Low Back Pain
Almost everyone experiences back pain at some time in their life. Low back pain is the second most common neurological ailment in the U.S., behind headaches. It’s also the second most common reason people see their doctor, behind colds and flu.
Most back pain is caused by muscle weakness resulting from a combination of overuse, muscle strain and injury to the muscles, ligaments and discs in the back. The pain usually follows an injury to the back, but pain may be caused by degenerative conditions such as arthritis, osteoporosis or other bone diseases, viral infections or congenital abnormalities.
You are at risk for back pain if you:
- Are older than 30.
- Are pregnant.
- Feel stressed or depressed.
- Have a low tolerance for pain.
- Have arthritis or osteoporosis.
- Have bad posture.
- Smoke, don’t exercise or are overweight.
- Have a job that requires a lot of heavy lifting, bending or twisting, or whole body vibration (like driving a truck or using a sandblaster).
Pain may be acute, lasting less than one month, or chronic, lasting more than three months. Occasionally, low-back pain may indicate a more serious medical problem. If pain lasts more than three months, see a physician to rule out serious problems. Similarly, call your doctor if your back pain is accompanied by fever; redness or swelling on the back or spine; pain traveling down your legs below the knee; weakness or numbness in your buttocks, thigh, leg or pelvis; burning with urination or blood in your urine; worse pain when you lie down or pain that wakes you at night; very sharp pain, or bladder or bowel incontinence. Also consult a doctor if your pain was the result of a severe blow or fall.
Your doctor may send you to a physical therapist to alleviate symptoms and strengthen your muscles. If your pain lasts longer than one month, your doctor may refer you to an orthopedist (bone specialist) or neurologist (nerve specialist).
Most back pain, however, does not require a doctor’s intervention and will go away on its own. In the meantime, minimize physical activity only in the first few days to reduce inflammation and calm symptoms. For the first six weeks after pain begins, avoid activities and exercise that involve heavy lifting or twisting, such as football, golf, ballet, lifting weights and jogging. After two or three weeks, resume light cardiovascular exercise such as walking, riding a stationary bike or swimming. These exercises promote healing by improving blood flow and strengthening the muscles in your stomach and back.
You may want to apply ice to the injured area for the first 48 to 72 hours; after that, apply heat. Over-the-counter medications such as ibuprofen or acetaminophen help reduce pain and inflammation. While sleeping, try lying on your side in the fetal position with a pillow between your legs, or lie on your back with a pillow underneath your legs.
In some cases, surgery may be needed to treat chronic back pain. Surgical procedures include:
- Spinal fusion to “weld” vertebrae together into a single, solid bone.
- Disc replacement that removes the damage disc, replacing it with artificial parts.
- Spinal laminectomy that removes damaged parts of the lamina and opens the spinal column.
To reduce the likelihood of experiencing back pain, follow these recommendations:
- Exercise regularly, and always stretch beforehand.
- Maintain proper posture and avoid slouching.
- Make sure your work surface is at a comfortable height.
- Sit in a chair with good lumbar support and proper position and height for the task. Switch sitting positions often and take breaks to walk around or stretch.
- Wear comfortable, low-heeled shoes.
- Avoid lifting very heavy objects. When you do lift heavy objects, lift with your knees, keep your head down and in line with your back, and keep the object close to your body.
- Don’t smoke, as it reduces blood flow to the lower spine and causes disc degeneration.