<>Transcutaneous electric nerve stimulation (TENS): TENS provides pulses of electrical stimulation through surface electrodes. For acute back pain, there is no proven benefit. Two small studies produced inconclusive results, with a trend toward improvement with TENS. In chronic back pain, there is conflicting evidence regarding its ability to help relieve pain. One study showed a slight advantage at one week for TENS but no difference at three months and beyond. Other studies showed no benefit for TENS at any time. There is no known benefit for sciatica. >
<>Clinical examination and diagnostic skills are essential in the workup of low back pain. Athletes with neurologic compromise, fever, chills, or incontinence of bowel or bladder function or those with mechanism of action that could result in fracture or other serious injuries must first be evaluated for emergent causes. Workup and diagnosis must be individualized on the basis of differential diagnosis. >
<>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 >
<>The use of injections and procedures in and around the spine is limited as such treatments often provide only temporary relief. However, they can be important in helping diagnose structural causes in pain and assisting the physical rehabilitation when other methods have failed. The various injection procedures are costly and have potential side effects, which should be discussed in detail before proceeding. Often, a pain specialist or back specialist will also employ rehabilitation and counseling by non-physician personnel such as therapists, counselors, and patient educators. >
<>Low back pain can cause a wide variety of symptoms and signs depending on the precise cause of the pain as reviewed above. Symptoms that can be associated with low back pain include numbness and/or tingling of the lower extremities, incontinence of urine or stool, inability to walk without worsening pain, lower extremity weakness, atrophy (decreased in size) of the lower extremity muscles, rash, fever, chills, weight loss, abdominal pains, burning on urination, dizziness, joint pain, and fatigue. >
<>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. >
<>Another muscle which can be tight when you have lower back pain is the piriformis, a muscle in your butt. The stretch below is really effective in stretching this muscle, and very easy to do. To carry out the exercise, lie on your back and cross the right ankle over the left knee. Grip the thigh of your left leg and take a deep breath in. As you breathe out pull the knee in towards you. Hold the stretch for 20-30 seconds. Repeat two times for each side. >
<>You don’t need to take my word for anything — you can just take the word of the many low back pain medical experts that I quote,12 and the hard evidence that their opinions are based on. At the same time, I am realistic about the limits of the science, much of which is pretty junky.13 My own credentials are somewhat beside the point. My decade of professional experience as a Registered Massage Therapist does help me understand and write about low back pain, but what really matters is that I refer to and explain recent scientific evidence, but without blindly trusting it. >
<>Grandma was right! Slouching is bad for you. And poor posture can make back pain worse, especially if you sit for long periods. Don't slump over your keyboard. Sit upright, with your shoulders relaxed and your body supported against the back of your chair. Try putting a pillow or a rolled towel between your lower back and your seat. Keep your feet flat on the floor. >
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