<>Aquatic therapy is essentially physical therapy in a pool. Instead of using weights for resistance, patients use the resistance of the water. Studies show it may help alleviate lower back pain. In one 2013 study, sedentary adults who underwent aquatic therapy five times a week for two months saw reductions in pain and increases in quality of life. One smaller study found that aquatic therapy also helped pregnant women who were experiencing aching lower backs.
<>Save a bundle on a bundle! The boxed set is a 50% discounted bundle of all 8 book-length tutorials for sale on this website, about 8 different common injuries and pain problems. It’s ideal for professionals, keen patients, and anyone who wants more for less. Purchased individually, all the tutorials would cost $160, but the set price is only $79.50. More information and purchase options.
<>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.
<>Today, the most common conventional treatments for lower back pain relief are medications, including NSAIDS like aspirin and Tylenol, along with more potent prescription painkillers, such analgesics. These drugs can potentially cause adverse side effects in some patients and commonly don’t solve the underlying causes of lower back pain (such as poor posture, obesity or exercise-related strains). Some medications for back pains have even been tied to complications, such as liver damage or intestinal bleeding, when taken for long periods of time or in high doses.
<>Staying in bed for any prolonged period can make you stiff and increase pain. When you don’t move and bend, you lose muscle strength and flexibility. With bed rest, you lose about 1 percent of your muscle strength each day. And you can lose 20 to 30 percent in a week. It becomes more difficult to return to any activity. As you become weaker and stiffer your recovery takes longer.
<>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
<>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.
<>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:
<>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.
<>The Agency for Healthcare Research and Quality has identified 11 red flags that doctors look for when evaluating a person with back pain. The focus of these red flags is to detect fractures (broken bones), infections, or tumors of the spine. Presence of any of the following red flags associated with low back pain should prompt a visit to your doctor as soon as possible for complete evaluation.
<>Too Much of an Activity: For the active person, chronic back pain can come from repetitive pounding on the spine as in running, jumping or other high impact activities. Think of the “wear and tear” that happens on cars or appliances—the same holds true for our bodies. It can also be from repetitive twisting and turn as in swinging a golf club or a tennis racket. There are endless things that cause wear and tear on the back.
<>Nerve blocks, epidural steroid injections, nerve ablations and other types of injection-based procedures are available for chronic back pain. They are used when the source of the pain is known and can sometimes help rule out certain causes if the treatment doesn’t work. Injections may stop or lessen pain for a certain period of time, but are not intended as long-term solutions and shouldn’t be used in isolation.
<>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.
<>I had suffered from undiagnosed and seemingly untreatable low back pain since late August last year. Three physiotherapists, my GP, two RMTs, and my generally excellent personal trainer failed to help me make any progress. At my last visit to my GP in late December, he maintained his insistence that I just needed to loosen up my hamstrings! The systematic approach you took to reviewing all the supposed cures and providing a clear analysis of each and no doubt saved me thousands of dollars and months of frustration. That gave me the focus to work on trigger points known to cause LBP (with the help of some additional books and a great TP therapy app for my phone). My back pain isn’t totally gone, but I’m 95% there and I’ve got a handle on it.
<>Do you want to prevent back pain? Try a few basic exercises to stretch and strengthen your back and supporting muscles. Repeat each exercise a few times, then increase the number of repetitions as the exercise gets easier. If you've ever hurt your back or have other health conditions, such as osteoporosis, consult your doctor before doing these exercises.
<>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!
<>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
<>Try taking one 250-milligram capsule of valerian four times a day. Some scientists claim that this herb’s active ingredient interacts with receptors in the brain to cause a sedating effect. Although sedatives are not generally recommended, valerian is much milder than any pharmaceutical product. (Valerian can also be made into a tea, but the smell is so strong-resembling overused gym socks-that capsules are vastly preferable.)
<>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.
<>It may seem like the fix is lying in bed and bingeing on Netflix, but the opposite is true. For back pain in which there’s no real known cause (the majority of cases), movement is often the antidote for the ache. Research shows it’s best to do a mix of activity. Aerobic exercise boosts blood flow to heal soft tissue and increase mobility, strength exercises support the spine, and flexibility work improves movement and function. Try these exercises that ease back 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.
