<>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
<>Spines haven’t changed in the last century,21 and yet modern civilization suffers from a great plague of low back pain.2223 Yet the real causes of most back pain are obscured by medical mythology and misunderstanding.24 Before I discuss what does cause most low back pain, it’s important to talk about what does not cause it. In this section, I will challenge the mythology in just a few paragraphs, supported by over thirty references to the best scientific information available — references you can check for yourself. This is quite different than most sources of patient-focused low back pain information, which tend to avoid discussing the evidence.
<>Bed Rest. Bed rest should not be recommended for patients with nonspecific acute low back pain. Moderate-quality evidence suggests that bed rest is less effective at reducing pain and improving function at three to 12 weeks than advice to stay active.46 Prolonged bed rest can also cause adverse effects such as joint stiffness, muscle wasting, loss of bone mineral density, pressure ulcers, and venous thromboembolism.37
<>Opioids are commonly prescribed for patients with severe acute low back pain; however, there is little evidence of benefit. Three studies showed no difference in pain relief or time to return to work between oral opioids and NSAIDs or acetaminophen, and there is risk of harmful dose escalation over time with opioids, especially with purer formulations.16,21 Although epidural steroid injections are not beneficial for isolated acute low back pain, they may be helpful for radicular pain that does not respond to two to six weeks of noninvasive treatment. Transforaminal injections appear to have more favorable short- and long-term benefit than traditional interlaminar injections.22
<>Most experts agree that prolonged bed rest is associated with a longer recovery period. Further, people on bed rest are more likely to develop depression, blood clots in the leg, and decreased muscle tone. Very few experts recommend more than a 48-hour period of decreased activity or bed rest. In other words, get up and get moving to the extent you can.
<>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.
<>Just how does acupuncture work? According to traditional Chinese medicine, pain results from blocked energy along the meridians of the body, which are unblocked when acupuncture needles are inserted along these invisible pathways. Acupuncture may also release natural pain-relieving opioids, send signals to the sympathetic nervous system, and release neurochemicals and hormones.
<>Start on all fours. Lower onto your forearms with shoulders directly over elbows. Step feet back into a plank position. Draw your shoulders down and back—not hunched. Engage abdominal muscles tight to keep hips in line with shoulders so your body forms a long, straight line. Squeeze legs and glutes for support. Hold this position for 45 to 60 seconds. Gradually add time as your core gets stronger. Repeat for 3 to 5 reps.
<>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.
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<>My original inspiration for this tutorial was Dr. John Sarno’s 1984 book Mind over back pain. (His more recent Healing back pain makes too many empty promises. See my review.) However, as much as I respect Dr. Sarno’s early work, there are at least three reasons why this tutorial is better than his books: (1) I make a much more airtight case against the conventional medical myths of back pain than Dr. Sarno does; (2) I also build a much better case for the real causes of back pain, heavily referencing more credible sources than Dr. Sarno does; (3) and I offer many more practical suggestions than Dr. Sarno does, instead of focusing exclusively on the psychological factors. Although I have less experience and education than Dr. Sarno, I do have a lot more hands-on experience (and the useful perspective of a journalist). BACK TO TEXT
<>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.
<>Nerve root syndromes are those that produce symptoms of nerve impingement (a nerve is directly irritated), often due to a herniation (or bulging) of the disc between the lower back bones. Sciatica is an example of nerve root impingement. Impingement pain tends to be sharp, affecting a specific area, and associated with numbness in the area of the leg that the affected nerve supplies.
<>Back pain is one of the most common reasons why people visit a health care provider. The good news is that the pain often goes away on its own, and people usually recover in a week or two. Many people want to stay in bed when their back hurts. For many years, getting bed rest was the normal advice. But current studies recommend no bed rest at all and stress that staying in bed longer than 48 hours not only won’t help but it may, in fact, actually delay your recovery. Here’s why:
<>Bed Rest. Bed rest should not be recommended for patients with nonspecific acute low back pain. Moderate-quality evidence suggests that bed rest is less effective at reducing pain and improving function at three to 12 weeks than advice to stay active.46 Prolonged bed rest can also cause adverse effects such as joint stiffness, muscle wasting, loss of bone mineral density, pressure ulcers, and venous thromboembolism.37
<>Degenerative bone and joint conditions: As we age, the water and protein content of the body's cartilage changes. This change results in weaker, thinner, and more fragile cartilage. Because both the discs and the joints that stack the vertebrae (facet joints) are partly composed of cartilage, these areas are subject to wear and tear over time (degenerative changes). Degeneration of the disc is called spondylosis. Spondylosis can be noted on X-rays of the spine as a narrowing of the normal "disc space" between the vertebrae. It is the deterioration of the disc tissue that predisposes the disc to herniation and localized lumbar pain ("lumbago") in older patients. Degenerative arthritis (osteoarthritis) of the facet joints is also a cause of localized lumbar pain that can be detected with plain X-ray testing. These causes of degenerative back pain are usually treated conservatively with intermittent heat, rest, rehabilitative exercises, and medications to relieve pain, muscle spasm, and inflammation.
<>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.

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These back pain movements really did help me with my chronic back pain.
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