<>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.
<>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
<>This traditional treatment scores well in research for its pain-relieving properties—and you can add lower back pain relief to the list. In a review published in the journal Evidence-based Complementary and Alternative Medicine, researchers concluded that for chronic low back pain, acupuncture alone or in conjunction with other treatments could provide short-term improvements in pain and function compared to no treatment at all.
<>You probably don't know it, but you and Paula Abdul have more in common than you think! You are both part of the 65 million Americans affected by back pain. The good news is 95 percent of cases involving back pain do not require surgical treatment. As we age, lower back pain becomes increasingly more and more common. Not to mention, muscle elasticity and bone strength decrease over time, leaving your back vulnerable to strain and injury.
<>Dr. Jerome Groopman has written brilliantly about back pain, from personal experience. In How Doctors Think he puts back pain in the context of how medical thinking is influenced by marketing and money, giving us a somewhat chilling insiders’ view of the surgical treatment of back pain. In The Anatomy of Hope, he tells his own story of super severe back pain. It has a happy ending! Both books are also otherwise worthwhile. “Marketing, Money, and Medical Decisions,” a chapter in the book How doctors think, by Jerome Groopman. Groopman, writing from personal experience with chronic back pain and a spinal fusion surgery, discusses back pain as intelligently as any medical expert I’ve come across, but he does so in a way that will fascinate patients. In this chapter, his discussion of back pain is placed in the context of how medical thinking is influenced by marketing and money, giving us a somewhat chilling insiders’ view of the surgical treatment of back pain.
<>Kneeling Lunge Stretch. Starting on both knees, move one leg forward so the foot is flat on the ground, keeping weight evenly distributed through both hips (rather than on one side or the other). Place both hands on the top of the thigh, and gently lean the body forward to feel a stretch in the front of the other leg. This stretch affects the hip flexor muscles, which attach to the pelvis and can impact posture if too tight.
<>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
<>2009 — New section: Today I found a way to say some simple things about the power of self-treatment that have been “on the tip of my tongue” for years now. It all evolved from writing about an important bit of research, showing that manual therapists cannot (reliably) diagnose trigger points. [Section: Limitations of trigger point therapy, and how to take advantage of them.]
<>Magnetic resonance imaging (MRI) scans are a highly detailed test and are very expensive. The test does not use X-rays but very strong magnets to produce images. Their routine use is discouraged in acute back pain unless a condition is present that may require immediate surgery, such as with cauda equina syndrome or when red flags are present and suggest infection of the spinal canal, bone infection, tumor, or fracture.
<>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.
<>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.
<>A very important muscle to strengthen is the transverse abdominis, which provides a great deal of support for the lower back. In many people this muscle is extremely weak and this can lead to lower back pain. A very gentle and safe way to strengthen this muscle is shown below. To carry out this exercise lie on your back, place a small cushion under your head, and bend your knees. Your feet should be hip distance apart and placed on the floor. Keep your upper body relaxed and your chin gently tucked in. Take a deep breath in, and as you breathe out focus on drawing your belly button in towards your spine. Hold this gentle contraction for 5 to 10 seconds. As you breathe out relax your tummy muscles. This is a slow, gentle tightening so aim to use less than 25% of your maximum strength. Repeat five times.
<>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.
<>That’s a huge topic, but here’s one simple example of an extremely common problem with back pain science: control groups that don’t control. Rather than comparing a treatment to a good, carefully selected placebo, most studies use a comparison to a treatment that is allegedly neutral, underwhelming, or placebo-ish. That makes the results hard to interpret: if each works about the same, it could mean that the treatments are equally effective … or equally ineffective! So much back pain science has this problem — or any one of a dozen other weak points — that you can effectively ignore at least 80% of all back pain research, because it’s so far from the last word on anything. Good science is essential to solving these problems, but really good studies are also difficult to design and rare. BACK TO TEXT
<>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.
<>A rub down can deliver real lower back pain relief. In a 2017 study, more than half of participants told researchers that a series of massage therapy sessions eased their backache. “The study can give primary care providers the confidence to tell patients with chronic low back pain to try massage if the patients can afford to do so,” co-author of the study Niki Munk, PhD, said in a press release. Here are 10 more things you should do if you wake up with back pain.
<>That being said, the best medicine for dealing with back pain is (drum roll please)…. EXERCISE! And before you jump to the conclusion that the fitness professional is turning to exercise yet again, there are just a few other professionals who would agree, namely Harvard Medical School, The American Academy of Orthopedic Surgeons and the Mayo Clinic. All three organizations list exercise as their number one solution for low back pain prevention. In addition, the American Council on Exercise recommends specific dos and don'ts for exercising with low back pain. Yes, the recommendations for exercise seem to be overwhelming when it comes to dealing with back pain. However, the type of exercise you perform is going to make a difference and when it comes to exercising to relieve back pain there are two important goals:
<>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.
<>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.
<>Physical therapists can teach you how to sit, stand, and move in a way that keeps your spine in proper alignment and alleviates strain on your back. They also can teach you specialized exercises that strengthen the core muscles that support your back. A strong core is one of the best ways to prevent more back pain in the future. Studies show that when you increase your strength, flexibility, and endurance, back pain decreases -- but it takes time.

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