<>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.
<>Spinal manipulation: Osteopathic or chiropractic manipulation appears to be beneficial in people during the first month of symptoms. Studies on this topic have produced conflicting results. The use of manipulation for people with chronic back pain has been studied as well, also with conflicting results. The effectiveness of this treatment remains unknown. Manipulation has not been found to benefit people with nerve root problems.
<>Most acute low back pain fades steadily — up to 90% of it, for uncomplicated cases.14 So does a lot of so-called “chronic” low back pain!15 But when you don’t recover, many of the therapeutic options — things like surgery for a herniated disc — cause anxiety that is unnecessary and harmful. The purpose of this tutorial is to review and expand the options.
<>“For most people, it means their back hurts,” says Richard A. Deyo, MD, MPH,the Kaiser-Permanente Endowed Professor of Evidence-Based Medicine in the department of family medicine at Oregon Health & Science University in Portland. “But it’s often impossible to know the precise anatomical cause of back pain because the back has so many sources of pain.”
<>Also referred to as "hypnosis," hypnotherapy is a mind-body technique that involves entering a trance-like state of deep relaxation and concentration. When undergoing hypnotherapy, patients are thought to be more open to suggestion. As such, hypnotherapy is often used to effect change in behaviors thought to contribute to health problems (including chronic 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
<>Back pain can have many underlying reasons, but often no specific cause will be found and the pain will stop. This chapter will review many of the causes of back pain and proper evaluation and diagnosis. Please be sure to discuss your individual symptoms as well as the suggested treatments with your health-care professional to determine the appropriate diagnostic and treatment plan for your circumstances.
<>The information on this website has not been evaluated by the Food & Drug Administration or any other medical body. We do not aim to diagnose, treat, cure or prevent any illness or disease. Information is shared for educational purposes only. You must consult your doctor before acting on any content on this website, especially if you are pregnant, nursing, taking medication or have a medical condition.
<>Use this movement to stretch the paraspinal muscles and strengthen the abdominal muscles. Lie on your back with your legs extended straight out. Bend the right knee up and cross it over the left side of your body. Hold in a position that allows you to feel a gentle stretch through the back and buttocks muscles for 20 seconds. Tighten your core muscles and rotate back to center. Repeat three times on each side.
<>Patient Education. Patient education involves a discussion of the often benign nature of acute back pain and reassurance that most patients need little intervention for significant improvement. Patients should be advised to stay as active as possible, within pain limits; to avoid twisting and bending, particularly when lifting; and to return to normal activities as soon as possible. The goal is to reduce worry about back pain and to teach ways to avoid worsening of pain or pain recurrence.
<>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.
<>Research suggests that topical medications may be just as effective as oral ones. Many of them worked significantly better than placebo. These medications can come in the form of gels, creams, patches, and more. One study also saw decrease in pain when people applied lavender essential oil or ointments prepared with cayenne peppers with acupressure.
<>Research suggests that topical medications may be just as effective as oral ones. Many of them worked significantly better than placebo. These medications can come in the form of gels, creams, patches, and more. One study also saw decrease in pain when people applied lavender essential oil or ointments prepared with cayenne peppers with acupressure.
<>Shingles (herpes zoster) is an acute infection of the nerves that supply sensation to the skin, generally at one or several spinal levels and on one side of the body (right or left). Patients with shingles usually have had chickenpox earlier in life. The herpes virus that causes chickenpox is believed to exist in a dormant state within the spinal nerve roots long after the chickenpox resolves. In people with shingles, this virus reactivates to cause infection along the sensory nerve, leading to nerve pain and usually an outbreak of shingles (tiny blisters on the same side of the body and at the same nerve level). The back pain in patients with shingles of the lumbar area can precede the skin rash by days. Successive crops of tiny blisters can appear for several days and clear with crusty inflammation in one to two weeks. Patients occasionally are left with a more chronic nerve pain (postherpetic neuralgia). Treatment can involve symptomatic relief with lotions, such as calamine, or medications, such as acyclovir (Zovirax), for the infection and pregabalin (Lyrica) or lidocaine (Lidoderm) patches for the pain.
<>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.
<>Surgery for nonspecific back pain is a last resort as spinal problems are unlikely to be the cause of chronic non-specific back pain in the absence of loss of movement and sensation or other findings such as loss of muscle bulk and reflexes. In cases where the pain spreads into the extremities and imaging studies reveal compression or damage to nerve tissue in the spine, surgery remains a consideration if loss of function as well as pain continues after a trial of conservative treatment with medications and activity modification including a home exercise program and physical therapy.
<>To improve your workstation, position your computer monitor at eye level, at least 20 inches away from your face. Invest in a comfortable chair with armrests and good lower back support. Keep your head and neck in line with your torso, your shoulders relaxed. While you work, keep elbows close to your body, and your forearms and wrists parallel to the floor.
<>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
<>Spinal disc degeneration coupled with disease in joints of the low back can lead to spinal-canal narrowing (spinal stenosis). These changes in the disc and the joints produce symptoms and can be seen on an X-ray. A person with spinal stenosis may have pain radiating down both lower extremities while standing for a long time or walking even short distances.
<>2013 — New section: An overdue upgrade! This way pain and fear power each other is now explained much more clearly and thoroughly than before. It’s noteworthy that, with this update, Dr. Lorimer Moseley’s valuable perspective on back pain is now fairly well-represented in this book. [Section: Pain and fear, together at last: an even simpler vicious cycle.]
