<>Break out that bag of frozen peas (or an ice pack, if you want to get fancy) for the first 48 hours after the pain sets in, and put it to use for 20 minutes a session, several sessions per day. After those two days are behind you, switch to 20-minute intervals with a heating pad. Localized cooling shuts down capillaries and reduces blood flow to the area, which helps ease the swelling, says Lisa DeStefano, an associate professor at Michigan State University College of Osteopathic Medicine in East Lansing. Cold also thwarts your nerves' ability to conduct pain signals. Heat, on the other hand, loosens tight muscles and increases circulation, bringing extra oxygen to the rescue.
<>Infection of the discs (septic discitis) and bone (osteomyelitis) is extremely rare. These conditions lead to localized pain associated with fever. The bacteria found when these tissues are tested with laboratory cultures include Staphylococcus aureus and Mycobacterium tuberculosis (TB bacteria). TB infection in the spine is called Pott's disease. These are each very serious conditions requiring long courses of antibiotics. The sacroiliac joints rarely become infected with bacteria. Brucellosis is a bacterial infection that can involve the sacroiliac joints and is usually transmitted in raw goat's milk.
<>"Having excess weight pulling on your back all day (except when you're lying down) is just bad news for your back," says Lauri Grossman, DT, a licensed chiropractor in private practice in New York City. "Often times, when people who wrestle with back pain for a lifetime lose a few pounds, they find that the pain that they've taken a million medications for and a million vitamins for just goes away." If you're having trouble shedding extra pounds, consider consulting with a registered dietitian or personal trainer.
<>Avoiding injury to the low back is a method of preventing low back pain. Additionally, conditioning exercise programs designed to strengthen the lumbar area and adjacent tissues can help to minimize risk of injury to the low back. Specific programs to relieve and prevent back pain can be designed with the help of physical therapists and other treating health-care professionals.
<>Limited bed rest. Once the mainstay of treatment for back pain, bed rest has fallen out of favor. Doctors now know it's better to keep moving, so that your muscles don't become stiff. Bed rest can still be useful relief from low back pain, particularly if your pain is so severe that it hurts to sit or stand. But try to limit it to a few hours at a time and for no more than one or two days.
<>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
<>Low back pain is one of the most common complaints on the planet. And you may wonder where to turn when you start experiencing some of those aches or twinges in the lower part of your back. Take heart. "In most cases, you won't need a specialist," says Dr. Robert Shmerling, a rheumatologist at Harvard-affiliated Beth Israel Deaconess Medical Center.
<>Nerve blocks, epidural steroid injections, nerve ablations and other types of injection-based procedures are available for chronic back pain. They are used when the source of the pain is known and can sometimes help rule out certain causes if the treatment doesn’t work. Injections may stop or lessen pain for a certain period of time, but are not intended as long-term solutions and shouldn’t be used in isolation.
<>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.
<>High-quality evidence shows that individual patient education of greater than two hours is more effective than no education or less-intense education for pain that persists for four weeks or more.23 Moderate-quality evidence shows that less-intense individual education and advice to stay active have small benefits and are at least as effective as other back pain interventions.23,24 It is unclear whether patient education and advice for patients with acute low back pain are cost-effective.25
<>Physical activity. Exercise helps build strong, flexible muscles that will be less prone to injury. It can also help the healing process for an aching back, prevent problems in the future, and improve function. Work with your doctor to develop an exercise program, or seek a referral to another health professional who can. A good program typically includes the three major forms of exercise: aerobic activity, strength training, and flexibility exercises.
<>Nachemson says, “Rarely are diagnoses scientifically valid … .” And Deyo: “There are wide variations in care, a fact that suggests there is professional uncertainty about the optimal approach.” Many other researchers have made this point, but Sarno states it most eloquently: “There is probably no other medical condition which is treated in so many different ways and by such a variety of practitioners as back pain. Though the conclusion may be uncomfortable, the medical community must bear the responsibility for this, for it has been distressingly narrow in its approach to the problem. It has been trapped by a diagnostic bias of ancient vintage and, most uncharacteristically, has uncritically accepted an unproven concept, that structural abnormalities are the cause of back pain” (p111). BACK TO TEXT
<>CBT: If you consult a psychotherapist for cognitive behavioral therapy (CBT), your treatment may include stress management, behavioral adaptation, education, and relaxation techniques. CBT can lessen the intensity of back pain, change perceptions about levels of pain and disability, and even lift depression. The NIH considers CBT useful for relieving low back pain, citing studies that show CBT to be superior to routine care and placebo.
<>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
<>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
<>When we stand, the lower back is functioning to support the weight of the upper body. When we bend, extend, or rotate at the waist, the lower back is involved in the movement. Therefore, injury to the structures important for weight bearing, such as the bony spine, muscles, tendons, and ligaments, often can be detected when the body is standing erect or used in various movements.
<>Because back pain can be so debilitating, a lot of people turn to more serious interventions, like surgery or painkillers — but turns out, all you really need is a good stretch. “Most back pain can be resolved by doing regular exercises to keep muscles that support your spine strong and flexible,” says Fei Jiang, PT, DPT, OCS, at Providence Saint John’s Health Center’s Performance Therapy in Santa Monica, California. In fact, a recent study on back pain found that participants who followed a 12-week stretching regimen reported better back functioning, less pain, and a reduced need for pain medication.[1]
<>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.
<>Meditation has been proven to reduce chronic pain in several scientific studies. Research from Duke University found that people suffering from chronic back pain saw significant reductions in pain and psychological distress after practicing a form of meditation that focuses on releasing anger. In another study, meditators experienced a 40% reduction in pain intensity.
