<>The mission of the National Institute of Arthritis and Musculoskeletal and Skin Diseases is to support research into the causes, treatment, and prevention of arthritis and musculoskeletal and skin diseases; the training of basic and clinical scientists to carry out this research; and the dissemination of information on research progress in these diseases.
<>Joint Replacement Surgery Bursitis Fibromyalgia Fibrous Dysplasia Growth Plate Injuries Marfan Syndrome Osteogenesis Imperfecta Osteonecrosis Osteopetrosis Osteoporosis Paget’s Disease of Bone Scoliosis Spinal Stenosis Tendinitis Sports Injuries Sports Injuries in Youth: A Guide for Parents Sprains and Strains Back Pain Shoulder Problems Knee Problems Hip Replacement Surgery
<>The treatment of lumbar strain consists of resting the back (to avoid reinjury), medications to relieve pain and muscle spasm, local heat applications, massage, and eventual (after the acute episode resolves) reconditioning exercises to strengthen the low back and abdominal muscles. Initial treatment at home might include heat application, acetaminophen (Tylenol) or ibuprofen (Advil, Motrin), and avoiding reinjury and heavy lifting. Prescription medications that are sometimes used for acute low back pain include anti-inflammatory medications, such as sulindac (Clinoril), naproxen (Naprosyn), and ketorolac (Toradol) by injection or by mouth, muscle relaxants, such as carisoprodol (Soma), cyclobenzaprine (Flexeril), methocarbamol (Robaxin), and metaxalone (Skelaxin), as well as analgesics, such as tramadol (Ultram).
<>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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<>I bought two of your eBooks last week, and I’m enjoying going through them. Your presentation is excellent. It’s far too early too say, of course, but I think I’ve already begun to benefit from your approach. One of the things I like most about your approach is your respect for “science,” as opposed to “merchandising.” You've put so much into those two eBooks, it's going to take time to do them the justice they deserve.
<>Purchase full access to this tutorial for USD$1995. Continue reading this page immediately after purchase. A second tutorial about muscle pain is included free. See a complete table of contents below. Most content on PainScience.com is free.?Almost everything on this website is free: about 80% of the site by wordcount (well over a million words), or 95% of the bigger pages (>1000 words). This page is only one of 8 big ones that have a price tag. There are also hundreds of free articles, including several about low back pain. But this page goes into extreme detail, and selling access to it keeps the lights on and allows me to publish everything else (without ads).
<>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.
<>To avoid unwanted weight gain, consuming inflammatory ingredients or complications due to nutrient deficiencies, reduce or eliminate the following foods: added sugar, sweetened beverages or snacks, refined vegetable oils, refined grain products, too much alcohol and tobacco products (smoking impairs blood flow and adds to nutrient deprivation to spinal tissues).
<>Narcotic pain medications. Narcotic medications, also called opioids or painkillers, alter one’s perception of pain by weakening signals sent to the brain. Narcotic medications are most often used for treating intense, short-term pain, such as acute pain after an operation. Narcotics are rarely used to treat long-term pain, as they have many side effects and can easily become addictive.
<>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."
<>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.
<>Pregnancy commonly leads to low back pain by mechanically stressing the lumbar spine (changing the normal lumbar curvature) and by the positioning of the baby inside of the abdomen. Additionally, the effects of the female hormone estrogen and the ligament-loosening hormone relaxin may contribute to loosening of the ligaments and structures of the back. Pelvic-tilt exercises and stretches are often recommended for relieving this pain. Women are also recommended to maintain physical conditioning during pregnancy according to their doctors' advice. Natural labor can also cause low back pain.
<>Epidural steroid injections are most commonly used in situations of radicular pain, which is a radiating pain that is transmitted away from the spine by an irritated spinal nerve. Irritation of a spinal nerve in the low back (lumbar radiculopathy) causes pain that goes down the leg. Epidural injections are also used to treat nerve compression in the neck (cervical spine), referred to as cervical radiculopathy, which causes pain.
<>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.
<>A Cochrane review of 10 antidepressant and placebo trials showed no difference in pain relief or depression severity.62 The qualitative analyses found conflicting evidence on the effect of antidepressants on pain intensity in chronic low back pain and no clear evidence that antidepressants reduce depression in chronic low-back-pain patients. Two pooled analyses showed no difference in pain relief between different types of antidepressants and placebo. Another systemic review found different results: Antidepressants were more effective than placebo,9 but the effects were not consistent with all antidepressants. Tricyclic antidepressants were moderately more effective than placebo, but paroxetine and trazodone were not.9 Antidepressants were associated with significantly higher risk for adverse events compared with placebo, with drowsiness, dry mouth, dizziness, and constipation the most commonly reported.54 Duloxetine has recently been approved by the Food and Drug Administration for treatment of chronic low back pain and osteoarthritis,63 and evidence suggests effectiveness in chronic low back pain.58,57
<>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.
