2016 — Minor update: Clarification of the significance of some previously cited science, Ferreira et al. [Section: Core strengthening has failed to live up to the hopes and dreams of therapists and patients.]
This tutorial has been continuously, actively maintained and updated for 14 years now, staying consistent with professional guidelines and the best available science. The first edition was originally published in September 2004, after countless hours of research and writing while I spent a month taking care of a farm (and a beautiful pair of young puppies) in the Okanagan.
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Ten updates have been logged for this article since publication (2009). All PainScience.com updates are logged to show a long term commitment to quality, accuracy, and currency. more When’s the last time you read a blog post and found a list of many changes made to that page since publication? Like good footnotes, this sets PainScience.com apart from other health websites and blogs. Although footnotes are more useful, the update logs are important. They are “fine print,” but more meaningful than most of the comments that most Internet pages waste pixels on.
If you are experiencing sharp pain in the lower back, particularly on one side, you may be experiencing kidney stones. Also known as a renal calculus, a kidney stone is a solid piece of material formed in the kidney by minerals.
Protruding disk – People with significant disk disease sometimes have pain in the lower back. If a disk compresses a nerve, the pain may spread down one leg. The pain gets worse during bending or twisting.
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.
Lifting: Don’t lift objects that are too heavy for you. If you attempt to lift something, keep your back straight up and down, head up, and lift with your knees. Keep the object close to you, don’t stoop over to lift. Tighten your stomach muscles to keep your back in balance.
Feel better with lumbar back support braces or cushions. There are lumbar back cushions that are designed specifically for use with wheelchairs and others that can be used anywhere home, office or car. Lumbar back support braces and belts can provide support all day long, whether you’re sitting or are active. Try lumbar support products from brands such as Hudson Medical or Nova.
The cushion is created using premium grade memory foam that works remarkably well in conforming to the contours of your spine. This not only keeps your lower back in check but alleviates pressure along your entire spine by forcing you to sit up straight. The material responds to pressure and body heat to become more supple as you sit. Moreover, it also has the wonderful property of quickly returning to its original shape once the pressure and heat is removed, making it easily usable for multiple people with different body dimensions.
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.
Feldman M, et al. Sleisenger & Fordtran’s Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 9th ed. Philadelphia, Pa.: Saunders Elsevier; 2010. http://www.clinicalkey.com. Accessed Oct. 25, 2014.
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
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Infections are not a common cause of back pain. However, infections can cause pain when they involve the vertebrae, a condition called osteomyelitis; the intervertebral discs, called discitis; or the sacroiliac joints connecting the lower spine to the pelvis, called sacroiliitis.
Use of a lumbar support pillow that allows space for the posterior pelvic bulk significantly decreased lumbar flattening during sitting in healthy individuals and patients with LBP. However, thoracolumbar curvature was increased. The difference in angular change was small and further study is required to determine clinical relevance over the long term. Furthermore, an objective measure of comfort was improved with the pillow but subjective reports on comfort were not significantly affected. Future studies should investigate the long term clinical benefit of using a lumbar pillow in males and females with a higher intensity of LBP.
Studies on complementary therapies have given mixed results. Some people have experienced significant benefit, while others have not. It is important, when considering alternative therapies, to use a well qualified and registered therapist.
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COX-2 inhibitors, such as celecoxib (Celebrex), are more selective members of NSAIDs. Although increased cost can be a negative factor, the incidence of costly and potentially fatal bleeding in the gastrointestinal tract is clearly less with COX-2 inhibitors than with traditional NSAIDs. Long-term safety (possible increased risk for heart attack or stroke) is currently being evaluated for COX-2 inhibitors and NSAIDs.
Hexenschuss is a German word for back spasm or lumbago, but translated literally it means shot by the witch (hexe = witch and Schuss = shot). Those Germans have a word for everything! Hat tip to reader Richard Moison for teaching it to me. BACK TO TEXT
Cortisone injections – if the above-mentioned therapies are not effective enough, or if the pain reaches down to the patient’s legs, cortisone may be injected into the epidural space (space around the spinal cord).
Regular activity and gentle stretching exercises is encouraged in uncomplicated back pain, and is associated with better long-term outcomes. Physical therapy to strengthen the muscles in the abdomen and around the spine may also be recommended. These exercises are associated with better patient satisfaction, although it has not been shown to provide functional improvement. However, one study found that exercise is effective for chronic back pain, but not for acute pain. If used, they should be performed under supervision of a licensed health professional.
2013 — Minor update: Added some great backup from a terrific surgeon blogger — who advocates for the necessity of testing placebo surgeries, exactly as I have in this section for many years. [Section: The back surgery placebo problem, and how it limits our knowledge of the effectiveness of back surgeries.]
Usual care provided by general practitioners for low back pain does not match the care endorsed in international evidence-based guidelines and may not provide the best outcomes for patients. This situation has not improved over time.