<>A great exercise for the lower tummy muscles is shown in the image below. It is extremely gentle and also very effective. Lie on your back with knees bent and feet flat on the floor. Breathe in and as you breathe out bring one knee in towards your chest and as you breathe in return the foot to the floor. Repeat this exercise six to eight times on each leg.
<>Try taking one 250-milligram capsule of valerian four times a day. Some scientists claim that this herb’s active ingredient interacts with receptors in the brain to cause a sedating effect. Although sedatives are not generally recommended, valerian is much milder than any pharmaceutical product. (Valerian can also be made into a tea, but the smell is so strong-resembling overused gym socks-that capsules are vastly preferable.)
<>Thirty-five randomized controlled trials did not allow firm conclusions for the effectiveness of acupuncture for acute low back pain.25 For chronic low back pain, acupuncture is more effective for pain relief and functional improvement than no treatment or sham treatment in the short term only. Acupuncture is not more effective than other conventional or alternative treatments.25
<>I found the [Consumer Reports] articles on back pain very disappointing. I hope I can still trust Consumer Reports when shopping for a washing machine, but I have no confidence that I can trust them when looking for an effective medical treatment. They seem not to understand the difference between anecdotes and data, between a popularity contest and a controlled scientific study. These articles may do harm by encouraging readers to try treatments that don’t work and by suggesting that it is reasonable to prioritize testimonial evidence over scientific studies. On the other hand, these articles may do some good insofar as they may dissuade some patients from rushing to a doctor and demanding imaging studies or prescription drugs.
<>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.
<>Nonsteroidal anti-inflammatory medications (NSAIDs) are the mainstay of medical treatment for the relief of back pain. Ibuprofen, naproxen, ketoprofen, and many others are available. No particular NSAID has been shown to be more effective for the control of pain than another. However, your doctor may switch you from one NSAID to another to find one that works best for you.
<>Since you shouldn't try to diagnose your own back pain, make your first call to a professional who can assess your problem, such as a primary care physician or a chiropractor. "Both can serve as the entry point for back pain," says Dr. Matthew Kowalski, a chiropractor with the Osher Clinical Center for Integrative Medicine at Harvard-affiliated Brigham and Women's Hospital. "And 35% to 42% of people with their first episode of back pain will consult a chiropractor."
<>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
<>Leg lifts are sometimes suggested as an exercise to "strengthen your core" or abdominal muscles. Exercising to restore strength to your lower back can be very helpful in relieving pain yet  lifting both legs together while lying on your back is very demanding on your core.  If weak, this exercise can make back pain worse. Instead, try lying on your back with one leg straight and the other leg bent at the knee. Keeping your lower back flat on floor. Slowly lift the straight  leg up about 6 inches and hold briefly. Lower leg slowly. Repeat 10 times, then switch legs.
<>An accurate history and physical examination are essential for evaluating acute low back pain. Often, patients awaken with morning pain or develop pain after minor forward bending, twisting, or lifting. It is also important to note whether it is a first episode or a recurrent episode. Recurrent episodes usually are more painful with increased symptoms. Red flags are often used to distinguish a common, benign episode from a more significant problem that requires urgent workup and treatment (Table 2).5,6,8 A recent study shows that some red flags are more important than others, and that red flags overall are poor at ruling in more serious causes of low back pain.8 Patients with back pain in the primary care setting (80 percent) tend to have one or more red flags, but rarely have a serious condition.8  However, physicians should be aware of the signs and symptoms of cauda equina syndrome, major intra-abdominal pathology, infections, malignancy, and fractures (Tables 15,6  and 25,6,8). Cauda equina syndrome and infections require immediate referral. Family physicians should rely on a comprehensive clinical approach rather than solely on a checklist of red flags.
<>Whether it was brought on by arthritis, a structural or nerve problem, bending the wrong way, or lifting something a little too heavy, low back pain is frustrating as all get-out. But if you're struggling, know this: You're definitely not alone. Most people experience back pain at some point in their lives, and it's one of the most common reasons people book doctor's appointments and call out of work. It's also one of the leading causes of disability worldwide.
