lower back pain : The Rules of Lifting

Many back injuries occur during lifting. Making a complete checklist for safe lifting can reduce the risks of injury.

First, plan and prepare for the lift. It only takes a moment to insure safety. The consequences of a back injury can be long lasting!

Insure a safe and clear path.

Before beginning, think through the lift.

Obtain good footing with a wide base of support, by placing the feet a minimum of shoulder width apart. This lowers the center of gravity and increases stability.

Keep the load close! Keeping the load close to the body can reduce stress on the spine and back muscles. Think of how a lever and fulcrum works. The back muscles, the spine, and the arms are the parts that form this lever system. The force needed to lift an object is lower if the load is nearer the fulcrum point. If the load is too far away from the body, the muscles of the spine have to work harder to help with the lift. This leads to too much stress on the muscles of the spine, and can cause injury.

Maintain the neutral spine position! By moving the pelvic wheel around its axis, the upper body hinges forward, but the spine stays in neutral. Remember the neutral spine position at all times!

Remember to lift with the large muscles of the legs!

Avoid twisting AND bending of the lower back at the same time! This is one the most damaging movements to the spine. To avoid twisting, pivot the feet to complete the lift.

Get help if necessary! If the load is too bulky or heavy, do not hesitate to get help or use a hand truck! Do not be too tough or too busy to get help. Will power does not take the place of a reasonably safe lift.

er back pain : Putting Safe Posture into Practice

Understanding body mechanics means understanding how we use our body. Proper body mechanics result when we put the neutral spine posture into action. To use proper body mechanics we need to learn how the spine should work during activities like: rising from a chair, walking, and lifting.

Sitting

Healthy sitting posture is based on the neutral spine position. Positioning your hips and knees at 90 degrees can help you keep a neutral sitting posture. Remember this position is balanced between the extremes of lumbar movement. Remember to choose a properly designed chair to help support the lumbar spine. The neutral spine position is also important when getting up from a chair. Holding the spine safely in neutral, the pelvic wheel turns forward, placing the "nose over the toes". With the feet placed shoulder width apart, stand upright. Use the buttock and thigh muscles to push yourself up. Do not twist or bend too far over at the waist and put too much strain on the lumbar spine.

Walking

Proper body mechanics are also important while walking - try to maintain the neutral spine position while walking. In the neutral position, the legs and arms swing naturally during forward motion. Conditions that alter the normal way of walking, and cause a limp, can severely stress the spine. While walking, always try to maintain your spine in the neutral position.

Lifting

Lifting is one of the most dangerous activities for the spine. The neutral position MUST be used to reduce the risk of injury. With the spine held in the neutral position, the movement occurs as the pelvic wheel turns. The hip is the axis of pelvic rotation - not the back! Notice how the back loses the neutral position when the pelvis does not rotate forward. This posture focuses the force on the back muscles during a lift. Lifting in a neutral position allows the larger and more powerful leg muscles to do the lifting.

When lifting - first find the neutral position. Bend at the hips by rotating the pelvic wheel at the hip joint axis. Keep the safe posture, hold the object securely, and use the large leg muscles to generate power. Tighten the abdominal muscles during the lift to create a stabilizing corset around the trunk.
lower back pain

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lower back pain : Understanding the Neutral Spine Position

Back pain is a serious subject. As you recover from a back injury, it is important that you begin to learn how to safely strengthen your back to help prevent injuries to your back later. Your therapist can teach you specific exercises that will help reduce your back pain now - and help you begin a new set of habits that will help keep your back healthy.

This presentation will help you understand what each part of your rehabilitation program is meant to do. It will also teach you how your back works and how to reduce or prevent further injury while your back heals.


First, you will learn why it is important for your spine to be properly balanced - in the Neutral Spine Position.
Then you will see how to use the neutral spine position in everyday activities - such as walking and lifting. Learning to lift properly is so important that a whole section has been devoted to the rules of lifting.
Finally, you will learn how you can benefit from exercise, after an injury and as protection against further injury.


Understanding the Neutral Spine Position

Management and prevention of back pain begin by understanding the neutral spine position. Three natural curves are present in a healthy spine. The neck, or the cervical spine, curves slightly inward. The mid back, or the thoracic spine, is curved outward. The low back, or the lumbar spine, curves inward again. The neutral alignment is important in helping to cushion the spine from too much stress and strain. Learning how to maintain a neutral spine position also helps you move safely during activities like sitting, walking, and lifting.

The natural curves of the spine are the result of the muscles, ligaments, and tendons that attach to the vertebrae of the spine. Without these supporting structures, the spine would collapse. They support the spine - much like guide wires support the mast of a ship. This guide wire system is made up mainly of the abdominal and back muscles. The abdominal muscles provide support by attaching to the ribs, pelvis, and indirectly to the lumbar spine. The muscles of the back are arranged in layers, with each layer playing an important role in balancing the spine. By using these muscles together, it is possible to change the curves of the spine.

Controlling pelvic tilt is one way to begin helping to balance the spine. As certain muscles of the back and abdomen contract, the pelvis rotates. As the pelvis rotates forward, the lumbar curve increases. As the pelvis rotates backward, the curve of the low back straightens. Rotation of the pelvis is like a wheel centered at the hip joint. The muscles of the upper thighs also attach to the pelvis and contraction of these muscles can be used to change the curve of the spine.

The abdominal muscles work alone, or with the hamstring muscles to produce a backward rotation of the pelvis. This causes the slight inward curve of the low back to straighten. If these muscles cause the curve of the low back to straighten too much, this may produce an unhealthy slouching posture.

In the other direction, as the hip flexors contract and back extensors contract, the pelvis is rotated forward - increasing the curvature of the lower back. If this curve is increased too much, another unhealthy posture may result. This condition is called lordosis in medical terminology, or swayback in common terms.

A balance of strength and flexibility is the key to maintaining the neutral spine position. This balance is the basis for optimal muscle function. Like a car, an imbalance may lead to wear and tear, eventually damaging the various parts of the car.

