Several studies suggest that people who suffer from low back pain actually benefit more from a medium-firm mattress. Why? If a mattress is too firm, it won’t support the body evenly and may cause discomfort at the heaviest points like hips and shoulders. If the mattress is too soft, a sleeper could sink into the bed and have a harder time moving, which could cause stiffness and pain come morning.
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Persistent (chronic) low back pain With a significant motor deficit, it is necessary to identify lesions that are amenable to surgical correction and to exclude the additional (and at times subclinical) presence of spinal cord or cauda equina compression. Thus, MRI studies are appropriate in this setting. With a very large disk protrusion or concomitant spinal cord compression, surgical intervention becomes a more important consideration, especially if neurologic deficits continue to worsen over time or if pain persists.
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The history should also explore factors that increase the likelihood of an underlying systemic disorder as a cause. These include advanced age, history of cancer, unexplained weight loss, use of injected drugs, chronic infection, prolonged duration of pain, pain that does not respond to rest or recumbency, and failure to respond to previous therapy. Box 1 reviews these factors.
Popcorn Makers Language * Holiday Decor: Save up to 60% Free Shipping Over $49* Decorative Shelves Numerous treatment guidelines have been written regarding the evaluation, treatment, and management of LBP. [2, 3] Perhaps the most widely reviewed (and controversial) guideline was published in 1994 by the Agency for Health Care Policy and Research titled “Acute Lower Back Problems in Adults: Clinical Practice Guidelines.” 
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Less common causes Functions of the low back, or lumbar area, include structural support, movement, and protection of certain body tissues.
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^ Jump up to: a b c Cohen SP, Argoff CE, Carragee EJ (2008). “Management of low back pain”. BMJ. 337: a2718. doi:10.1136/bmj.a2718. PMID 19103627.
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Massage may relieve chronic low back pain, especially when combined with exercise and stretching. Researchers noted patients who did all 3 were able to move around easier and had less short term and long term pain.
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Pain management What’s new in this article? Repetitive, compressive loading of the disks in flexion (eg, lifting) puts the disks at risk for an annular tear and internal disk disruption. Likewise, torsional forces on the disks can produce shear forces that may induce annular tears. (Degenerative disk forces are demonstrated in the image below.) The contents of the annulus fibrosis (nucleus pulposus) may leak through these tears. Central fibers of the disk are pain free, so early tears may not be painful. Samples of disk material taken at the time of autopsy reveal that the cross-linked profile of pentosidine, a component of the collagen matrix, declines. This may indicate the presence of increased matrix turnover and tissue remodeling.
Bowel or bladder dysfunction All Ceiling Lighting Audio Tees Email In another study, patients with lumbar spondylolisthesis, lumbar canal stenosis, and neurogenic claudication with neurologic signs were randomized to conservative treatment or decompressive surgery with spinal fusion.20 This study demonstrated significantly greater improvement in pain and function among the surgically treated patients, but the analysis was complicated by an unexpectedly high rate of crossover from the conservative treatment group to the surgery group. Back pain did not improve as much as leg pain, indicating that the greatest benefit was likely to have occurred for nerve-root related symptoms.21 A study of patients with LCS without spondylolisthesis more convincingly demonstrated a benefit for surgically treated patients compared to medically treated patients over a 2-year period.22
1953 Back pain is a symptom. Most back pain is musculo-skeletal in origin. Pain arising from other organs may be felt in the back. This is called referred pain. Many intra- abdominal disorders – such as appendicitis, aneurysms, kidney diseases, bladder infections, pelvic infections and ovarian disorders, amongst others – can cause pain referred to the back. Your doctor will consider this when evaluating your pain.
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