<>Start on your hands and knees, and tighten your stomach muscles. Lift and extend one leg behind you. Keep hips level. Hold for 5 seconds, and then switch to the other leg. Repeat 8 to 12 times for each leg, and try to lengthen the time you hold each lift. Try lifting and extending your opposite arm for each repetition. This exercise is a great way to learn how to stabilize the low back during movement of the arms and legs. While doing this exercise don't let the lower back muscles sag. Only raise the limbs to heights where the low back position can be maintained. >
<>Looking for a way to adjust your desk chair without buying a new one? Nikki Walter, a personal trainer in North Dakota, recommended a washable orthopedic seat cushion. “Since it’s made of gel memory foam, you can squish it into a bag, take it with you, and pull it out when you need it," Walter said. "Watch it bounce back to life and relieve your stress in seconds!” >
<>Evidence from the small number of placebo-controlled trials does not support the use of transcutaneous electrical nerve stimulation in the routine management of chronic low back pain.36 Evidence from single lower quality trials is insufficient to accurately judge efficacy of transcutaneous electrical nerve stimulation versus other interventions for chronic low back pain or acute low back pain.10 >
<>Poor posture and crookedness is another popular scapegoat — it seems obvious that posture is relevant. Many professionals assume that back pain is some kind of postural problem that you can exercise your way clear of. Unfortunately, the evidence shows that no kind of exercise, not even the most hard-core core strengthening, has any significant effect on low back pain. >
<>Whether or not research can prove that massage therapy helps, many people report that it relaxes them and eases chronic pain. In a 2009 research review published in Spine, researchers reviewed 13 clinical trials on the use of massage in the treatment of back pain. The study authors concluded that massage "might be beneficial for patients with subacute and chronic nonspecific low back pain, especially when combined with exercises and education." The authors called for further studies that might help determine whether massage is a cost-effective treatment for low back pain. >
<>Spinal Manipulation and Chiropractic Techniques. Low-quality evidence shows that spinal manipulation may be more effective than sham treatments in the short-term reduction of pain (less than six weeks), but no more effective in reducing disability.18,20,42,43 There is little evidence that manipulation is cost-effective for treating acute low back pain.25 >
<>Sleep disturbances are common among people with chronic back pain, and not getting enough quality sleep may actually worsen inflammation and pain. For a better night's sleep, invest in a good mattress and experiment with different sleeping positions. Adding an extra pillow under your body can help maintain the natural curve in your spine. If you’re a back sleeper, try putting the pillow under both knees; for stomach sleepers, try under your pelvis. If you sleep on your side, sleeping with a pillow between the knees may help. >
<>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 >
<>Heat/ice therapy. Heat from a warm bath, hot water bottle, electric heating pad, or chemical or adhesive heat wraps can relax tense muscles and improve blood flow. Increased blood flow brings nutrients and oxygen that muscles need to heal and stay healthy. If the low back is painful due to inflammation, ice or cold packs can be used to reduce swelling. It’s important to protect the skin while applying heat and ice to prevent tissue damage. >
<>The prevention of back pain is, itself, somewhat controversial. It has long been thought that exercise and an all-around healthy lifestyle would prevent back pain. This is not necessarily true. In fact, several studies have found that the wrong type of exercise such as high-impact activities may increase the chance of suffering back pain. Nonetheless, exercise is important for overall health and should not be avoided. Low-impact activities such as swimming, walking, and bicycling can increase overall fitness without straining the low back. >
<>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 >
<>Having strong core muscles (we’re talking abs here) can help protect your back from injury. Do this core-strengthening pelvic tilt 2 to 3 times per week: Lie on your back with knees bent, feet flat on the floor, and lower back flattened. Pull in your belly button toward your spine, contracting your abs; your pelvis should lift slightly off the floor. >
<>Back pain is a health concern for most people in the United States at some point in their lives and one of the most common reasons people miss work or visit the doctor. More than 80 percent of Americans will experience low back pain, and this health problem costs the United States over $100 billion each year, most of which is a result of lost wages. >
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