Muscle imbalances that affect the spine have many causes. One common cause of muscle imbalance is weak abdominal muscles. As the abdominal muscles sag, the hip flexors become tight, causing an increase in the curve of the low back. This leads to the swayback posture mentioned above. Another common problem results from tight hamstrings. As the hamstring muscles become tight, the pelvis is rotated backwards. This produces an abnormal slouching posture.

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lower back pain : What You Need to Know

What is Lower Back Pain?
Low back pain (LBP) is often described as sudden, sharp, persistent, or dull pain felt below the waist. LBP is very common and affects the majority of people at some point during their life.

Low back pain is most commonly caused by muscle strain associated with heavy physical work, lifting or forceful movement, bending or twisting, awkward positions, or standing in one position too long. Any of these movements can exacerbate a prior or existing back disorder.

Other conditions that can cause low back pain include spinal stenosis, arthritis (osteoarthritis), spinal infection (osteomyelitis), spinal tumors (benign and malignant), spondylolisthesis, and vertebral fractures (e.g. burst fracture).

Low back pain is either acute or chronic. Acute LBP may begin suddenly with intense pain usually lasting less than 3 months. Chronic pain is persistent long-term pain, sometimes lasting throughout life. Even chronic pain may present episodes of acute pain.

Other symptoms include localized pain in a specific area of the low back, general aching, and/or pain that radiates into the low back, buttocks, and leg(s). Sometimes pain is accompanied by neurologic symptoms such as numbness, tingling, or weakness.

Neurologic symptoms requiring immediate medical attention include bowel or bladder dysfunction, groin or leg weakness or numbness, severe symptoms that do not subside after a few days, or pain prohibiting everyday activities.

© 1999-2006 SpineUniverse.com

lower back pain : Is there relief for ongoing back problems?

Is there relief for ongoing back problems?
Treatment of ongoing back problems must be directed at the cause. This may mean losing weight (because being overweight can make back pain worse), getting your muscles in better shape, and improving your posture when you're sitting, standing and sleeping.

Tips for preventing back strain
Don't lift by bending over. Lift an object by bending your hips and knees and then squatting to pick up the object. Keep your back straight and hold the object close to your body. Avoid twisting your body while lifting.
Push rather than pull when you must move heavy objects.
If you must sit at your desk or at the wheel of a car or truck for long hours, break up the time with stops to stretch.
Wear flat shoes or shoes with low heels (1 inch or lower).
Exercise regularly. An inactive lifestyle contributes to lower back pain.

What's the best way to sit?
Sit in chairs with straight backs or low-back support. Keep your knees a little higher than your hips. Adjust the seat or use a low stool to prop your feet on. Turn by moving your whole body rather than by twisting at your waist.

When driving, sit straight and move the seat forward. This helps you not lean forward to reach the controls. You may want to put a small pillow or rolled towel behind your lower back if you must drive or sit for a long time.

What's the best position for standing?
If you must stand for long periods, rest 1 foot on a low stool to relieve pressure on your lower back. Every 5 to 15 minutes, switch the foot you're resting on the stool. Maintain good posture: Keep your ears, shoulders and hips in a straight line, with your head up and your stomach pulled in.

What's the best position for sleeping?
The best way to sleep is on your side with your knees bent. You may put a pillow under your head to support your neck. You may also put a pillow between your knees.

If you sleep on your back, put pillows under your knees and a small pillow under your lower back. Don't sleep on your stomach unless you put a pillow under your hips.

Use a firm mattress. If your mattress is too soft, use a board of 1/2-inch plywood under the mattress to add support.


What exercises can I do to strengthen my back?
Some specific exercises can help your back. One is to gently stretch your back muscles. Lie on your back with your knees bent and slowly raise your left knee to your chest. Press your lower back against the floor. Hold for 5 seconds. Relax and repeat the exercise with your right knee. Do 10 of these exercises for each leg, switching legs.

While some exercises are specific for your back, it's also important to stay active in general. Swimming and walking are good overall exercises to improve your fitness.

Copyright © 1996-2005 American Academy of Family Physicians

lower back pain : Tips on Pain Relief and Prevention

What can cause low back injuries?
Many things can cause low back injuries--muscle strain or spasm, sprains of ligaments (which attach bone to bone), joint problems or a "slipped disk." The most common cause is using your back muscles in activities you're not used to, like lifting heavy furniture or doing yard work.

A slipped disk happens when the disk between the bones bulges and presses on nerves. This is often caused by twisting while lifting. But many people won't know what caused their slipped disk.

What can I do for relief when I've hurt my lower back?
The best position for relief when your back hurts is to lie on your back on the floor with pillows under your knees, with your hips and knees bent and your feet on a chair, or just with your hips and knees bent. This takes the pressure and weight off your back.
If you're resting a hurt back, you may need 1 to 2 days of this sort of rest. Resting longer than this can cause your muscles to weaken, which can slow your recovery. Even if it hurts, walk around for a few minutes every hour.

What else can I do for relief?
Heating pads can help to relax painful muscle spasms. Use heat for 20 to 30 minutes at a time. Ice packs and massages may also give relief.

Nonprescription medicines that reduce pain or swelling include aspirin, acetaminophen (brand name: Tylenol), naproxen (brand name: Aleve), ketoprofen (brand name: Orudis), and ibuprofen (brand name: Motrin).

Call your family doctor if:

Pain goes down your leg below your knee.
Your leg, foot, groin or rectal area feels numb.
You have fever, nausea or vomiting, stomachache, weakness or sweating.
You lose control over going to the bathroom.
Your pain was caused by an injury.
Your pain is so intense you can't move around.
Your pain doesn't seem to be getting better after 2 to 3 weeks.

Copyright © 1996-2005 American Academy of Family Physicians

lower back pain : Back Pain for Restful Sleep

Although the common wisdom is that we spend a third of our lives sleeping, many of us don't get the quantity or the quality of sleep we need. Our hectic lifestyles and the 24-7-365 availability of distractions such as cable television and the Internet can cause us to cut back on the seven to nine hours of sleep that experts recommend we get each night. But even if we shoot for an adequate quantity of sleep, back pain and other problems can prevent us from getting the quality of sleep we need.

