<>Battié MC, Videman T, Kaprio J, et al. The Twin Spine Study: contributions to a changing view of disc degeneration. Spine J. 2009;9(1):47–59. PubMed #19111259. “The once commonly held view that disc degeneration is primarily a result of aging and wear and tear from mechanical insults and injuries was not supported by this series of studies. Instead, disc degeneration appears to be determined in great part by genetic influences. Although environmental factors also play a role, it is not primarily through routine physical loading exposures (eg, heavy vs. light physical demands) as once suspected.” BACK TO TEXT
<>Back pain can interrupt your day or interfere with your plans. In fact, there’s an 84 percent chance that you will develop low back pain in your lifetime. But back pain isn’t always something you can ignore or wait for it to resolve on its own. Thankfully, there are several ways to treat back pain at home. These remedies include everything from herbs to massages. Keep reading to see how you can ease your 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
<>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.
<>Low back pain is the fifth most common reason for all physician visits in the United States.17,29 Approximately one quarter of US adults report having low back pain lasting at least 1 whole day in the past 3 months,17 and 7.6% report at least 1 episode of severe acute low back pain within a 1-year period.8 The prevalence rates of low back pain in athletes range from 1% to 40%.5 Back injuries in the young athlete are a common phenomenon, occurring in 10% to 15% of participants.18 It is not clear if athletes experience low back pain more often than the general population. Comparisons of wrestlers,27 gymnasts,60 and adolescent athletes40 have found back pain more common versus age-matched controls. Other comparisons of athletes and nonathletes have found lower rates of low back pain in athletes than nonathletes.67
<>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
<>Chiropractic care involving spinal manipulation appears to reduce symptoms and improve function in patients with chronic low back pain, acute low back pain, and sub-acute low back pain, according to a research review published in the Journal of Manipulative Physiological Therapeutics. In their analysis of 887 documents (including 64 clinical trials), the review's authors concluded that combining chiropractic care with exercise is "likely to speed and improve outcomes" and protect against future episodes of back pain.
<>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.
<>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
<>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 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.
<>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.
<>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.
<>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.
<>Is “much” information really “just plain wrong”? I will establish this in the sections ahead with a steady supply of clearly explained references to the medical literature that patients can understand and professionals can respect. This extra layer of information in easy-to-use footnotes is available for any reader who wants to dig deeper and check my facts. For example, here’s a good start: In 2010, the Journal of Bone & Joint Surgery reported that “the quality and content of health information on the internet is highly variable for common sports medicine topics,” such as knee pain and low back pain — a bit of an understatement, really. Expert reviewers examined about 75 top-ranked commercial websites and another 30 academic sites. They gave each a quality score on a scale of 100. The average score? Barely over 50! For more detail, see Starman et al. BACK TO TEXT
<>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.
<>For a 2006 report published in Rheumatology, investigators analyzed the available research on the use of balneotherapy in treatment of low back pain. Looking at five clinical trials, the report's authors found "encouraging evidence" suggesting that balneotherapy may be effective for treating patients with low back pain. Noting that supporting data are scarce, the authors call for larger-scale trials on balneotherapy and low back pain.
<>Low back pain can certainly be sensitive to emotional state, just like an ulcer gets worse when you’re stressed. But both are real physical problems! All of this will be discussed in detail, and it’s important, but this is not a tutorial about treating back pain through psychoanalysis, stress relief, and positive thinking. Tools like yoga and meditation are great for those who enjoy them, but not required.
<>Muscle relaxants: Muscle spasm is not universally accepted as a cause of back pain, and most relaxants have no effect on muscle spasm. Muscle relaxants may be more effective than a placebo (sugar pill) in treating back pain, but none has been shown to be superior to NSAIDs. No additional benefit is gained by using muscle relaxants in combination with NSAIDs over using NSAIDs alone. Muscle relaxants cause drowsiness in up to 30% of people taking them. Their use is not routinely recommended.
<>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.
