant ache to a sudden, sharp pain. Acute back pain comes on suddenly and usually lasts from a few days to a few weeks. Back pain is called chronic if it lasts for more than three months.
<>Most persons will experience acute low back pain during their lifetime. The first episode usually occurs between 20 and 40 years of age. For many, acute low back pain is the first reason to seek medical care as an adult. Pain can be moderate to severe and debilitating, causing anxiety. Many cases are self-limited and resolve with little intervention. However, 31 percent of persons with low back pain will not fully recover within six months,1 although most will improve. Recurrent back pain occurs in 25 to 62 percent of patients within one to two years, with up to 33 percent having moderate pain and 15 percent having severe pain.2–4
<>A There is no paper book. I sell digital reading material only: web-based tutorials — for instant delivery, and many benefits “traditional” e-books can’t offer, especially hassle-free lending and free updates for life. Health care information changes fast! You get free lifetime access to the always-current “live” web version and offline reading is no problem.
<>Use this movement to stretch the paraspinal muscles and strengthen the abdominal muscles. Lie on your back with your legs extended straight out. Bend the right knee up and cross it over the left side of your body. Hold in a position that allows you to feel a gentle stretch through the back and buttocks muscles for 20 seconds. Tighten your core muscles and rotate back to center. Repeat three times on each side.
<>Since you shouldn't try to diagnose your own back pain, make your first call to a professional who can assess your problem, such as a primary care physician or a chiropractor. "Both can serve as the entry point for back pain," says Dr. Matthew Kowalski, a chiropractor with the Osher Clinical Center for Integrative Medicine at Harvard-affiliated Brigham and Women's Hospital. "And 35% to 42% of people with their first episode of back pain will consult a chiropractor."
<>When you first hurt your back, one of the best back pain remedies is to ice the area. Injury to a muscle means that blood will rush to the site, bringing healing chemicals to ease the pain. Unfortunately, this leads to swelling, and that swelling leads to pain. Applying cold compresses constricts the blood vessels, and this reduces the flow of that blood. The reduction in swelling means that you will have less pain, and this is a great way to relieve back pain naturally. Be sure to keep the cold on for 20 minutes and off for 40. Don’t use this method after the first 24 hours. These are 10 surprising reasons your back hurts.
<>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
<>Not Enough Activity: Sedentary people experience the same kind of pain for the opposite reasons. Muscles that go unused become stiff and inflexible. Sitting all day causes tight hip-flexors, poor posture and weak abdominals. When your muscles are limited to the same basic body position day in and day out they do not learn to move safely and freely through different ranges of motions and are injured more easily at sudden movements. In addition, the body is one long kinetic chain. Tight hamstrings or hip flexors turn into tight hips and glutes, which pull on the back and create pain.
<>Nearly everyone suffers from some type of back pain at some point in their lives. But no matter when it appears or what may have caused it, back pain can be a real, well … pain to deal with. The good news? There are several simple things you can do to ease pain and keep your back in good condition. The following tips can help you get on the way toward feeling better.

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