When lower back pain, neck pain, snoring, or a sleep disorder prevents us from getting the sleep we need, we accumulate what experts term a "sleep debt." One or two nights of restless or inadequate sleep won't harm us, but a pattern of sleep disruptions can have serious repercussions on our health, ranging from mental fuzziness and mood swings to cessations of breathing and even death. According to the National Sleep Foundation, "Sleep deprivation has been linked to health problems such as obesity and high blood pressure, negative mood and behavior, decreased productivity, and safety issues in the home, on the job, and on the road."

When back pain or neck pain causes sleep disruptions, it may be time to invest in a new mattress. Mattresses that use natural fibers, such as cotton, tend to harden over time, while box springs can begin to sag. A mattress that has outlived its usefulness forces you to sleep in positions that cause or exacerbate lower back pain and neck pain. While a new mattress set is an investment, it is one that will repay you a hundredfold in the form of mental alertness and physical energy that comes from getting restful sleep.

Sleep culprits like neck pain and snoring can often be alleviated with a new pillow. Special posture pillows are available that provide back and neck support, and that can raise your head enough to reduce snoring. A sleep posture pillow may take a period of adjustment, since your body will need to get used to a new position, but the positive effects should kick in within two to three weeks.

Keep in mind that severe snoring can sometimes be a symptom of obstructive sleep apnea, a condition where the tissues at the back of the throat block the airway. This causes the person with sleep apnea to stop breathing for a moment and then awaken. Sleep apnea can cause dozens of awakenings each hour, and can be a life-threatening condition. The bed partner of a person with sleep apnea is often the first to know something is wrong, since he or she can hear the person snoring and hear pauses in breathing, usually followed by a snort or a loud snore.

If you suspect you have sleep apnea, it's important to have the condition properly diagnosed through a sleep study conducted overnight in a sleep lab. Treatment is most often the use of a CPAP (continuous positive airway pressure) machine that pushes air through the throat and into the lungs during sleep. Like a sleep posture pillow, a CPAP machine takes some getting used to. But it's a minor adjustment compared with the benefits of restful sleep.


by Chris Robertson

lower back pain : What is Causing Your Back Pain?

Back pain can be a terrible condition to have to live with, especially when nothing seems to give relief. The cause of back pain is often extremely difficult to diagnose, and it can take months or even years to find complete relief. The first step in treating your back pain is to diagnose the cause of it.

Typically, back pain occurs in two areas, either upper or lower back pain. Many conditions can cause pain in either the upper or the lower back, including injury such as bruising of the soft tissue, muscle pulls, muscle spasms, muscle stiffness, muscle strain or tearing, muscle tension, pinched nerves, sprains, strains, or ligament tearing. When such injuries occur, it is important to see a doctor in order to form a plan for proper treatment.

Other conditions or disorders are made easier to diagnose by the fact that they tend to cause pain in specific areas of the back. Sciatica and Sacroiliac joint dysfunction tend to cause pain in the lower back and hip area. Piriformis Syndrome causes pain in the buttocks area. Pregnancy related back pain typically occurs in the mid to lower back pain.

Once your doctor has diagnosed the cause of your back pain, the two of you can work together to develop a treatment plan. Chiropractic care is also covered by many insurance companies these days, and can be extremely helpful in repairing damage that has occurred over a period of years and may take many months to treat.

When attempting to find the cause of your back pain, patience is a must. Causes of back pain are often difficult to find, but once the cause is known, your doctor can begin treating you to give you some relief.

by Timothy Gorman

lower back pain : Lower Back Pain Relief

As many as 8 out of 10 adults will experience back pain in their lifetime, and most of them will feel it in their lower back. When we consider that our lower back bears the brunt of our body weight, and that our back is made up of many vertebrae, a few discs to absorb shock, several major nerves and joints that allow for movement of the spine, stacked on top of each other, this statistic begins to make more sense.

Back pain is either acute, appearing quickly and intensely after an accident or injury and lasting only a short while, or chronic, recurrent pain that can come seemingly out of nowhere. The direct causes of chronic back pain are rarely obvious – simple movements, arthritis, bad posture, obesity, and internal disorders can all cause our backs to ache.

It is important to try to pinpoint the cause so you can get the most appropriate type of treatment for your low back pain. Doctors often recommend medications for lower back pain relief. Both over-the-counter and prescription medicines can ease lower back pain, and Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), which include aspirin and ibuprofen, can significantly reduce inflammation as well as back pain. Acetaminophen, available in many over-the-counter medicines, acts as an analgesic and is often used to treat acute pain. Occasionally doctors prescribe opioids or muscle relaxants for severe pain, although these can be habit-forming. Once common, doctors prescribe back surgery less often nowadays, which usually involves implanting one of several medical devices to stabilize and fuse the spine.

The medical community is now questioning the efficacy of bed rest, once thought to be essential for healing and lower back pain relief. Medical studies seem to prove just the opposite – that exercise is the real healer. Specific exercises strengthen back muscles, increase flexibility and tone, and pump fluid into back discs, alleviating soreness caused by disc dehydration. Getting up and moving or performing physical therapy can relieve back pain.

Many sufferers say they have experienced lower back pain relief through acupuncture, an ancient Chinese treatment in which needles are placed in specific points on the body. Chiropractic, whose practitioners realign the vertebrae of the spine to correct imbalances in the musculoskeletal system, provides relief for others. Whichever type of treatment one chooses, it is important to remember that there are many causes of lower back pain, and no one treatment will work for everyone.

By Eddie Tobey

lower back pain : Symptoms, Diagnosis and Self-Care

1. Did your pain begin with a fall, a twisting injury or when you lifted an object?

2. Do you have numbness or pain extending down your leg?

3. Do you have a sudden loss of bladder or bowel control, or weakness of a leg?
You may have a slipped disk, or HERNIATED DISK
EMERGENCY
If you have lost bladder or bowel control, call your doctor or be seen in
an emergency room right away.

4. Does the pain stay in your lower back and become worse with twisting or bending?
Your pain may be from MUSCLE SPASM, a PULLED MUSCLE or a COMPRESSED NERVE.
Use heat, an anti-inflammatory medicine, and rest for up to three days. After
improvement, begin abdominal muscle strengthening exercises to prevent future recurrences. If you don't improve, contact your doctor for instructions.