<>Epidural steroid injections. This injection involves a steroid administered directly into the outer part of the dural sac, which surrounds the spinal cord. A live x-ray, called fluoroscopy, is used to guide the needle to the correct area. The goal of the injection is to temporarily relieve pain by reducing inflammation around a compressed nerve root.
<>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
<>Testimonials on health care websites reek of quackery, so publishing them has always made me a bit queasy. But my testimonials are mostly about the quality of the information I’m selling, and I hope that makes all the difference. So here’s some highlights from the kind words I’ve received over the years … plus some of the common criticisms I receive, at the end. These are all genuine testimonials, mostly received by email. In many cases I withold or change names and identifying details.
<>I am a science writer and a former Registered Massage Therapist with a decade of experience treating tough pain cases. I was the Assistant Editor of ScienceBasedMedicine.org for several years. I’ve written hundreds of articles and several books, and I’m known for readable but heavily referenced analysis, with a touch of sass. I am a runner and ultimate player. • more about me • more about PainScience.com
<>Evidence from the small number of placebo-controlled trials does not support the use of transcutaneous electrical nerve stimulation in the routine management of chronic low back pain.36 Evidence from single lower quality trials is insufficient to accurately judge efficacy of transcutaneous electrical nerve stimulation versus other interventions for chronic low back pain or acute low back pain.10
<>Massage: There's an upside to your discomfort: It's a legit excuse to get a weekly massage. One study found that people who did had less lower back pain and disability after 10 weeks, compared with the control group—and general relaxation rubdowns worked just as well as structural massage targeted at specific parts of the body. Osteopathic and chiropractic therapies—in which joints and muscles get stretched and repositioned—have been shown to work, too. In a study published in the Annals of Family Medicine
<>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
<>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.
<>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.
<>Acute low back pain can be defined as six to 12 weeks of pain between the costal angles and gluteal folds that may radiate down one or both legs (sciatica). Acute low back pain is often nonspecific and therefore cannot be attributed to a definite cause. However, possible causes of acute low back pain (e.g., infection, tumor, osteoporosis, fracture, inflammatory arthritis) need to be considered based on the patient's history and physical examination. Table 1 presents the differential diagnosis of acute low back pain.5,6
<>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.
<>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.
<>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.
<>Over-the-counter (OTC) pain relievers. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve), might relieve acute back pain. Take these medications only as directed by your doctor. Overuse can cause serious side effects. If OTC pain relievers don't relieve your pain, your doctor might suggest prescription NSAIDs.
<>This stretch is designed to help lengthen the piriformis muscle over time. This muscle is often the source of sciatica, or radiating leg pain. Sitting with a straight back, cross your left leg over your right leg placing your foot next to your thigh and tuck your right leg in towards your buttocks. Place your right arm on your leg as pictured and slowly ease into a stretch. Be sure to keep your back straight and chest lifted. Hold for 20 seconds and alternative sides, three times.
<>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.
<>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.
<>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
<>How old is your bed? You may be surprised to learn that the average life span of a mattress is less than 10 years. "There's no hard-and-fast rule," says Sean Mackey, chief of the division of pain medicine at Stanford University, "but if your mattress is sagging significantly or is more than 6 to 8 years old, I'd think about getting a new one. Something else to consider: a firm mattress may not do your back any favors, says Carmen R. Green, a physician at the University of Michigan Back & Pain Center. A number of studies over the years suggest that people with lower back pain who sleep on medium-firm mattresses do better than those with firm beds.
<>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.
<>Chiropractors use posture exercises and hands-on spinal manipulation to relieve back pain, improve function, and help the body heal itself. They often work in conjunction with other doctors, and they can prescribe diet, exercise, and stretching programs. "A well-trained chiropractor will sort out whether you should be in their care or the care of a physical therapist or medical doctor," Dr. Kowalski explains.
