T-tests (paired and unpaired where appropriate) employing Holm’s method of p-value adjustment were used for all post-hoc pair-wise comparisons following significant ANOVA/ANCOVA results. The R-Project statistical software version 2.12.1 was used for all data analyses (The R Foundation for Statistical Computing, Institut für Statistik und Wahrscheinlichkeitstheorie, Vienna, Austria).
Jump up ^ Smith C, Grimmer-Somers K (2010). The treatment effect of exercise programmes for chronic low back pain. J Eval Clin Pract. 16 (3): 484–91. doi:10.1111/j.1365-2753.2009.01174.x. PMID 20438611.
It is unclear if among those with non-chronic back pain alternative treatments are useful. For chiropractic care or spinal manipulation therapy (SMT) it is unclear if it improves outcomes more or less than other treatments. Some reviews find that SMT results in equal or better improvements in pain and function when compared with other commonly used interventions for short, intermediate, and long-term follow-up; other reviews find it to be no more effective in reducing pain than either inert interventions, sham manipulation, or other treatments, and conclude that adding SMT to other treatments does improve outcomes. National guidelines reach different conclusions, with some not recommending spinal manipulation, some describing manipulation as optional, and others recommending a short course for those who do not improve with other treatments. A 2017 review recommended spinal manipulation based on low quality evidence. Manipulation under anaesthesia, or medically assisted manipulation, has not enough evidence to make any confident recommendation.
After you use the Bed Rest Pillowthe first time, you’ll wonder why you didn’t buy one sooner. It is the perfect accessory for a bed, sofa. The side arms & high back help prop you up in a comfortable p…
In most episodes of low back pain, a specific underlying cause is not identified or even looked for, with the pain believed to be due to mechanical problems such as muscle or joint strain. If the pain does not go away with conservative treatment or if it is accompanied by red flags such as unexplained weight loss, fever, or significant problems with feeling or movement, further testing may be needed to look for a serious underlying problem. In most cases, imaging tools such as X-ray computed tomography are not useful and carry their own risks. Despite this, the use of imaging in low back pain has increased. Some low back pain is caused by damaged intervertebral discs, and the straight leg raise test is useful to identify this cause. In those with chronic pain, the pain processing system may malfunction, causing large amounts of pain in response to non-serious events.
Injections. If other measures don’t relieve your pain and if your pain radiates down your leg, your doctor may inject cortisone — an anti-inflammatory medication — or numbing medication into the space around your spinal cord (epidural space). A cortisone injection helps decrease inflammation around the nerve roots, but the pain relief usually lasts less than a few months.
Exercises: In acute back pain, there is currently no evidence that specific back exercises are more effective in improving function and decreasing pain than other conservative therapy. In chronic pain, studies have shown a benefit from the strengthening exercises. Physical therapy can be guided optimally be specialized therapists.
Analgesic medications are those specifically designed to relieve pain. They include OTC acetaminophen and aspirin, as well as prescription opioids such as codeine, oxycodone, hydrocodone, and morphine. Opioids should be used only for a short period of time and under a physician’s supervision. People can develop a tolerance to opioids and require increasingly higher dosages to achieve the same effect. Opioids can also be addictive. Their side effects can include drowsiness, constipation, decreased reaction time, and impaired judgment. Some specialists are concerned that chronic use of opioids is detrimental to people with back pain because they can aggravate depression, leading to a worsening of the pain.
I am a science writer, former massage therapist, and I was the assistant editor at ScienceBasedMedicine.org for several years. I have had my share of injuries and pain challenges as a runner and ultimate player. My wife and I live in downtown Vancouver, Canada. See my full bio and qualifications, or my blog, Writerly. You might run into me on Facebook or Twitter.
“Ominous” is medical jargon for “truly scary.” Cue Jaws theme music. Low back pain is ominous when it is caused by a spinal cord trauma, or a progressive disease that can maim or kill. Ominous causes of low back pain are rare, fortunately. But they are real. Awful things do happen, even the best doctors can miss them, and “alternative” health care professionals are even more likely to.
Ibuprofen (Advil, Nuprin, or Motrin), available over the counter, is an excellent medication for the short-term treatment of low back pain. Because of the risk of ulcers and gastrointestinal bleeding, talk with your doctor about using this medication for a long time.
Lumbar radiculopathy: Lumbar radiculopathy is nerve irritation that is caused by damage to the discs between the vertebrae. Damage to the disc occurs because of degeneration (wear and tear) of the outer ring of the disc, traumatic injury, or both. As a result, the central softer portion of the disc can rupture (herniate) through the outer ring of the disc and abut the spinal cord or its nerves as they exit the bony spinal column. This rupture is what causes the commonly recognized sciatica pain of a herniated disc that shoots from the low back and buttock down the leg. Sciatica can be preceded by a history of localized low-back aching or it can follow a popping sensation and be accompanied by numbness and tingling. The pain commonly increases with movements at the waist and can increase with coughing or sneezing. In more severe instances, sciatica can be accompanied by incontinence of the bladder and/or bowels. The sciatica of lumbar radiculopathy typically affects only one side of the body, such as the left side or right side, and not both. Lumbar radiculopathy is suspected based on the above symptoms. Increased radiating pain when the lower extremity is lifted supports the diagnosis. Nerve testing (EMG/electromyogramspina bifida
Now you can kick back and relax anywhere with this comfortable and supportive Pillow. This Pillow provides back and head that is perfect for many activities such as reading, watching TV or playing video games. Stuffed with a super loft recycled polyester fiber fill, these pillows zippered slipcover is woven from Cotton twill. Hand wash slipcover with mild detergent and line dry.