5. Did you have sudden and severe pain with minimal motion or a minimal fall and are you over age 60, or do you have arthritis or some changes in your spine?
You may have a COLLAPSED VERTEBRA or a crushed spine. Though it's extremely painful, it's usually not dangerous.

6. Do you have pain that comes and goes in your lower spine that may have started in your teen years and was possibly aggravated by an injury?
You may have been born with a defect or crack in the spine called SPONDYLOLISTHESIS or SPONDYLOSIS.

7. Do you have a fever?

8. Do you have blood in your urine and one-sided back pain along with burning during urination?
Your symptoms may be from a kidney infection, PYELONEPHRITIS. KIDNEY STONES may start a kidney infection or may cause pain, blood and painful urination without a fever. You may have a viral illness such as the FLU.
Treat yourself with analgesics, and with cold medicine. Consult your doctor if the symptoms are prolonged or severe

9. Do you have a blistering rash and burning pain on your back and chest?
Your pain may be from a viral infection called SHINGLES.

10. Do you have stiffness in the morning or are other joints also stiff, sore, swollen or red?
ANKYLOSING SPONDYLITIS is a form of arthritis that affects the lower back. Other forms of arthritis can also cause lower back pain.
Treat yourself with an anti-inflammatory medicine. Heat also provides comfort. If you do not improve, or if your pain is severe, contact your doctor.

11. Are you pregnant?
pregnancy causes stretching of the ligaments around the uterus and pressure on the
lower back.
Use mild heat to the back only. Consult your doctor if the pain continues or if fever or bleeding accompanies the pain.

12. Is the pain centered in the lower spine and do you have pain radiating down your leg to your knee or ankle?
You may have a ruptured or HERNIATED DISK
Consult your doctor right away.

This tool has been reviewed by doctors and is for general educational purposes only. It is not a substitute for medical advice. The information in this tool should not be relied upon to make decisions about your health. Always consult your family doctor with questions about your individual condition(s) and/or circumstances. Source: American Academy of Family Physicians. Family Health & Medical Guide. Dallas: Word Publishing; 1996.

Copyright © 2006 American Academy of Family Physicians

a common back problem : a common back problem

From top to bottom down the entire length of the spine, at each spinal level nerves exit through holes in the bone of the spine (foramen) on the right side and left side of the spinal column. These nerves are called nerve roots, or radicular nerves. They branch out at each level of the spine and innervate different parts of our body. For example, nerves that exit the cervical spine travel down through the arms, hands and fingers. This is why neck problems that affect a cervical nerve root can cause pain and other symptoms through the arms and hands, and low back pain problems that affect a lumbar nerve root can radiate through the leg and into the foot (sciatica).

As mentioned earlier, there is no spinal cord in the lumbar spine. Because of this, and because the spinal canal is usually fairly spacious in the low back, problems in the lumbosacral region (the lumbar spine and sacral region of the spine) usually cause nerve root problems, not spinal cord injury. Even serious conditions such as a large disc herniation or fracture in the low back are less likely to cause permanent loss of motor function in the legs (paraplegia, or paralysis).

The nerve roots are named for the level of the spine at which they exit. However, nerve roots are not labeled consistently throughout the length of the spine.

In the cervical spine, the nerve root is named according to the LOWER spinal segment that the nerve root runs between. For example, the nerve at the C5-C6 level is called the C6 nerve root.

It is named this way because as it exits the spine the nerve root passes OVER the C6 pedicle (a piece of bone that is part of the spinal segment).
In the lumbar spine, the nerve roots are named according to the UPPER segment that the nerve runs between. For example, the nerve root at the L4-L5 level is called the L4 nerve root.

The nerve root is named this way because as it exits the spine it passes UNDER the L4 pedicle (a piece of bone that is part of the spinal segment).
The area that the naming change occurs is at the C7-T1 level (Thoracic 1), meaning that there are 8 cervical nerve roots and only 7 cervical vertebrae. Here, the C8 nerve exits UNDER the C7 vertebra and OVER the T1 vertebra. From this point down through the upper back, lower back and sacral region, the nerve is named for the upper segment of the spine that the nerve root runs between (and the pedicle it passes UNDER as it exits the spine).

This is part of the picture. However, the doctor may still say that you have a problem with the L5 nerve root at the L4-L5 level. Since we just explained that the L4 nerve root exits at the L4-L5 level, this sounds like a contradiction. However, both statements are correct, and can be explained by the fact that there are two nerve roots at each level.

Two nerve roots at each level
It should be mentioned that two nerves cross each disc level and only one exits the spine (through the foramen) at that level.

Exiting nerve root. The nerve root that exits the spine at a particular level is referred to as the “exiting” nerve root.

Example: The L4 nerve root exits the spine at the L4-L5 level.
Traversing nerve root. Another nerve root goes across the disc and exits the spine at the next level below. It is called the “traversing” nerve root.

Example: The L5 nerve root is the traversing nerve root at the L4-L5 level, and is the exiting nerve root at the L5-S1 level.
A lot of confusion occurs because when a nerve root is compressed by disc herniation or other cause, it is common to refer both to the intervertebral level (where the disc is) and to the nerve root that is affected. Depending on where the disc herniation or protrusion occurs, it may impinge upon either the exiting nerve root or the traversing nerve root. For example:

When the traversing nerve root is affected
In the lumbar spine, there is a weak spot in the disc space that lies right in front of the traversing nerve root, so lumbar discs tend to herniate or leak out and impinge on the traversing nerve root. For example, a typical posterolateral (behind the disc and to the side) lumbar disc herniation at the L4-L5 level often affects the nerve that traverses the L4-L5 level and exits at the L5 level, called the L5 nerve root.

When the exiting nerve root is affected
The opposite is true in the neck. In the cervical spine, the disc tends to herniate to the side (laterally), rather than toward the back and the side (posterolaterally). If the disc material herniates to the side, it would likely compress the exiting nerve root. For example, the C6 nerve root would be affected at the C5-C6 level (because in the neck the exiting nerve root is named for the level below it).

