You don’t need to take my word for anything — you can just take the word of the many low back pain medical experts that I quote,11 and the hard evidence that their opinions are based on. At the same time, I am realistic about the limits of the science, much of which is pretty junky.12 My own credentials are somewhat beside the point. My decade of professional experience as a Registered Massage Therapist does help me understand and write about low back pain, but what really matters is that I refer to and explain recent scientific evidence, but without blindly trusting it.
Lumbar strain (acute, chronic): A lumbar strain is a stretch injury to the ligaments, tendons, and/or muscles of the low back. The stretching incident results in microscopic tears of varying degrees in these tissues. Lumbar strain is considered one of the most common causes of low back pain. The injury can occur because of overuse, improper use, or trauma. Soft-tissue injury is commonly classified as acute if it has been present for days to weeks. If the strain lasts longer than three months, it is referred to as chronic. Lumbar strain most often occurs in people in their 40s, but it can happen at any age. The condition is characterized by localized discomfort in the low back area with onset after an event that mechanically stressed the lumbar tissues. The severity of the injury ranges from mild to severe, depending on the degree of strain and resulting spasm of the muscles of the low back. The diagnosis of lumbar strain is based on the history of injury, the location of the pain, and exclusion of nervous system injury. Usually, X-ray testing is only helpful to exclude bone abnormalities.
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The presence of certain signs, termed red flags, indicate the need for further testing to look for more serious underlying problems, which may require immediate or specific treatment. The presence of a red flag does not mean that there is a significant problem. It is only suggestive, and most people with red flags have no serious underlying problem. If no red flags are present, performing diagnostic imaging or laboratory testing in the first four weeks after the start of the symptoms has not been shown to be useful.
I am a science writer & amateur athlete in Vancouver, Canada. I’ve been writing about low back pain for over a decade, in part to understand & manage my own chronic pain problems, including rare but nasty episodes of back pain. ~ Paul Ingraham
Whiplash: Causes, symptoms, and treatments Whiplash is a series of neck injuries related to a sudden distortion of the neck. Here, we explain how whiplash happens, how it is treated, and more. Read now
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The gluteus medius is sandwiched between the glute maximus and minimus and lies in and around the hip area. The role of the muscle is to abduct your hip or lift your leg out to the side in either standing or side lying and to keep your pelvis level whenever you take a step. Prolonged sitting during the day as well as an unequal weight distribution when standing are two of the most common reasons for this muscle to get weak and imbalanced.
Back pain can originate from the muscles, nerves, bones, joints or other structures in the spine. Internal structures such as the gallbladder, pancreas, aorta, and kidneys may also cause referred pain in the back.
The vast majority of low back pain is mechanical in nature. In many cases, low back pain is associated with spondylosis, a term that refers to the general degeneration of the spine associated with normal wear and tear that occurs in the joints, discs, and bones of the spine as people get older. Some examples of mechanical causes of low back pain include:
Back pain is generally treated with non-pharmacological therapy first, as it typically without the use of medication. Superficial heat and massage, acupuncture, and spinal manipulation therapy may be recommended.
Several NIH-funded clinical trials and other studies in patients aim to improve treatment options and prevention strategies for chronic low back pain, as well as add to the evidence base about existing treatments. A multi-year multicenter study called the Spine Patient Outcomes Research Trial (SPORT) compared the most commonly used surgical and nonsurgical treatments for patients with the three most common diagnoses for which spine surgery is performed: intervertebral disc herniation, spinal stenosis, and degenerative spondylisthesis. SPORT represented the largest clinical investigation to date looking at treatment results for these disabling and costly causes of chronic low back pain.