<>Lumbar radiculopathy: Lumbar radiculopathy is nerve irritation that is caused by damage to the discs between the vertebrae. Damage to the disc occurs because of degeneration ("wear and tear") of the outer ring of the disc, traumatic injury, or both. As a result, the central softer portion of the disc can rupture (herniate) through the outer ring of the disc and abut the spinal cord or its nerves as they exit the bony spinal column. This rupture is what causes the commonly recognized "sciatica" pain of a herniated disc that shoots from the low back and buttock down the leg. Sciatica can be preceded by a history of localized low-back aching or it can follow a "popping" sensation and be accompanied by numbness and tingling. The pain commonly increases with movements at the waist and can increase with coughing or sneezing. In more severe instances, sciatica can be accompanied by incontinence of the bladder and/or bowels. The sciatica of lumbar radiculopathy typically affects only one side of the body, such as the left side or right side, and not both. Lumbar radiculopathy is suspected based on the above symptoms. Increased radiating pain when the lower extremity is lifted supports the diagnosis. Nerve testing (EMG/electromyogramspina bifida
<>You probably don't know it, but you and Paula Abdul have more in common than you think! You are both part of the 65 million Americans affected by back pain. The good news is 95 percent of cases involving back pain do not require surgical treatment. As we age, lower back pain becomes increasingly more and more common. Not to mention, muscle elasticity and bone strength decrease over time, leaving your back vulnerable to strain and injury.
<>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.
<>Magnetic resonance imaging (MRI) scans are a highly detailed test and are very expensive. The test does not use X-rays but very strong magnets to produce images. Their routine use is discouraged in acute back pain unless a condition is present that may require immediate surgery, such as with cauda equina syndrome or when red flags are present and suggest infection of the spinal canal, bone infection, tumor, or fracture.
<>While it’s true that some lower back pain just cannot be fixed, it’s also true that many “incurable” cases do turn out to be surprisingly treatable. People who believed for years that their pain was invincible have found relief. Not always, and often not completely — but sometimes any relief is far better than nothing. How can extremely stubborn pain finally ease up? Simple: because many cases weren’t truly stubborn to begin with, despite all appearances. So many health professionals are poorly prepared to treat low back pain that patients can easily go for months or even years without once getting good care and advice. When they finally get it, it’s hardly surprising that some patients finally get some relief from their pain.
<>Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. Patient Platform Limited has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.
<>Low back pain is one of the most common complaints on the planet. And you may wonder where to turn when you start experiencing some of those aches or twinges in the lower part of your back. Take heart. "In most cases, you won't need a specialist," says Dr. Robert Shmerling, a rheumatologist at Harvard-affiliated Beth Israel Deaconess Medical Center.
<>Writers go on and on about how grateful they are for the support they had while writing one measly book, but this website is a much bigger project. PainScience.com was originally created in my so-called “spare time” with a lot of assistance from family and friends. Thanks to my wife for countless indulgences large and small; to my parents for (possibly blind) faith in me, and much copyediting; and to friends and technical mentors Mike, Dirk, Aaron, and Erin for endless useful chats, repeatedly saving my ass, and actually building many of the nifty features of this website.
<>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. 
<>Low back pain is one of the most common complaints on the planet. And you may wonder where to turn when you start experiencing some of those aches or twinges in the lower part of your back. Take heart. "In most cases, you won't need a specialist," says Dr. Robert Shmerling, a rheumatologist at Harvard-affiliated Beth Israel Deaconess Medical Center.
<>An accurate history and physical examination are essential for evaluating acute low back pain. Often, patients awaken with morning pain or develop pain after minor forward bending, twisting, or lifting. It is also important to note whether it is a first episode or a recurrent episode. Recurrent episodes usually are more painful with increased symptoms. Red flags are often used to distinguish a common, benign episode from a more significant problem that requires urgent workup and treatment (Table 2).5,6,8 A recent study shows that some red flags are more important than others, and that red flags overall are poor at ruling in more serious causes of low back pain.8 Patients with back pain in the primary care setting (80 percent) tend to have one or more red flags, but rarely have a serious condition.8  However, physicians should be aware of the signs and symptoms of cauda equina syndrome, major intra-abdominal pathology, infections, malignancy, and fractures (Tables 15,6  and 25,6,8). Cauda equina syndrome and infections require immediate referral. Family physicians should rely on a comprehensive clinical approach rather than solely on a checklist of red flags.
<>While it’s true that some lower back pain just cannot be fixed, it’s also true that many “incurable” cases do turn out to be surprisingly treatable. People who believed for years that their pain was invincible have found relief. Not always, and often not completely — but sometimes any relief is far better than nothing. How can extremely stubborn pain finally ease up? Simple: because many cases weren’t truly stubborn to begin with, despite all appearances. So many health professionals are poorly prepared to treat low back pain that patients can easily go for months or even years without once getting good care and advice. When they finally get it, it’s hardly surprising that some patients finally get some relief from their pain.
<>Research shows that certain forms of magnesium can be effective for pain relief and muscle relaxation, as well as nerve pain. Many people in our society are magnesium deficient, so it may be a good idea to supplement. Magnesium glycinate is known to be a highly bioavailable form. Magnesium citrate can be used by those who tend toward constipation, as it has an additional effect of loosening the bowels.

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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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