Radiculopathy and sciatica
Another word for the nerve root is “radicular nerve”, and when a herniated disc or prolapsed disc presses on the radicular nerve, this is often referred to as a radiculopathy. Thus, a physician might say that there is herniated disc at the L4-L5 level, creating an L5 radiculopathy or an L4 radiculopathy, depending on where the disc herniation occurs (to the side or to the back of the disc) and which nerve root is affected. The lay term for a radiculopathy in the low back is sciatica.

© 1999-2006 Spine-health.com

lower back pain : Lower back pain symptoms and treatment

Types of low back pain
In the US, low back pain is one of the most common conditions and one of the leading causes of physician visits. In fact, at least four out of five adults will experience low back pain at some point in their lives.
Ironically, the severity of the pain is often unrelated to the extent of physical damage. Muscle spasm from a simple back strain can cause excruciating back pain that can make it difficult to walk or even stand, whereas a large herniated disc or completely degenerated disc can be completely painless.

The causes of low back pain can be very complex, and there are many structures in the low back that can cause pain. The following parts of spinal anatomy can cause pain:

The large nerve roots in the low back that go to the legs and arms may be irritated

The smaller nerves that innervate the spine in the low back may be irritated

The large paired lower back muscles (erector spinae) may be strained

The bones, ligaments or joints may be injured

The intervertebral disc may be injured

It is important to note that many types of low back pain have no known anatomical cause, but the pain is still real and needs to be treated. However, usually low back pain can be linked to a general cause (such as muscle strain) or a specific and diagnosable condition (such as degenerative disc disease or a lumbar herniated disc).

This article provides a review of the most common types of low back pain and related symptoms. The vast majority of lower back pain conditions will get better with time and can be addressed with conservative treatments, such as osteopathic or chiropractic manipulation, physical therapy, pain medications, etc. However, it is important to note that there are a few symptoms that indicate the need for emergency surgery.

Types of lower back pain that indicate a surgical emergency

There are a few symptoms that are possible indications of a serious medical condition requiring surgery, and patients with these symptoms should seek medical attention immediately. These symptoms include:

Sudden bowel and/or bladder incontinence (cauda equina syndrome)

Progressive weakness in the legs (cauda equina syndrome)

Severe, continuous abdominal and low back pain (see abdominal aortic aneurysm)

People with fever and chills, history of cancer with recent weight loss, or who have just suffered a severe trauma should also seek immediate medical attention.

© 1999-2006 Spine-health.com

lower back pain : Common conditions that cause lower back pain

For patients with low back pain that lasts longer than two weeks to three months, or with predominantly leg pain, a more specific and definable problem is often the source of pain. Several types of low back and leg pain tend to be more common in either younger or older adults.

Common types of low back pain for young adults (< 60 years old)

Leg pain and possible numbness
Pain that radiates through the buttocks, as well as pain and possibly numbness that radiates down to the foot, is frequently caused by a disc herniation in the lumbar (lower) spine. This type of pain is usually worse after a long period of standing or sitting.

• See also Lumbar disc herniation

Mechanical low back pain
Low back pain in young adults that is caused by movement (such as bending forward, running) is commonly caused by a syndrome called degenerative disc disease. This condition can result from a twisting injury that weakens the disc. The low back pain symptoms of degenerative disc disease can become chronic and may tend to fluctuate and at times become significantly worse.

• See also Degenerative disc disease

Low back pain (and possibly leg pain) that worsens when standing or walking
Sometimes a vertebral body in the low back slips forward, causing stress on the disc, which in turn may cause low back pain and may sometimes cause leg pain. These painful symptoms are sometimes caused by a stress fracture that occurs at a young age.|

• See also Isthmic spondylolisthesis

Common types of low back pain for older adults (>60 years old)

Low back pain that is worse in the morning and in the evening, and stiffness
Low back pain that is most pronounced first thing in the morning and later in the day is often caused by facet joint osteoarthritis (degenerative arthritis), a condition that involves breakdown of the cartilage between the facet joints in the back. The pain and stiffness is a result of the lack of cartilage between the joints.

• See also Facet joint osteoarthritis

Pain down the legs when walking and standing upright
Leg pain that occurs when walking, and increases with more walking, can be caused by conditions such as lumbar spinal stenosis or degenerative spondylolisthesis. Both conditions place pressure on the nerves at the point where they exit the spine. Standing upright, such as in normal walking, increases pressure on the nerve and results in leg pain.

• See also Lumbar spinal stenosis and Degenerative spondylolisthesis

By: Peter F. Ullrich, Jr., MD
October 1999 (Updated January 3, 2002)

lower back pain : Muscle strain and low back pain

The majority of episodes of acute lower back pain are caused by a muscular strain (such as from lifting a heavy object, a sudden movement or a fall). Even though this doesn’t sound like a serious injury, the low back pain can be very severe and last for several hours, several days or even a couple of weeks.

When the muscles in the back are strained or torn, the area around the muscles can become inflamed. With inflammation the muscles in the back can spasm and cause both severe lower back pain and difficulty moving.

Healing from acute low back pain
Fortunately, muscle strains usually heal with time (a couple of days or weeks) because muscles in the low back have a good blood supply to bring the necessary nutrients and proteins for healing to take place.

However, an episode of low back pain that lasts for more than two weeks can lead to muscle weakness (since using the muscles hurts, the tendency is to avoid using them). This process leads to disuse atrophy (muscle wasting), and subsequent weakening, which in turn causes more low back pain because the muscles are less able to help hold up the spine.

Exercise helps prevent acute low back pain
As a general rule, people who are active and well-conditioned are much less likely to suffer from low back pain due to muscle strain, as regular exercise stretches the muscles so they are less likely to strain, tear or spasm.

There are three types of muscles that support the spine:

Extensors (back muscles and gluteal muscles)

Flexors (abdominal muscles and iliopsoas muscles)

Obliques or Rotators (side muscles)

While some of these muscles are used in everyday life, most do not get adequate exercise from daily activities and tend to weaken with age unless they are specifically exercised. A complete exercise program for the low back should consist of a combination of stretching, strengthening, and aerobic conditioning.