Spinal fusion is used to strengthen the spine and prevent painful movements in people with degenerative disc disease or spondylolisthesis (following laminectomy). The spinal disc between two or more vertebrae is removed and the adjacent vertebrae are “fused” by bone grafts and/or metal devices secured by screws. The fusion can be performed through the abdomen, a procedure known as an anterior lumbar interbody fusion, or through the back, called posterior fusion. Spinal fusion may result in some loss of flexibility in the spine and requires a long recovery period to allow the bone grafts to grow and fuse the vertebrae together. Spinal fusion has been associated with an acceleration of disc degeneration at adjacent levels of the spine.
For older people with chronic pain, opioids may be used in those for whom NSAIDs present too great a risk, including those with diabetes, stomach or heart problems. They may also be useful for a select group of people with neuropathic pain.
^ Jump up to: a b c Downie A, Williams CM, Henschke N, Hancock MJ, Ostelo RW, de Vet HC, Macaskill P, Irwig L, van Tulder MW, Koes BW, Maher CG (11 December 2013). Red flags to screen for malignancy and fracture in patients with low back pain: systematic review. BMJ. 347 (dec11 1): f7095–f7095. doi:10.1136/bmj.f7095. PMC 3898572 . PMID 24335669.
2013 — New section: An overdue upgrade! This way pain and fear power each other is now explained much more clearly and thoroughly than before. It’s noteworthy that, with this update, Dr. Lorimer Moseley’s valuable perspective on back pain is now fairly well-represented in this book. [Section: Pain and fear, together at last: an even simpler vicious cycle.]
Pyelonephritis – People with a kidney infection typically develop sudden, intense pain just beneath the ribs in the back that may travel around the side toward the lower abdomen or sometimes down to the groin. There also can be a high fever, shaking chills and nausea and vomiting. The urine may be cloudy, tinged with blood or unusually strong or foul-smelling. There may be additional bladder related symptoms, such as the need to urinate more often than normal or pain or discomfort during urination.
2017 — Major upgrade: The section has been re-written and expanded significantly, with a key change in position. After reviewing the same scientific papers previously cited more carefully, I decided that they were much less promising than I originally thought. The section has flip-flopped from optimism to pessimism about nerve blocks without a single change in what’s actually cited, just a change in the level of diligence in interpreting the science. [Section: Diagnostic numbing of facet joints.]
Jump up ^ Conn’s current therapy 2017. Bope, Edward T.,, Kellerman, Rick D.,, Preceded by: Conn, Howard F. (Howard Franklin), 1908-1982. Philadelphia: Elsevier. 2017. ISBN 9780323443203. OCLC 961064076.
Bone scan – a bone scan may be used for detecting bone tumors or compression fractures caused by brittle bones (osteoporosis). The patient receives an injection of a tracer (a radioactive substance) into a vein. The tracer collects in the bones and helps the doctor detect bone problems with the aid of a special camera.
2016 — Correction: Removed overconfident statements about the clinical significance of the effects of psychoactive drugs, plus related minor updates. [Section: A trigger point checklist: does this sound like you?]
This myth of “mechanical” failure of the low back has many unfortunate consequences, such as unnecessary fusion surgeries — a common and routinely ineffective procedure — and low back pain that lasts for years instead of months or weeks. The seriousness of chronic low back pain is often emphasized in terms of the hair-raising economic costs of work absenteeism, but it may well be far worse than that — a recent Swedish study shows that it probably even shortens people lives.8 The stakes are high. “Tragedy” is not hyperbole.
X-ray is often the first imaging technique used to look for broken bones or an injured vertebra. X-rays show the bony structures and any vertebral misalignment or fractures. Soft tissues such as muscles, ligaments, or bulging discs are not visible on conventional x-rays.
And it’s always amazing to me how chronic pain can, with the right therapy, just suddenly end — it’s not common, but it does happen. Lots of people who thought they’d “tried everything” for lower back pain read this tutorial and then write to me and say, “Well, I guess I hadn’t tried everything!”
^ Jump up to: a b c Stockwell, Serena (2017-05-01). New Clinical Guideline for Low Back Pain Says Try Nondrug Therapies First. AJN, American Journal of Nursing. 117 (5). doi:10.1097/01.naj.0000516263.01592.38. ISSN 0002-936X.
Jump up ^ Woodman, JP; Moore, NR (January 2012). Evidence for the effectiveness of Alexander Technique lessons in medical and health-related conditions: a systematic review. International journal of clinical practice. 66 (1): 98–112. doi:10.1111/j.1742-1241.2011.02817.x. PMID 22171910.
The Tri-Tachment system allows you to adjust and secure the support in the exact position that’s right for you. This eliminates the need to constantly readjust the support every time you get in and out of the chair. Just clip the straps in place and it will stay put.
The interaction between the low back and chair support is an important health factor for employees using seated work stations. Canadian statistics indicate that back injuries make up 28.8% of the lost time claims and 7.0% occur in clerical jobs . The result of the musculoskeletal conditions is a reduction in work attendance and performance. For instance, 19% of those with low back pain (LBP) lose 6.2 hours of work per month and those with severe pain lose 8.2 hours of work per month .