<>COX-2 inhibitors, such as celecoxib (Celebrex), are more selective members of NSAIDs. Although increased cost can be a negative factor, the incidence of costly and potentially fatal bleeding in the gastrointestinal tract is clearly less with COX-2 inhibitors than with traditional NSAIDs. Long-term safety (possible increased risk for heart attack or stroke) is currently being evaluated for COX-2 inhibitors and NSAIDs.
<>If your symptoms persist more than four to six weeks, you have suffered trauma. If your doctor suspects a serious cause behind the back pain, X-rays may be ordered. X-rays are useful in pinpointing broken bones or other skeletal defects. They can sometimes help locate problems in connective tissue. To analyze soft-tissue damage, including disk problems, computed tomography (CT) or magnetic resonance imaging (MRI) scans may be needed. To determine possible nerve or muscle damage, an electromyogram (EMG) can be useful.
<>Levator scapula stretch. Rest one arm against a wall or doorjamb with the elbow slightly above the shoulder, then turn the head to face the opposite direction. Bring the chin down toward the collarbone to feel a stretch in the back of the neck. It may be helpful to gently pull the head forward with the other hand to hold the stretch for the desired time.
<>Most back pain can be successfully treated without surgery. If conservative back pain treatment fails, or if you have difficulty standing or walking, you may be a candidate for surgery. Dr. Stieber is a leader in the use of minimally-invasive surgical techniques with advanced expertise in restoring mobility to the back and helping his New York patients return to activity and an improved quality of life.
<>“The Pain Perplex,” a chapter in the book Complications, by Atul Gawande. Gawande’s entire book is worth reading, but his chapter on pain physiology is certainly the best summary of the subject I have ever read, and a terrific reminder that good writing for a general audience can be just as illuminating for professionals. Anyone struggling with a pain problem should buy the book for this chapter alone, though you are likely to enjoy the whole thing. Much of the chapter focuses on one of the most interesting stories of low back pain I’ve read, and it is a responsible and rational account — although Gawande, like most doctors, seems to be unaware of the clinical significance, or even existence, of myofascial trigger points.
<>A randomized single-blind controlled trial compared manual therapy and spinal stabilization rehabilitation to control (education booklet) for chronic back pain.26 Spinal stabilization rehabilitation was more effective than either manipulation or the education booklet in reducing pain, disability, medication intake, and improving the quality of life for chronic low back pain.26 A systemic review found segmental stabilizing exercises more effective in reducing the recurrence of pain in acute low back pain; however, exercises were no better than treatment by general practitioner in reducing short-term disability and pain.50 For chronic low back pain, segmental stabilizing exercises were more effective than treatment from general practitioners but no more effective than exercises using devices, massage, electrotherapy, or heat.50 In a trial of 30 hockey players, dynamic muscular stabilization techniques (an active approach to stabilization training) were more effective than a combination of ultrasound and short-wave diathermy and lumbar strengthening exercises.41
<>Stay strong. Once your low back pain has receded, you can help avert future episodes of back pain by working the muscles that support your lower back, including the back extensor muscles. "They help you maintain the proper posture and alignment of your spine," Reicherter says. Having strong hip, pelvic, and abdominal muscles also gives you more back support. Avoid abdominal crunches, because they can actually put more strain on your back.
<>Nerve irritation: The nerves of the lumbar spine can be irritated by mechanical pressure (impingement) by bone or other tissues, or from disease, anywhere along their paths -- from their roots at the spinal cord to the skin surface. These conditions include lumbar disc disease (radiculopathy), bony encroachment, and inflammation of the nerves caused by a viral infection (shingles). See descriptions of these conditions below.
<>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
<>Most experts agree that prolonged bed rest is associated with a longer recovery period. Further, people on bed rest are more likely to develop depression, blood clots in the leg, and decreased muscle tone. Very few experts recommend more than a 48-hour period of decreased activity or bed rest. In other words, get up and get moving to the extent you can.
<>There is no single best exercise for lower back pain, the key is to build up strength in your core and glutes, which often tend to be weak; consequently, the lower back works overtime to compensate. Strengthen your core and relieve your lower back. Below are a selection of the best core and ab workouts that don’t strain your back straight from the 8fit app.
<>There are a number of medications that can relieve back pain. Over-the-counter pain relievers, muscle relaxants, topical pain relievers and narcotics are all extremely effective in increasing your comfort. In addition, cortisone injections can decrease inflammation around the nerve roots and low doses of antidepressants can relieve certain types of chronic back pain.
<>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
<>Magnesium is the fourth most abundant mineral in the body. Involved in over 300 biochemical reactions, it helps maintain normal muscle and nerve function, keeps heart rhythm steady, supports a healthy immune system, and preserves bones strength. Magnesium also helps regulate blood sugar levels, promotes normal blood pressure, and is known to be involved in energy metabolism and protein synthesis.

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