© 1999-2006 Spine-health.com

lower back pain : Lower back pain symptoms and treatment

Types of low back pain
In the US, low back pain is one of the most common conditions and one of the leading causes of physician visits. In fact, at least four out of five adults will experience low back pain at some point in their lives.
Ironically, the severity of the pain is often unrelated to the extent of physical damage. Muscle spasm from a simple back strain can cause excruciating back pain that can make it difficult to walk or even stand, whereas a large herniated disc or completely degenerated disc can be completely painless.

The causes of low back pain can be very complex, and there are many structures in the low back that can cause pain. The following parts of spinal anatomy can cause pain:

The large nerve roots in the low back that go to the legs and arms may be irritated

The smaller nerves that innervate the spine in the low back may be irritated

The large paired lower back muscles (erector spinae) may be strained

The bones, ligaments or joints may be injured

The intervertebral disc may be injured

It is important to note that many types of low back pain have no known anatomical cause, but the pain is still real and needs to be treated. However, usually low back pain can be linked to a general cause (such as muscle strain) or a specific and diagnosable condition (such as degenerative disc disease or a lumbar herniated disc).

This article provides a review of the most common types of low back pain and related symptoms. The vast majority of lower back pain conditions will get better with time and can be addressed with conservative treatments, such as osteopathic or chiropractic manipulation, physical therapy, pain medications, etc. However, it is important to note that there are a few symptoms that indicate the need for emergency surgery.

Types of lower back pain that indicate a surgical emergency

There are a few symptoms that are possible indications of a serious medical condition requiring surgery, and patients with these symptoms should seek medical attention immediately. These symptoms include:

Sudden bowel and/or bladder incontinence (cauda equina syndrome)

Progressive weakness in the legs (cauda equina syndrome)

Severe, continuous abdominal and low back pain (see abdominal aortic aneurysm)

People with fever and chills, history of cancer with recent weight loss, or who have just suffered a severe trauma should also seek immediate medical attention.
Acute low back pain caused by muscle strain

© 1999-2006 Spine-health.com

lower back pain : Solving the Perplexing Puzzle of Back Pain

An estimated eight out of ten people in the United States will injure their back at some point during their lives. Few of these problems will require extended treatment, but back problems are invariably painful.

Managing and relieving back pain is not a simple process. The experience of pain is subjective; it cannot be measured from the outside. Health providers who treat back pain find it challenging to obtain the objective or measurable signs that verify and diagnose a patient's painful back symptoms.

Additionally, everyone's experience of pain is different. Pain descriptors encompass numerous adjectives - dull, sharp, throbbing, pulsating, stabbing and shock-like, just to name a few.

People experience and describe pain so differently partly due to its varied and complex origins. In fact, pain originates from numerous places in the body, such as muscles, bones, nerves, organs or blood vessels.

Pain is also described as acute or chronic. The word "acute" derives from the Latin word for needles and is usually described as a severe, sharp sensation. The initial stage of an injury is called the acute phase.

The word "chronic", on the other hand, originated from the Greek word for time. Chronic pain is pain that persists after a length of time, often months to years. Many back injuries tend to become chronic, especially when not treated properly during the acute phase. Chronic pain is often experienced as a dull ache or constant nagging irritant.

Acute and chronic pain sensations also travel different nervous system pathways inside the body. When you injure muscles or ligaments in your back, nerve endings called pain receptors pick up the pain impulses and transmit them to the spinal cord. From here, the pain message ascends to the brain. This process takes place at varying rates of speed depending on the size of the nerve fiber involved.

Acute pain tends to travel on faster, larger diameter fibers, while chronic pain prefers smaller, slower pain fibers. Experts suggest that chronic pain affects the brain's limbic system, which is associated with emotional states. Anyone who has ever had a long-term painful injury knows that negative or distressing emotions may accompany or perpetuate the initial injury.

The best way to treat chronic back pain syndromes is to prevent them. Although proficient early treatment does not always prevent an acute injury from turning into a chronic problem, it is a good insurance policy. Early treatment is especially important with injuries to the soft tissues (muscles, tendons and ligaments) to prevent them from becoming weaker, less elastic and more pain-sensitive.

One of the best ways to treat both acute and chronic soft tissue injuries is a hands-on approach that works to repair the injured tissues. Some examples are joint and soft tissue manipulation and mobilization, typically performed by a doctor of chiropractic or osteopath. Other good options are massage and physical therapy. A formal rehabilitation program at a health club or therapy clinic may also help to strengthen weakened and damaged muscles, especially the core stabilizers of the back.

By Arnel Ricafranca

lower back pain : Treating Back Pain Inexpensively

Some physiologists often claim that we human beings pay for our upright posture with painful back problems. Yet it's never socially acceptable or practical to crawl or walk on all fours. We are so unlike our upright distant ancestors who strengthened their posture is by running, hunting and gathering. We sit at workplaces or desks or drive cars, trucks, or busses more than we run or stretch. So, it is only inevitable that the back and stomach muscles that hold our spine in place have become weak.

Back problems are easy to recognize and can be quite common among the young and the old. The usual symptom is an unceasing aching along the spine or a crippling pain in the neck area or on the upper or lower back. The pain is aggravated particularly when bending to lift a heavy object or taking part in strenuous movements. For some people, simply standing up can trigger lower back pain.

Back pain is usually caused by weak or stressed back or abdominal muscles. An x-ray can reveal a herniated disk, which is the bulge in one of the cushion light shock absorbers that separates each of the 24 vertebrae. When the disk presses against the nerve, it can cause pain. Other underlying causes of back pain include a poor diet, weak bones made weaker by the lack of calcium, the lack of physical exercise, strain of pregnancy, wrong lifting techniques and poor posture.

You can take a variety of vitamin and mineral supplements to help ease back pain. The most important supplement to take would be 600 mg of calcium daily before bedtime to strengthen the bones. In addition, 1000 mg of vitamin C daily can also strengthen the bones and cartilage while 400 IU daily of vitamin D enhances calcium absorption. The effect of calcium is also enhanced by taking additional magnesium and manganese. A small amount of boron taken daily is also helpful in rebuilding damaged or brittle bones. Bromelain, an enzyme derived from pineapples, taken three times daily can help reduce inflammation and pain. Glucosamine sulfate taken after each meal can strengthen cartilage and spinal discs. Omega-3 fish oil is can also help ease back pain. If you prefer the natural method, white willow extract taken three times a day can relieve back pain like aspirin.

