<>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.
<>It may sound funny to massage your own back, but it is easy to have someone massage your back for you. In fact, having a loved one or friend use Ben Gay to massage the cream into your back is a great way to naturally help your back pain. Don’t massage directly over the spine, as this can cause harm to that delicate collection of anatomical structures. Long, smooth strokes over the entirety of the back are the best. These are called gliding movements, and they help to relax the muscles under the skin. Work the muscles up and down the back to either side of the spine, allowing the hands to glide over the problem area and work the cream into the muscle to provide maximum, natural healing. Next, find out the 15 everyday habits that are causing back pain and damaging your spine. 
<>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.
<>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
<>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.
<>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.
<>I’m writing to congratulate and thank you for your impressive ongoing review of musculoskeletal research. I teach a course, Medicine in Society, at St. Leonards Hospital in Hoxton. I originally stumbled across your website whilst looking for information about pain for my medical students, and have recommended your tutorials to them. Your work deserves special mention for its transparency, evidence base, clear presentation, educational content, regular documented updates, and lack of any commercial promotional material.
<>The discs are pads that serve as "cushions" between the individual vertebral bodies. They help to minimize the impact of stress forces on the spinal column. Each disc is designed like a jelly donut with a central, softer component (nucleus pulposus) and a surrounding, firm outer ring (annulus fibrosus). The central portion of the disc is capable of rupturing (herniating as in a herniated disc) through the outer ring, causing irritation of adjacent nervous tissue and sciatica as described below. Ligaments are strong fibrous soft tissues that firmly attach bones to bones. Ligaments attach each of the vertebrae to each other and surround each of the discs.
<>Doctors, pharmacists, and other health-care professionals use abbreviations, acronyms, and other terminology for instructions and information in regard to a patient's health condition, prescription drugs they are to take, or medical procedures that have been ordered. There is no approved this list of common medical abbreviations, acronyms, and terminology used by doctors and other health- care professionals. You can use this list of medical abbreviations and acronyms written by our doctors the next time you can't understand what is on your prescription package, blood test results, or medical procedure orders. Examples include:
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<>A 2008 study published in the journal Spine found "strong evidence that acupuncture can be a useful supplement to other forms of conventional therapy" for low back pain. After analyzing 23 clinical trials with a total of 6,359 patients, the study authors also found "moderate evidence that acupuncture is more effective than no treatment" in relief of back pain.
<>Pain from spine structures, such as musculature, ligaments, facet joints, and disks, can refer to the thigh region, but rarely to areas below the knee. Pain related to the sacroiliac joint often refers to the thigh, but can also radiate below the knee. Irritation, impingement, or compression of the lumbar root often results in more leg pain than back pain. Pain from the L1-L3 nerve roots will radiate to the hip and/or thigh, whereas pain from the L4-S1 nerve roots will radiate below the knee.
<>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.
<>“Opioid medications generally shouldn’t be used as the first, the only or the long-term line of treatment for chronic back pain,” recommends Nava. Many of them are addictive and don’t address the underlying cause of your pain. Opioids should be prescribed only after a thorough exam by a specialist and if other drugs have failed to provide relief. If you find yourself relying on opioids to get through the day, it may be time to seek a second opinion.
<>A physiatrist or interventional pain management doctor may help you avoid more invasive treatments. “These can include medications delivered to the spine such as epidural steroid injections to reduce inflammation, or radiofrequency nerve ablations to reduce transmission of neck or back pain,” explains Koser. The expert you meet with will go over all of the options available to you.
<>Physical Therapy. Physical therapists often recommend the McKenzie method or spine stabilization exercises for the treatment of low back pain. The McKenzie method is described at http://www.mckenziemdt.org/approach.cfm, and a video demonstration is available at http://www.youtube.com/watch?v=wBOp-ugJbTQ. The McKenzie method has been shown to be slightly more effective than other common low back pain treatments; however, the difference is not clinically significant,26,27 and evidence on its effect on disability is conflicting.26,27 There also do not appear to be good long-term benefits with the McKenzie method, other than decreased need for health care services.27 Spine stabilization exercises have been shown to decrease pain, disability, and risk of recurrence after a first episode of back pain.28
<>A physiatrist or interventional pain management doctor may help you avoid more invasive treatments. “These can include medications delivered to the spine such as epidural steroid injections to reduce inflammation, or radiofrequency nerve ablations to reduce transmission of neck or back pain,” explains Koser. The expert you meet with will go over all of the options available to you.
<>Low-impact aerobics. Low-impact aerobic exercise increases the flow of blood and supports healing from an injury without jarring the spine. Low-impact aerobics can include using stationary bikes, elliptical or step machines, walking, and water therapy. People with low back pain who regularly do aerobic exercise report fewer recurring pain episodes and are more likely to stay active and functional when pain flares.
<>Acupuncture: Both the American Pain Society and the American College of Physicians released guidelines stating that acupuncture may help patients with chronic low-back pain when other treatments have failed. It can be used alone or as part of a comprehensive treatment plan that includes medications and other therapies. However, there is not enough evidence yet to recommend it for acute back pain.
<>The good news regarding back pain is this: Most cases of lower back pain are believed to be due to “mechanical” problems of the musculoskeletal system rather than serious illness or chronic health problems. Abnormalities, weakness, and added stress placed on the bones, joints, ligaments and muscles can all contribute to back problems. It’s been found that the most common causes of low back pain (there are many!) include: (8)
<>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.
<>The Pelvic Tilt is another great exercise for mobilising your lower back muscles. As shown below, lie on your back and place a small cushion under your head. Bend your knees and keep your feet hip-width apart and placed on the floor. Keep your upper body relaxed and your chin gently tucked-in. Gently flatten your lower back into the floor and contract your stomach muscles. Now tilt your pelvis towards your heels until you feel a gentle arch in your lower back, feeling your back muscles contracting and return to the starting position. Place one hand on your stomach and the other under your lower back to feel the correct muscles working. Repeat eight to twelve times, tilting your pelvis back and forth in a slow rocking motion.
<>Achy back? You're not alone: back problems send more Americans to the doctor annually than nearly any other medical problem, according to a 2013 Mayo Clinic study. Whether you're recovering from misjudging a heavy load (we've all been there), dealing with a lingering injury, or have a chronic problem, you don't necessarily need to resort to popping tons of pain relievers. Talk to your doc about these 15 expert-approved natural back pain remedies, and find out if they are safe and appropriate for you.
<>There are no systemic reviews for ultrasound.10 One small nonrandomized trial48 for patients with acute sciatica found ultrasonography superior to sham ultrasonography or analgesics for relief of pain. All patients were prescribed bed rest. For patients with chronic back pain, the small trials were contradictory to whether ultrasonography was any better than sham ultrasonography.2,52
<>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.
<>Injections. If other measures don't relieve your pain, and if your pain radiates down your leg, your doctor may inject cortisone — an anti-inflammatory medication — or numbing medication into the space around your spinal cord (epidural space). A cortisone injection helps decrease inflammation around the nerve roots, but the pain relief usually lasts less than a few months.
<>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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These back pain movements really did help me with my chronic back pain.
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