The main causes of low back pain include muscle strain, herniated disks, arthritis, and more. You can treat low back pain with ice/heat, stretching, a back brace, and more. Keep reading to hear the main causes and treatments.
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Lower-back pain, or pain in the part of the back between the ribs and the legs, is one of the most common complaints of discomfort. It is the most common cause of job-related disability and a major reason for missed work. While most back twinges go away on their own after a few days, many people suffer from chronic back pain.
2010 — Minor update: Added clear evidence that family doctors don’t do a good job caring for patients with low back pain, and that a myth-busting ebook like this is still important. [Section: A tragic low back pain myth.]
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Experts believe TENS encourages the body to produce endorphins, and may possibly block pain signals returning to the brain. Studies on TENS have provided mixed results; some revealed no benefits, while others indicated that it could be helpful for some patients.
Osteoporosis – This common condition is characterized by thinned, weakened bones that fracture easily. It is most common in postmenopausal women. When vertebrae become compressed because of fracture, posture may become stooped over or hunched along with back pain. Osteoporosis is not painful unless a bone fractures.
Jump up ^ Lin CW, Haas M, Maher CG, Machado LA, van Tulder MW (July 2011). Cost-effectiveness of guideline-endorsed treatments for low back pain: a systematic review. Eur Spine J. 20 (7): 1024–38. doi:10.1007/s00586-010-1676-3. PMC 3176706 . PMID 21229367.
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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.
Exercises to improve posture and strengthen the muscles of the back and abdominal muscles, called the core muscles, are a treatment option that should be strongly considered. This treatment often involves:
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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.
Arthritis – patients with osteoarthritis commonly experience problems with the joints in the hips, lower back, knees and hands. In some cases spinal stenosis can develop, which is the term used to describe when the space around the spinal cord narrows.
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Oh, I get those too! I do not host public comments on PainScience.com for many reasons, but emailed constructive criticism, factual corrections, requests, and suggestions are all very welcome. I have made many important changes to this tutorial inspired directly by critical, informed reader feedback.
2017 — Science update: An important follow-up on August’s major massage evidence update, I’ve now added a summary of the evidence for trigger point massage. Although the topic is not covered in detail here, much study went into making this summary possible. [Section: The evidence for massaging back pain.]
Kidney infections, stones, and traumatic bleeding of the kidney (hematoma) are frequently associated with low back pain. Diagnosis can involve urine analysis, sound-wave tests (ultrasound), or other imaging studies of the abdomen.
Enthoven WT, Geuze J, Scheele J, et al. Prevalence and Red Flags Regarding Specified Causes of Back Pain in Older Adults Presenting in General Practice. Phys Ther. 2016 Mar;96(3):305–12. PubMed #26183589. How many cases of back pain in older adults have a serious underlying cause? Only about 6% … but 5% of those are fractures (which are serious, but they aren’t cancer either). The 1% is divided amongst all other serious causes. In this study of 669 patients, a vertebral fracture was found in 33 of them, and the chances of this diagnosis was higher in older patients with more intense pain in the upper back, and (duh) trauma. BACK TO TEXT
Cognitive behavioural therapy (CBT) may also be recommended as a treatment option. There is good evidence from research trials that it can help. CBT aims to help you to change the way that you think, feel and behave. It is used as a treatment for various health problems, including various types of chronic pain.
Welcome to one of the Internet’s saner sources of information about chronic low back pain.[NIH] This is a book-length tutorial, a guide to a controversial subject for both patients and professionals. It is not a sales pitch for a miracle cure system. It’s heavily referenced, but the tone is often light, like this footnote about being “shot by the witch.”1 I will offer some surprising ideas — underestimated factors in low back pain — but I won’t claim that all back pain comes from a single cause or cure. It’s just a thorough tour of the topic, the myths and misconceptions, and the best (and worst) low back pain treatment ideas available.
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Approximately 98 percent of people with back pain are diagnosed with nonspecific acute back pain in which there is no serious underlying pathology. Nearly 2 percent are comprised by metastatic cancers, while serious infections such as spinal osteomyelitis and epidural abscesses account for fewer than 1 percent.
Is “much” information really “just plain wrong”? I will establish this in the sections ahead with a steady supply of clearly explained references to the medical literature that patients can understand and professionals can respect. This extra layer of information in easy-to-use footnotes is available for any reader who wants to dig deeper and check my facts. For example, here’s a good start: In 2010, the Journal of Bone & Joint Surgery reported that “the quality and content of health information on the internet is highly variable for common sports medicine topics,” such as knee pain and low back pain — a bit of an understatement, really. Expert reviewers examined about 75 top-ranked commercial websites and another 30 academic sites. They gave each a quality score on a scale of 100. The average score? Barely over 50! For more detail, see Starman et al. BACK TO TEXT
Self-help measures are often very helpful in people with back pain. If your back pain is severe or chronic your GP may prescribe appropriate medicines or refer you for manual (physical) therapies. If an underlying cause of back pain is suspected, your GP may refer you to a back or pain specialist or clinic for diagnosis and specialised treatments (such as spinal injections).
We also carry pain relievers such as ibuprofen and acetaminophen to help you manage pain. Topical analgesics, heating pads and other heat therapy products might also provide relief. In addition, you can try other back braces as well as abdominal supports to aid sore muscles.
Driving – it is important to have proper support for your back. Make sure the wing mirrors are properly positioned so you do not need to twist. The pedals should be squarely in front of your feet. If you are on a long journey, have plenty of breaks – get out of the car and walk around.
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Of course, not all incidences of back pain are injury or trauma-related. Many back problems are congenital (found at birth), degenerative, age-related, disease-related, and may be linked to poor posture, obesity or an unhealthy lifestyle such as smoking. Sometimes the back pain is worse than the severity of the injury or disorder. That statement raises the question, “When should I seek medical attention for back pain?”
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Battié MC, Videman T, Kaprio J, et al. The Twin Spine Study: contributions to a changing view of disc degeneration. Spine J. 2009;9(1):47–59. PubMed #19111259. “The once commonly held view that disc degeneration is primarily a result of aging and wear and tear from mechanical insults and injuries was not supported by this series of studies. Instead, disc degeneration appears to be determined in great part by genetic influences. Although environmental factors also play a role, it is not primarily through routine physical loading exposures (eg, heavy vs. light physical demands) as once suspected.” BACK TO TEXT
Jump up ^ Pinto, RZ; Maher, CG; Ferreira, ML; Hancock, M; Oliveira, VC; McLachlan, AJ; Koes, B; Ferreira, PH (18 December 2012). Epidural corticosteroid injections in the management of sciatica: a systematic review and meta-analysis. Annals of Internal Medicine. 157 (12): 865–77. doi:10.7326/0003-4819-157-12-201212180-00564. PMID 23362516.
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