To support your vitamin regimen, regular exercise can boost muscle flexibility and strength. Walking and swimming are your best bets to help reduce back pain. A simple exercise that you can to is to lie down and draw your knees up to your chest. Then stretch out and relax. Repeat this several times unless pain strikes.

When you feel excruciating pain, it is advisable to take only one or two days of bed rest. You must make the effort to slowly become more active as much as possible. Use a hot water bag or heating pad on the site of the pain before taking any medication for it. Sometimes, an ice bag placed on the site of the pain five minutes at a time can also help reduce the inflammation. Do some gentle stretches and stop smoking to speed up healing. Try to add more calcium-containing foods to your diet like broccoli, story genes, salmon, Pinto beans and almonds. If you're not allergic or intolerant, milk is also a good calcium source. Put aside tight fitting jeans and slacks in favor of loose-fitting garments that permit free and normal movement. You may also have to give up wearing high heels unless your doctor allows it. When lifting objects, remember to bend your knees and keep the object is near to your body as possible. At night, sleep on a firm mattress on your side or back, never on your belly.

At work, stand up and stretch frequently to break the monotony of sitting. Make sure your chair supports your lower back when you were seated. When your back pain is accompanied by a fever or vomiting, see your doctor immediately and get a second opinion when he suggests surgery.

by Michael Russell

lower back pain : Lower Back Pain Remedies - Chinese Style

Traditional Chinese Medicine (TCM), with its 2500 year old history, offers many lower back pain remedies - lower back stretches, lower back strengthening exercises, massage techniques, acupuncture, herbal remedies, liniments, sticking plasters and others. Some require a trained TCM practitioner to administer them, while others can be easily learnt and applied by anyone. This article introduces the latter - simple, effective lower back pain remedies and stretches for lower back pain that YOU can apply yourself to relieve and prevent lower back pain.

Lower Back Stretches

Breath slowly, smoothly and deeply through your nose while doing the exercises.

Exercise 1. Lie on your back on a firm bed or the floor. Gently bring your knees up until they're above your abdominal area. Spread your knees a little and grab the inside of your shins just below your knees, or the inside of your ankles if you can. Inhale. As you exhale let your knees naturally fall further out to the side with gravity. Focus your mind on your lower back (closing your eyes helps). Feel your inner thighs stretching and your lower back relaxing. Hold the position for a few minutes as you continue to breath slowly, smoothly and deeply. This exercise stretches and relaxes your iliopsoas muscle which connects from your lumbar vertebrae to the inside of your hip joints. Tension in this muscle often causes and/or aggravates lower back pain.

Exercise 2. Lie flat on your back on a firm bed or the floor. Bend your knees and slide your feet up till they are near your backside. Inhale. As you exhale, flatten your lower back by gently pressing it into the bed or floor. Hold for several seconds, then let your lower back return to its natural, curved position. Repeat 3 or 4 times, several times a day.

Exercise 3. Lean across a table and grab the far edge with both hands. Your torso should be on the table and your legs hanging from the edge. Inhale. As you exhale, let gravity naturally pull your legs down towards the floor. Feel your lower back stretching. Hold the position for several minutes as you continue slow, deep breathing. Focus your mind on your lower back (closing your eyes helps) and imagine the pain releasing with each exhalation. Repeat several times a day.

For more lower back stretches as well as lower back strengthening exercises, try these:

http://chinese-holistic-health-exercises.com/back-stretching-exercises.html

Lower Back Pain Remedies

1. Ginger & Sesame Oil Liniment

Mix together equal parts of pure sesame oil and the juice from grated ginger. Heat in a pot till warm. Apply a small amount to the painful area and rub it in for a couple of minutes. It should be applied to unbroken skin only. Ginger and sesame oil liniment is a superb, easy-to-make, home remedy for back ache and other aches and pains. It warms, circulates your blood and stops pain. You can safely apply it several times a day, particularly after showering and before bed. Make sure you pull your clothing down over your lower back immediately afterwards to keep the area warm. Also, while it's normal for your skin to become hot and turn red after you apply the liniment, if a rash develops discontinue use.

2. Lower Back Self-Massage

Can be done standing or sitting. With fists clenched (not too tightly), use the backs of your hands, including your knuckles, to vigorously rub your lower back up and down for several minutes, 3 or 4 times a day. Rub close to your spine and also the sides of your lower back - where ever you experience pain and stiffness. Self-massage is a highly beneficial lower back pain remedy you can do anytime, anywhere to relieve AND prevent lower back pain. Massage warms the area, moves the blood and directly stimulates your kidneys, which helps to maintain a strong, healthy lower back.

Tip: To greatly enhance the effects of the above lower back pain remedies and lower back stretches, combine them. For example, lie down and do the first 2 stretches, then stand up and do the lower back self-massage, then apply some Ginger & Sesame Oil Liniment. You know your body best though, so experiment till you find what works best for your particular situation. For more lower back pain remedies and lower back stretches visit the authors website.

By Matthew Scott

lower back pain : Solve Your Back Pain

Your back supports you. Backache is responsible for many a day taken off sick and much misery. Of course with any mechanical problem, helping that problem mechanically is important. For instance, if one of your vertebrae, or backbones, is out of place, it makes sense to get it back pain in place in order to prevent further damage. Individual vertebrae and the cushioning discs in between them are subject to wear and tear. And it is important to take action to minimize this damage. Pain is there to make sure that you do something about it.

For a mechanical back problem, getting your back a massage by an experienced professional massage therapist could remove the problem. It may simply reduce the problem, which is also good. With a regular massage, your back can be kept supple and strong. Sometimes the legs or neck contribute as well, and they may need a massage too. And there are also some special places such as on your chest that help your body with flushing out toxins, and they often need to be massaged to remove toxins. These toxins collect when produced by unhappy muscles strained by the wrong positions of the backbones. The are removed via your lymphatic system, which is the body internal effluent system.