<>As part of your exercise routine, you may want to consider doing yoga regularly for lower back pain relief. One study of over 960 people with low back pain found that those who completed a 12-week yoga program experienced greater improvements in back function and reduced pain compared to controls who did not participate. (4) There’s even evidence that mindfulness meditation, often practiced in some form with yoga, can also help people deal with chronic back pain more effectively. (5)
<>Looking for a way to adjust your desk chair without buying a new one? Nikki Walter, a personal trainer in North Dakota, recommended a washable orthopedic seat cushion. “Since it’s made of gel memory foam, you can squish it into a bag, take it with you, and pull it out when you need it," Walter said. "Watch it bounce back to life and relieve your stress in seconds!”
<>Long-term bed rest is not only no longer considered necessary for most cases of back pain, it is actually potentially harmful, making recovery slower and potentially causing new problems. In most cases, you will be expected to start normal, nonstrenuous activity (such as walking) within 24 to 72 hours. After that ask your doctor about controlled exercise or physical therapy. Physical therapy treatments may employ massage, ultrasound, whirlpool baths, controlled application of heat, and individually tailored exercise programs to help you regain full use of the back. Strengthening both the abdominal and back muscles helps stabilize the spine. You can help prevent further back injury by learning - and doing - gentle stretching exercises and proper lifting techniques, and maintaining good posture.
<>Use capsaicin cream. Capsaicin is a substance found in chili peppers. When used medicinally it helps reduces the amount of substance P, a neurotransmitter that leads to pain impulses in the brain. One study showed that after 3 weeks of capsaicin use, patients had a significant reduction in pain. To use: apply topically, at least twice per day, for maximum relief. The warm sensation also allows you to stretch and move without pain.
<>Most of us spend a good part of our day sitting down, which may be more harmful than you realize. You can minimize the impact by maintaining good posture. Correct posture in a chair means having all the bones in your spine lined up neatly, like a stack of perfectly aligned blocks. You should keep your feet flat on the floor and your computer keyboard within easy reach so you’re not leaning forward or slumping. This is part of proper office ergonomics.
<>When the first 24 hours are over, you can turn to heat to cure back pain fast at home. Heat helps to ease the strained muscle and reduce tension. It can help to increase range of motion and reduce pain. In this case, you want to bring the healing blood to the site, and heat will do that, dilating the blood vessels and encouraging blood flow. Don’t let the heating pad get too hot and don’t use it for more than an hour or so at a time. The heat can hurt your skin, leading to more problems. Here’s how heat therapy works to make you feel better.
<>As with any sort of pain, it's crucial to figure out the source so you can properly treat it. Sharp or stabbing pain that extends beyond your low back or is accompanied by symptoms like abdominal pain, nausea, and vomiting, could be signs of various other conditions and definitely warrant a trip to the doctor. If you have a history of lower back injuries or disc problems, always see your doctor before trying any new exercise.
<>In addition to strengthening the core muscles, it's also important to address any mobility problems, says Jacque Crockford, M.S., C.S.C.S., exercise physiology content manager at American Council on Exercise, which can sometimes be what's causing pain. If specific movements like twisting or bending or extending your spine feel uncomfortable, there may be mobility (flexibility) issues at play. Doing some gentle stretching (like these yoga poses) might help. (If it gets worse with those stretches, stop and see a doctor.)
<>Paget's disease of the bone is a condition of unknown cause in which the bone formation is out of synchrony with normal bone remodeling. This condition results in abnormally weakened bone and deformity and can cause localized bone pain, though it often causes no symptoms. Paget's disease is more common in people over the age of 50. Heredity (genetic background) and certain unusual virus infections have been suggested as causes. Thickening of involved bony areas of the lumbar spine can cause the radiating lower extremity pain of sciatica.
<>Three small higher quality trials found that systemic corticosteroids were not clinically beneficial compared with placebo when given parenterally or as a short oral taper for acute or chronic sciatica.21,28,49 With acute low back pain and a negative straight-leg raise test, no difference in pain relief through 1 month was found between a single intramuscular injection of methylprednisolone (160 mg) or placebo.23 Glucocorticosteroids are banned by the World Anti-doping Association.70
<>Subacute low back pain. Lasting between 6 weeks and 3 months, this type of pain is usually mechanical in nature (such as a muscle strain or joint pain) but is prolonged. At this point, a medical workup may be considered, and is advisable if the pain is severe and limits one’s ability to participate in activities of daily living, sleeping, and working.
<>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
<>Exercise is the foundation of chronic back pain treatment. It’s one of the first treatments you should try under the guidance of your physician and spine physical therapist. However, the same set of exercises doesn’t work for everyone, says Nava. The exercises have to be tailored to your specific symptoms and condition. Maintaining the exercise routine at home is also a big part of success.
<>Perhaps you bent the wrong way while lifting something heavy. Or you're dealing with a degenerative condition like arthritis. Whatever the cause, once you have low back pain, it can be hard to shake. About one in four Americans say they've had a recent bout of low back pain. And almost everyone can expect to experience back pain at some point in their lives.
<>Physical therapists often recommend aquatic therapy — including exercises done in warm, therapeutic pools — for back pain. The buoyancy of the water helps alleviate strain on the joints to encourage strengthening and gentle stretching of the muscles. Even floating in warm water can help relax muscles and release tension as well as increase circulation, according to the Arthritis Foundation. With home whirlpool baths, try aiming the jets directly at your sore spots for a soothing underwater massage.
<>Music therapy is a low-cost natural therapy that may reduce some of the stress of chronic pain in conjunction with other treatments. Studies find that it may reduce the disability, anxiety, and depression associated with chronic pain. It is thought to help because it can shift attention away from the unpleasant sensations of pain, and it may cause the release of endorphins or changes in catecholamine levels.

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