<>Too much tension and tightness can cause back pain. "Our goal in increasing flexibility is to put an equal load throughout the body from the feet all the way up to the head,” Davis says. “One good exercise is to sit on the edge of the bed with one leg extended and the other one on the floor. Give your hamstrings a stretch by leaning forward while keeping your back in a neutral position.”
<>Save a bundle on a bundle! The boxed set is a 50% discounted bundle of all 8 book-length tutorials for sale on this website, about 8 different common injuries and pain problems. It’s ideal for professionals, keen patients, and anyone who wants more for less. Purchased individually, all the tutorials would cost $160, but the set price is only $79.50. More information and purchase options.
<>Pain is a leading cause of insomnia—difficulty with falling asleep and/or staying asleep. Approximately two-thirds of people with chronic back pain suffer from some type of sleep disorder. Paradoxically, inadequate sleep can make your back pain worse. This vicious cycle makes it ineffective to treat just the pain. If you have sleep problems, you need to get the sleep problems addressed too.
<>Tip: One good pre-activity stretch is a yoga move called the cat-cow: Start on your hands and knees with your back straight and your head and neck in line. On an inhale, drop your belly toward the ground and look up toward the ceiling (cow pose). On an exhale, tuck in your stomach, arch your back and lower your head to your chest (cat pose). Do it gently, and stop if you feel any pain.
<>“I went in not knowing what the problem was, I hurt and I figured I was out of place. I was seeing another chiropractor but they were only adjusting me and there was no improvement - I was worsening. I went to see Dr. Riley and in one visit he found that I was weak in my left glute and my body was overcompensating and causing me pain. It took four visits working on strengthening that side and I'm pain free.”
<>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]
<>For short-term pain relief, over-the-counter pain relievers including acetaminophen and NSAIDs (non-steroidal anti-inflammatory drugs) are sometimes suggested. The most common NSAIDs include aspirin, ibuprofen (Advil, Motrin), and naproxen (Aleve). Potential side effects of NSAIDs include stomach and liver problems. Talk to your doctor if you don't find relief after taking the recommended dose.
<>A meta-analysis found traction no more effective than placebo, sham, or no treatment for any outcome for low back pain with or without sciatica.12 The results consistently indicated that continuous or intermittent traction as a single treatment for low back pain is not effective.12 Side effects included worsening of signs and symptoms and increased subsequent surgery; however, the reports are inconsistent.10
<>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.
<>Physician specialties that evaluate and treat low back pain range from generalists to subspecialists.These specialties include emergency medicine physicians, general medicine, family medicine, internal medicine, gynecology, spine surgeons (orthopaedics and neurosurgery), rheumatology, pain management, and physiatry. Other health care providers for low back pain include physical therapists, chiropractors, massage therapists, psychologists, and acupuncturists.
<>2011 — Updated: Added scientific cases studies, examples, pictures and video of true dislocation and abnormal anatomy to help drive home the point that even significant spinal joint dysfunction can be surprisingly harmless … never mind subtle joint problems. [Section: Spinal manipulative therapy (SMT): Adjustment, manipulation, and cracking of the spinal joints.]
<>Hyperlordosis (lordotic low back pain) is the second most common cause of adolescent low back pain.18,47 This condition is related to adolescent growth spurts when the axial skeleton grows faster than the surrounding soft tissue, resulting in muscular pain.55 Other causes of low back pain unique to children are vertebral endplate fractures and bacterial infection of the vertebral disk. Adolescents have weaker cartilage in the endplate of the outer annulus fibrosis, allowing avulsion and resulting in symptoms similar to a herniated vertebral disk.58 Additionally, the pediatric lumbar spine has blood vessels that traverse the vertebral bodies and supply the vertebral disk, increasing the chance of developing diskitis.51
<>Research is being conducted on certain treatments that stimulate nerves to reduce chronic back pain. Your doctor may consider adding acupuncture to your treatment plan if you aren't finding relief with more conservative care. Another method your doctor might suggest is transcutaneous electrical nerve stimulation (TENS), during which mild electric pulses are delivered to the nerves to block incoming pain signals.

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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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