Herzog R, Elgort DR, Flanders AE, Moley PJ. Variability in diagnostic error rates of 10 MRI centers performing lumbar spine MRI examinations on the same patient within a 3-week period. Spine J. 2016 Nov. PubMed #27867079.
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MRI and x-ray for low back pain are surprisingly unreliable,1 because things like bulging discs aren’t actually that big a deal,2 most back pain goes away on its own,3 and trigger points (“muscle knots”) are common and can be alarmingly intense but aren’t dangerous.4 Most patients are much better off when they feel confident about these things; the power of justified, rational confidence is a huge factor in back pain.5 Sadly, many healthcare professionals continue to perpetuate the idea of fragile backs.6
About 80 percent of people in the United States experience at least one bout of lower-back pain in their lives, according to the National Institute of Neurological Disorders and Stroke. The back can get out of whack very easily because it supports most of the body’s weight. People ages 30 to 50 tend to be more likely to suffer from back pain, possibly because they spend large amounts of their day sitting, with the occasional too-vigorous workout that can cause injury.
There is controversy and scientific uncertainty about trigger points. It’s undeniable that mammals suffer from sensitive spots in our soft tissues … but their nature remains unclear, and the “tiny cramp” theory could be wrong. The tiny cramp theory is formally known as the “expanded integrated hypothesis,” and it has been prominently criticized by Quintner et al (and not many others). However, it’s the mostly widely accepted explanation for now. BACK TO TEXT
^ Jump up to: a b c Furlan AD, Yazdi F, Tsertsvadze A, Gross A, Van Tulder M, Santaguida L, Gagnier J, Ammendolia C, Dryden T, Doucette S, Skidmore B, Daniel R, Ostermann T, Tsouros S (2012). A systematic review and meta-analysis of efficacy, cost-effectiveness, and safety of selected complementary and alternative medicine for neck and low-back pain. Evidence-Based Complementary and Alternative Medicine. 2012: 953139. doi:10.1155/2012/953139. PMC 3236015 . PMID 22203884.
While it’s true that some lower back pain just cannot be fixed, it’s also true that many “incurable” cases do turn out to be surprisingly treatable. People who believed for years that their pain was invincible have found relief. Not always, and often not completely — but sometimes any relief is far better than nothing. How can extremely stubborn pain finally ease up? because many cases weren’t truly stubborn to begin with, despite all appearances. So many health professionals are poorly prepared to treat low back pain that patients can easily go for months or even years without once getting good care and advice. When they finally get it, it’s hardly surprising that some patients finally get some relief from their pain.
Jump up ^ van Tulder MW, Touray T, Furlan AD, Solway S, Bouter LM (2003). Muscle relaxants for non-specific low back pain. The Cochrane Database of Systematic Reviews (2): CD004252. doi:10.1002/14651858.CD004252. PMID 12804507.
Whether you’re a weekend warrior, an elite athlete, or somewhere in between, there’s a strong chance that eventually you’ll deal with back pain, too. Here’s why: Everyday activities that you do without thinking — sitting at the computer, slipping on a pair of shoes, crawling into bed at night — can make or break your spine health. Most aches are caused by strains (injured muscles or tendons) or sprains (damage to the tough fibrous tissue, or ligaments, located where your vertebrae connect to joints). These injuries are typically brought on by overuse, a new activity, excessive lifting, or an accident. Other times, a compressed (aka pinched) nerve, such as in a herniated disk, is to blame for the ache.
Most commonly, mechanical issues and soft-tissue injuries are the cause of low back pain. These injuries can include damage to the intervertebral discs, compression of nerve roots, and improper movement of the spinal joints.
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Although some discs in the spine deteriorate naturally with age, this process can happen abnormally quickly in some patients. Disc degeneration heightens your vulnerability to a myriad of spinal problems and can lead to distressing lower back pain.
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It is extremely difficult to alter the potentially disabling belief among the lay public that low back pain has a structural mechanical cause. An important reason for this is that this belief continues to be regularly reinforced by the conditions of care of a range of ‘hands-on’ providers, for whom idiosyncratic variations of that view are fundamental to their professional existence.”
I was surprised at how firm and heavy this back rest is. Others I have bought have been very plush and soft, but never gave me the support this one does. It is plenty wide for a plus size person and is a joy to use. It’s well worth the extra money I spent!
Bending your back initially is unavoidable, but when you bend your back try not to stoop or squat, and be sure to tighten your stomach muscles so that your pelvis is pulled in. Most important, do not straighten your legs before lifting; otherwise you will be using your back for most of the work.
Or this guy’s. Dr. Siegfried Mense is the world’s foremost expert in muscle pain. He is the author of the most current and authoritative text on that subject, and one of this tutorial’s most important sources.
Future studies investigating the effect of different seating systems on patient postures and symptoms ought to include patients with higher pain levels, longer follow-up and female participants, so as to more realistically replicate the range of demographics and development of symptoms in those who work in seated environments.
Most acute low back pain fades steadily — up to 90% of it, for uncomplicated cases.13 So does a lot of so-called “chronic” low back pain!14 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.
The road to understanding what may be causing your pain can seem overwhelming when you aren’t sure where to look. We want to help you take the next step. Read on to learn about back pain conditions and treatment options.
This paper presents some unusually optimistic old data about low back pain recovery: in a sample of about 100 patients, “90% of patients recovered within two weeks and only two developed chronic low back pain,” which is “much higher than reported in other studies,” but the authors suggest some good reasons why their number makes sense.
Workers who experience acute low back pain as a result of a work injury may be asked by their employers to have x-rays. As in other cases, testing is not indicated unless red flags are present. An employer’s concern about legal liability is not a medical indication and should not be used to justify medical testing when it is not indicated. There should be no legal reason for encouraging people to have tests which a health care provider determines are not indicated.
Symptoms that spread equally into both legs, especially numbness and/or tingling and/or weakness, and especially if it is aggravated by lifting. The same symptoms limited to one side are also a concern, but less so.
The Agency for Healthcare Research and Quality has identified 11 red flags that doctors look for when evaluating a person with back pain. The focus of these red flags is to detect fractures (broken bones), infections, or tumors of the spine. Presence of any of the following red flags associated with low back pain should prompt a visit to your doctor as soon as possible for complete evaluation.