<>Exercise therapy appears to be slightly effective at decreasing pain and improving function in adults with chronic low back pain.30 In subacute low back pain, there is weak evidence that a graded activity program improves absenteeism.30 In acute low back pain, exercise therapy was no better than no treatment or conservative treatments. Exercise therapy using individualized regimens, supervision, stretching, and strengthening was associated with the best outcomes. The addition of exercise to other noninvasive therapies was associated with small improvements in pain and function.
<>Pregnancy symptoms can vary from woman to woman, and not all women experience the same symptoms. When women do experience pregnancy symptoms they may include symptoms include missed menstrual period, mood changes, headaches, lower back pain, fatigue, nausea, breast tenderness, and heartburn. Signs and symptoms in late pregnancy include leg swelling and shortness of breath. Options for relief of pregnancy symptoms include exercise, diet, and other lifestyle changes.
<>In both younger and older patients, vertebral fractures take weeks to heal with rest and pain relievers. Compression fractures of vertebrae associated with osteoporosis can also be treated with a procedure called vertebroplasty or kyphoplasty, which can help to reduce pain. In this procedure, a balloon is inflated in the compressed vertebra, often returning some of its lost height. Subsequently, a "cement" (methymethacrylate) is injected into the balloon and remains to retain the structure and height of the body of the vertebra. Pain is relieved as the height of the collapsed vertebra is restored.
<>Piriformis Muscle Stretch. Lie on the back with knees bent and both heels on the floor. Cross one leg over the other, resting the ankle on the bent knee, then gently pull the bottom knee toward the chest until a stretch is felt in the buttock. Or, lying on the floor, cross one leg over the other and pull it forward over the body at the knee, keeping the other leg flat.
<>I love what you do, I read your site often, and I recommend it to friends. I bought the boxed set because I read the studies you linked to, because I decided since my back hurts and so does everyone else’s in my family, I want it all. Plus my best friend has wicked iliotibial band syndrome, so I figured I’d pass along that info to him. Anyways, dude, you rock socks off, keep on fighting the woo woo, you’ve made a reader for life! Thanks more than you know.
<>This final stretch is great at stretching out your spine and it feels good to do, too. Lie on your back and place a small cushion under your head. Keep your knees bent and together. Keep your upper body relaxed and your chin gently tucked in. Take a big deep breath in and as you breathe out roll your knees to one side, followed by your pelvis, keeping both shoulders on the floor. Take a big deep breathe in as you return to the starting position. Repeat six to eight times, alternating sides.
<>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.
<>Despite the high prevalence of low back pain and the significant burden to the athletes, there are few clearly superior treatment modalities. Superficial heat and spinal manipulation therapy are the most strongly supported evidence-based therapies. Nonsteroidal anti-inflammatory medications and skeletal muscle relaxants have benefit in the initial management of low back pain; however, both have considerable side effects that must be considered. Athletes can return to play once they have recovered full range of motion and have the strength to prevent further injury.
<>It’s estimated that up to 80 percent of adults experience persistent symptoms of lower back pain at some point in their lives, and about 31 million Americans struggle with the condition at any given time. Given its extremely high prevalence rate — whether due to a weak psoas muscle, sciatic nerve pain or some other cause — it’s not surprising that lower back pain is considered the single leading cause of disability worldwide according to the American Chiropractic Association, with half of all American workers reporting having occasional back troubles each year. (1) Naturally, this leads to millions searching for lower back pain relief.
<>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.
<>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. 
<>A recent double-blind randomized placebo-controlled study of 546 patients with acute low back pain (less than 4 weeks) with radiculopathy compared LLLT and nimesulide to nimesulide alone to sham LLLT. Treatment with LLLT and nimesulide improved movement, with more significant reduction in pain intensity and disability and with improvement in quality of life, compared with patients treated only with drugs or placebo LLLT.38
<>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
<>I was an alternative health professional myself for many years — a Registered Massage Therapist, trained in Canada (which has unusually good training standards). Of course, some of my colleagues in alternative medicine were diligent students of medical science. However, in my experience, most were certainly not — indeed, many lacked even the most basic knowledge of how medical science works or how to keep current about recent discoveries with clinical implications. BACK TO TEXT
<>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.
<>When you first hurt your back, one of the best back pain remedies is to ice the area. Injury to a muscle means that blood will rush to the site, bringing healing chemicals to ease the pain. Unfortunately, this leads to swelling, and that swelling leads to pain. Applying cold compresses constricts the blood vessels, and this reduces the flow of that blood. The reduction in swelling means that you will have less pain, and this is a great way to relieve back pain naturally. Be sure to keep the cold on for 20 minutes and off for 40. Don’t use this method after the first 24 hours. These are 10 surprising reasons your back hurts.
<>Sitting at a desk for eight (or more) hours a day can really do a number on your back. Make sure to sit with your back against your chair (get a lumbar pillow if you chair doesn’t allow this) and both feet flat on the floor. Another option: Try using a stability ball as your desk chair like many Health staffers do—good posture is a must just to stay on the thing. Start off slow (20 minutes at a time), and if it feels good, stick with it.
<>Jackson, M., & Tummon Simmons, L. (2018, April 1). Challenging case in clinical practice: Improvement in chronic osteoarthritis pain with use of arnica oil massage, therapeutic ultrasound, and acupuncture — A case report [Abstract]. Alternative and Complementary Therapies, 24(2), 60–62. Retrieved from https://www.liebertpub.com/doi/abs/10.1089/act.2018.29152.mja?journalCode=act

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