LowBackPain

DESCRIPTION:Eightypercentofadultswillexperiencesignificantlowbackpainsometimeduringtheirlifetime.Lowbackpainusuallyinvolvesmusclespasmofthesupportivemusclesalongthespine.Also,pain,numbnessandtinglinginthebuttocksorlowerextremitycanberelatedtotheback.Therearemultiplecausesoflowbackpain(seebelow).Preventionoflowbackpainisextremelyimportant,assymptomscanrecuronmorethanoneoccasion.COMMONCAUSES:Musclestrain.Themusclesofthelowbackprovidethestrengthandmobilityforallactivitiesofdailyliving.Strainsoccurwhenamuscleisoverworkedorweak.Ligamentsprain.Ligamentsconnectthespinalvertebraeandprovidestabilityforthelowback.Theycanbeinjuredwithasudden,forcefulmovementorprolongedstress.Poorposture.Poorposturalalignment(suchasslouchinginfrontoftheTVorsittinghunchedoveradesk)createsmuscularfatigue,jointcompression,andstressesthediscsthatcushionyourvertebrae.Yearsofabusecancausemuscularimbalancessuchastightnessandweakness,whichalsocausepain.Age.“Wearandtear”andinheritedfactorsmaycausedegenerativechangesinthediscs(calleddegenerativediscdisease),andjointdegenerationofthefacetjointsofthespine(calleddegenerativejointdisease).Normalagingcausesdecreasedbonedensity,strengthandelasticityofmusclesandligaments.Theseeffectscanbeminimizedbyregularexercise,properliftingandmovingtechniques,propernutritionandbodycomposition,andavoidanceofsmoking.Discbulge.orherniation,cancausepressureonanerve,whichcanradiatepaindowntheleg.Thisgenerallyrespondswelltoastrengtheningandstretchingprogramandrarelyrequiressurgery.Othercausesoflowbackpainincludebladder/kidneyinfection,endometriosis,cancer,orovarianproblems.TREATMENT:REST:Restfromaggravatingactivity.Avoidprolongedsitting,driving,bending,heavyliftingandtwisting.ICE:Iceappliedtothelowbackfor15minutesevery1–2hoursishelpfulinreducingpainandspasm.Avoidusingheatforthefirst48hoursofanacuteinjury.NSAIDs:Yourdoctormayprescribeanti-inflammatorymedicationsuchasaspirin,advil,aleve,ibuprofenornaproxensodium.EARLYEXERCISE:Gentleexerciseformobilityandstretching(especiallythemusclesofthelegsandback)canhelpdecreasetheseverity,durationandrecurrenceoflowbackpain.Trythesuggestedexercisesonthebackofthissheet.Donotperformexercisesthatincreaseyourpain.POSITIONING:Modifyingyoursleepingpositioncanhelpeasestraintoyourlowback.Makesureyourbedisfirmenoughtogiveyouadequatesupport,anduseasmallpillowforyouhead.Ifyousleeponyourback,tryputtingapillowunderyourknees.Orifyouprefertosleepsidelying,putapillowbetweenyourthighsandifyouaresidebent,afoldedtowelunderyourwaistline.PREVENTION:Oncetheseverityofpainhasdecreased,arehabilitationprogramtostrengthenyourhip,abdominalandbackmusclescanhelppreventrecurrences.Posture!Posture!Posture!Thegoalisneutralspine,notslumpedorover-arched.Properliftingandbodymechanics.Seeyourhealthcareproviderifyouhavethefollowing:significantpainthatpersistsbeyondaweek,unexplainedfever,unexplainedweightloss,rednessorswellingonthebackorspine,pain/numbness/tinglingthattravelsdowntheleg(s)belowtheknee,legweakness,bowelorbladderproblems,orbackpainduetoaseverebloworfall.Ifyoursymptomsdonotresolvewithin2-4weekspleasecontactyourclinician.BASICEXERCISESFORTHELOWBACKPerformtheseexercisesslowly,withoutforcingmovement.Besuretobreathethroughouttheexercises.Youshouldfeelaslightstretch,however,donotmoveintopain.Yoursymptomsshouldnotintensifyasaresultofdoingyourexercises.Performtheexercises2-3timesdaily.Hamstrings(fig.1)Lyingonfloor,pullthightowardsyourchesttoabout90.Straightenyourkneeuntilastretchisfeltinbackofthigh.Hold1minute.Repeatwithoppositeleg.SingleKneetoChest(fig.2)Pullkneeintochestuntilacomfortablestretchisfeltinhipandlowerback.Hold15seconds.Repeatwithoppositeleg.Repeat5-10timeseachleg.PelvicTilt(fig.3)Flattenbackbytighteningstomachandbuttockmuscles.Hold10seconds.Repeat10times.CatandCamel(fig.4)Onallfours,assumea“hump”backpositionbyarchingthebackup.Holdbrieflyandthenslowlylowerthebackintoasaggingposition.Repeat10-15times.HipFlexors(fig.5)Lyingonyouback,pullonekneetothechesttokeepthebackflat.Allowtheoppositethightodropovertheedgeofthebed.Donotallowthethightomoveawayfromthemidlineorrotate.Hold30seconds.Repeat2timeseachleg.PropUponElbows(fig.6)Onfirmsurface,lyingonyourstomach,propuponyourelbows.Keeppelvis,hipsandlegsrelaxed.Ifproppingonelbowsispainful,tryonlylyingonstomachorwithapillowunderyourabdomen.Hold30seconds.Repeat3-5times.TailWag(fig.7)Onallfourswithbackmaintainedinneutralposition,gentlymovehipstowardribcagetosidebendtrunk.Holdbriefly,thenalternateanddootherside.Repeat10-15times.LumbarRotation(fig.8)Slowlyrockkneesfromsidetosideinapainfreerangeofmotion.Allowbacktorotateslightly.Repeat10-15times.↓stretchfrontofhipRev9/11