<>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
<>Pain in the lower back or low back pain is a common concern, affecting up to 80% of Americans at some point in their lifetime. Many will have more than one episode. Low back pain is not a specific disease, rather it is a symptom that may occur from a variety of different processes. In up to 85% of people with low back pain, despite a thorough medical examination, no specific cause of the pain can be identified.
<>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.
<>Plain X-rays are generally not considered useful in the evaluation of acute back pain, particularly in the first 30 days. In the absence of red flags, their use is discouraged. Their use is indicated if there is significant trauma, mild trauma in those older than 50 years of age, people with osteoporosis, and those with prolonged steroid use. Do not expect an X-ray to be taken.
<>These exercises should be performed three to four times per day when you are experiencing acute low back pain. Be sure to monitor your symptoms while exercising, and stop if you feel any increase in pain. If you have leg pain coming from your back, watch for the centralization phenomenon; this is a good sign that you are doing the right exercise for your condition When your pain has subsided, perform the exercises once per day to help maintain a healthy spine and to help prevent future low back pain.
<>Free second tutorial! When you buy this tutorial, you will also get Save Yourself from Trigger Points and Myofascial Pain Syndrome! — a $1995 value. The low back pain tutorial makes the case that trigger points are a major factor in low back pain. However, trigger point therapy is not an easy skill to master — and it’s an enormous subject. PainScience.com publishes a separate tutorial about trigger point therapy. It’s offered as a free, essential companion to the low back pain tutorial. As a pair, they give you everything you need to know about helping most cases of low back pain.
<>Lie on your back with knees bent and just your heels on the floor. Push your heels into the floor, squeeze your buttocks, and lift your hips off the floor until shoulders, hips, and knees are in a straight line. Hold about 6 seconds, and then slowly lower hips to the floor and rest for 10 seconds. Repeat 8 to 12 times. Avoid arching your lower back as your hips move upward. Avoid overarching by tightening your abdominal muscles prior and throughout the lift.
<>It is very common for your hamstring muscles, which are found on the back of your legs, to be very tight when you experience lower back pain. For this reason it is recommended to stretch them out. You can see a great stretch for the hamstrings below. To carry out this exercise, lie on your back with both feet on the floor and knees raised up. Loop a towel under the ball of one foot. Straighten your knee and slowly pull back on the towel. You should feel a gentle stretch down the back of your leg, try not to overdo it. Hold for 20 to 30 seconds. Repeat two times for each leg.
<>Hyperlordosis (lordotic low back pain) is the second most common cause of adolescent low back pain.18,47 This condition is related to adolescent growth spurts when the axial skeleton grows faster than the surrounding soft tissue, resulting in muscular pain.55 Other causes of low back pain unique to children are vertebral endplate fractures and bacterial infection of the vertebral disk. Adolescents have weaker cartilage in the endplate of the outer annulus fibrosis, allowing avulsion and resulting in symptoms similar to a herniated vertebral disk.58 Additionally, the pediatric lumbar spine has blood vessels that traverse the vertebral bodies and supply the vertebral disk, increasing the chance of developing diskitis.51
<>To prevent back pain, you need to work on strength and flexibility through the entire kinetic chain. Your spine and spinal muscles get lots of support from your core. In addition, tightness or weakness in your glutes, hips, quads, and hamstrings will impact the muscles in your lower back, putting more strain on those muscles and setting them up for a spasm.
<>I found the [Consumer Reports] articles on back pain very disappointing. I hope I can still trust Consumer Reports when shopping for a washing machine, but I have no confidence that I can trust them when looking for an effective medical treatment. They seem not to understand the difference between anecdotes and data, between a popularity contest and a controlled scientific study. These articles may do harm by encouraging readers to try treatments that don’t work and by suggesting that it is reasonable to prioritize testimonial evidence over scientific studies. On the other hand, these articles may do some good insofar as they may dissuade some patients from rushing to a doctor and demanding imaging studies or prescription drugs.
<>Some people may need prescription-strength NSAIDs or opioid medications to help with pain. It is important to talk to your doctor or pharmacist if you are taking any other medications -- including over-the-counter medicines -- to avoid overdosing on certain active ingredients. Your doctor may also prescribe muscle relaxants to help ease painful muscle spasms.

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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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