You may prefer to visit an osteopath or chiropractor to put your back right. Osteopathy or chiropractic involves structural manipulation of the joints to put them back in place. This is often accompanied by a cracking sound as the joints go back to the right position. Some people choose a combination of visiting an osteopath or chiropractor and a massage therapist, in order to pay equal attention to joints and muscles.

Another option, and none of these is mutually exclusive, is to visit a physiotherapist. Good physiotherapists are hard to find, and help you rehabilitate your body. A good physiotherapist uses a combination of manipulations, stretches and exercises to ease tension, move bones back into place and strengthen weakened muscles that are needed to support your back.

Some prefer an exercise instructor or personal trainer for strengthening the back. This helps prevent further injury and may even re-balance the position of the joints.

Additionally, being free from negative emotions results in over-tense muscles relaxing, allowing the right muscles to strongly hold up your back. Techniques such as EFT, or Emotional Freedom Techniques, are a very easy-to learn and cost-effective way of removing the emotional contributor to a physical pain. A good EFT practitioner will work with all the emotional root causes and free your muscle tension, releasing the joints to a better position. Then your EFT practitioner teaches you how you can do this for yourself.

Ideally, a combination of strategies is best; one for mechanical manipulation, exercise rehabilitation, and emotional freedom. Done properly, it need not cost the earth, and you benefit from a stronger back and calmer mind.

Complementary and alternative health education and empowerment is my passion. My name is Suzanne Zacharia and I am committed to empowering people to take conrol of their health and wellness.

A virus caught along with 5 other students at university at the end of 1986, plus medical negligence, meant that I got smokers lung at a relatively young age. In desperation for help with my symptoms and quality of life, I turned to complementary therapy, and this is the 11th year I have outlived one doctor's prognosis.

By Suzanne Zacharia

lower back pain : Lower Back Care

Many people have pain in different areas of their body including their lower back. There's a variety of medical issues that can cause pain. Many type of lower back pain are caused by injury and generally do not last long. You can know what to do about the uncomfortable pain in your lower back by trying to eliminate the factors that cause it, and by the length of time its been going on. The pain can be dealt with, and you can find a way to live with it.

There's are a lot of reasons that you might be experiencing back pain. The body is a complicated machine, so it might take you a lot of investigation and deduction on finding out the cause for the pain in your lower back. The back is a long and complex structure that helps us remain upright, helps us sit, and keeps us balanced when we walk. An acute condition is when pain erupts from your back that is sudden and usually related to an injury in the lower back. Chronic pain is found in on going medical problems that are more than likely related to disease or an injury from the past.

Traumatic injury occurs from situations like lifting something incorrectly, or suddenly reaching for an item that makes you stretch too far. When the back is tight, overstretching it cause acute pain. Lots of injuries occur at work in the lower back, but don't be fooled that it can't happen at home either. The back in involved whenever we try to lift or carry anything. A sprain or strain in your lower back happens when you damage muscles, tendons or ligaments in your lower back. There is usually a dull aching pain, and sharp pain when moving about. You can relieve the pain by lying in a prone position and apply ice or heat.

On-going long term pain can be due to several conditions. If you're an elderly person, know that the disc in the spine become rigid and looses elasticity as you age. The discs are jelly-like sacs filled with fluid that help to cushion the vertebrae. As we age, these discs start to dry out and loose their elasticity. Osteoarthritis and osteoporosis are two of the top reasons pain develops in the lower back for the aged. Pain sensations can be sharp or a continual dull ache. Other types of diseases and birth defects can cause pain, so be sure to let your doctor know if its been going on for longer than 3 months. A chronic condition involving pain needs to be treated, so you can live a more productive life.

Taking care of yourself is a necessity if you want to live an active and pain-free life. You can use a few precautions and healthy life-style choices by not gaining weight, having poor posture, or sleeping in awkward positions. Excess weight puts strain on the back so watch your weight, and poor posture especially when you're sitting, pulls the muscles and ligaments out of their natural position from the spine. An unnatural sleeping position does the same pulling on your lower back that poor posture does while you're awake. Caring for your lower back is not all that hard, and it is the least you can do for your hard working back.

By Dean Novosat

lower back pain : Lower Back Pain Treatments

There are many different exercises and stretches you can do for lower back pain treatment. Lower back pain is one of the most common ailments and results in many hours of lost-time at work each year. It doesn't matter what age you are, back pain can be a problem. Lower back pain treatment can be in the form of exercise and physical therapy or professional treatment, as it all depends on the severity of the back problem. The back is one of the most important areas of the body to keep healthy in order to have the ability to move around without pain.

One of the most effective things you can do if you feel a bit of strain in your back is simple stretches. By stretching your back and abdomen muscles, those muscles will become stronger. When those muscles are strengthened there is less chance of the occurrence of back troubles considering the strength of the muscles to begin with. Lower back pain treatment, in terms of stretching, will also loosen the muscle-up making them warm and letting the blood flow throughout the muscle. There are many different types of stretches for lower back pain treatment. You doctor will be able to suggest several that should help you. Yoga stretching exercises have been proven to help strengthen back muscles and relieve much of the back pain.

If stretching isn't working, you may consider consulting a chiropractor. Many times lower back pain can be caused by different parts of the back not being properly aligned. This is called a subluxation. By consulting a chiropractor they can tell you if everything in your back is how it should be. Not being aligned is one of the biggest causes of back problems. Lower back pain treatment is a specialty of many chiropractors as there are so many back problems that people have. Chiropractic treatments have been proven to bring immediate relief for many types of lower back pain.

If you are feeling pain in your back because of an injury try applying ice to the area first. By applying ice, you will reduce any swelling that can occur from an injury. After a day or two, apply heat to the injured area. Using heat loosens up the back and causes the back to become less stiff. This form of treatment generally alleviates the pain at first but finding out what is wrong with your back will only help the healing process in the long run.

The last option is surgery. This is definitely the final option if stretching and exercises do not work. Surgery for lower back pain treatment is only contemplated if there are no other option or if the other options do not work. Any type of surgery comes with risks so it's important to be certain that it's the only choice that is left. Lower back pain treatment is all about alleviating the discomfort you feel in the back which can be the most uncomfortable and annoying back problem. If stretching and exercising do not work something more drastic such as surgery may be your best option.

By Dean Novosat