This Web site provides general educational information on health-related issues and provides access to health-related resources for the convenience of our users. This site and its health-related information and resources are not a substitute for professional medical advice or for the care that patients receive from their physicians or other health care providers.
Athletes are at greater risk of sustaining a lumber spine injury due to physical activity. Whether the sport is skiing, basketball, football, gymnastics, soccer, running, golf, or tennis-the spine undergoes a lot of stress, absorption of pressure, twisting, turning, and even bodily impact. This strenuous activity puts stress on the back that can cause injury to even the finest and most fit athletes.
The only activity performed on a regular basis that fully extends the hip is walking and running. Hence as activity levels decrease so does the ability to extend the hip. This results in compensatory pelvic tilting and lumbar extension, with a reduction in the ability to accommodate uneven ground, negotiate obstacles, or attempt to change walking speed quickly. The compensatory pelvic tilt that accompanies tight hip flexors also predisposes the individual to postural problems and back pain. Hip stretches done on a regular basis can help you maintain extension range of motion and thereby improve function.
Neglect your lower body too often and you risk losing mobility — that thing that allows you to plop down on the floor to play with your kids, or get up and out of even the cushiest chair with ease. “A lot of people sit all day, so they’re not necessarily using their glute muscles,” says Daily Burn Fitness/Nutrition Coach Allie Whitesides. “And a lot of people are in the car all the time, so we’re not using our leg muscles much, either.”
^ Chou R, Loeser JD, Owens DK, Rosenquist RW, Atlas SJ, Baisden J, Carragee EJ, Grabois M, Murphy DR, Resnick DK, Stanos SP, Shaffer WO, Wall EM, American Pain Society Low Back Pain Guideline Panel (2009). "Interventional therapies, surgery, and interdisciplinary rehabilitation for low back pain: An evidence-based clinical practice guideline from the American Pain Society". Spine. 34 (10): 1066–77. doi:10.1097/BRS.0b013e3181a1390d. PMID 19363457.
Swimming is a low impact form of exercise that can help to relieve the pressure on your joints. It’s thought that water aerobics may help to reduce the impact on your joints by up to 75%!2 Be careful though; start with a beginner’s class and always do only what you’re comfortable with – try to avoid over-exercising or pushing your muscles too far!
Compressive pain is a result of pressure or irritation on the spinal cord, nerves that leave the spine. For example, if an intervertebral disc herniates (usually called a ruptured disc) and pushes into the spinal canal, it can cause problems with the nerve. Usually this pressure or irritation causes pain, numbness, and muscle weakness where the nerve travels.
Long periods of inactivity in bed are no longer recommended, as this treatment may actually slow recovery. Spinal manipulation for periods of up to one month has been found to be helpful in some patients who do not have signs of nerve irritation. Future injury is avoided by using back-protection techniques during activities and support devices as needed at home or work.
The treatment of lumbar strain consists of resting the back (to avoid reinjury), medications to relieve pain and muscle spasm, local heat applications, massage, and eventual (after the acute episode resolves) reconditioning exercises to strengthen the low back and abdominal muscles. Initial treatment at home might include heat application, acetaminophen (Tylenol) or ibuprofen (Advil, Motrin), and avoiding reinjury and heavy lifting. Prescription medications that are sometimes used for acute low back pain include anti-inflammatory medications, such as sulindac (Clinoril), naproxen (Naprosyn), and ketorolac (Toradol) by injection or by mouth, muscle relaxants, such as carisoprodol (Soma), cyclobenzaprine (Flexeril), methocarbamol (Robaxin), and metaxalone (Skelaxin), as well as analgesics, such as tramadol (Ultram).
Subacute low back pain. Lasting between 6 weeks and 3 months, this type of pain is usually mechanical in nature (such as a muscle strain or joint pain) but is prolonged. At this point, a medical workup may be considered, and is advisable if the pain is severe and limits one’s ability to participate in activities of daily living, sleeping, and working.
How to: Lie on your back with your right knee bent and foot flat on the floor (a). Extend your left leg up to the ceiling and wrap a strap around the sole of your left foot (b). While holding both ends with your left hand, extend your right arm directly out to the side in order to anchor yourself (c). Slowly let the left leg fall toward the left while keeping your right side grounded. Hold for six to eight breaths, then repeat on the opposite side.
Whether you lift heavy items for your job or simply have a slipped disk from a pesky athletic injury, lower back pain is likely to plague you at some point in your life. Low back pain can result from an acute injury or from chronic overuse that leads to arthritis. This, in turn, can break down the fluid-filled disks in your spine that act as shock absorbers. Whatever the cause, there are some practices you can do to strengthen your back and keep lower back pain at bay.
Imaging is indicated when there are red flags, ongoing neurological symptoms that do not resolve, or ongoing or worsening pain. In particular, early use of imaging (either MRI or CT) is recommended for suspected cancer, infection, or cauda equina syndrome. MRI is slightly better than CT for identifying disc disease; the two technologies are equally useful for diagnosing spinal stenosis. Only a few physical diagnostic tests are helpful. The straight leg raise test is almost always positive in those with disc herniation. Lumbar provocative discography may be useful to identify a specific disc causing pain in those with chronic high levels of low back pain. Similarly, therapeutic procedures such as nerve blocks can be used to determine a specific source of pain. Some evidence supports the use of facet joint injections, transforminal epidural injections and sacroilliac injections as diagnostic tests. Most other physical tests, such as evaluating for scoliosis, muscle weakness or wasting, and impaired reflexes, are of little use.
You’ve heard the saying: it’s all in the hips, but for many of us, our hips – or more precisely, our hip flexors – are tight, stiff and inflexible. If you’re an office worker you can probably thank sitting down at your desk 8 or more hours a day for your tight hip flexors. Habitual sitting causes your hip flexors to tighten and shorten – adjustable standing desks, anyone?
The more than 20 muscles that make up your hips are responsible for stabilizing your pelvis, moving your legs from side to side, and shortening to draw your knees toward your chest every time you sit down, run, jump or pedal, explains Kelly Moore, a certified yoga instructor and co-founder of Mindfuel Wellness, which brings health and wellness initiatives to companies throughout Chicago.
2016 — More editing, more! Added some better information about pain being a poor indicator, and the role of myofascial trigger points. This article has become extremely busy in the last couple months — about 4,000 readers per day, as described here — so I am really polishing it and making sure that it’s the best possible answer to people’s fears about back pain.
At the start of the 20th century, physicians thought low back pain was caused by inflammation of or damage to the nerves, with neuralgia and neuritis frequently mentioned by them in the medical literature of the time. The popularity of such proposed causes decreased during the 20th century. In the early 20th century, American neurosurgeon Harvey Williams Cushing increased the acceptance of surgical treatments for low back pain. In the 1920s and 1930s, new theories of the cause arose, with physicians proposing a combination of nervous system and psychological disorders such as nerve weakness (neurasthenia) and female hysteria. Muscular rheumatism (now called fibromyalgia) was also cited with increasing frequency.
The multifidus muscles run up and down along the back of the spine, and are important for keeping the spine straight and stable during many common movements such as sitting, walking and lifting. A problem with these muscles is often found in someone with chronic low back pain, because the back pain causes the person to use the back muscles improperly in trying to avoid the pain. The problem with the multifidus muscles continues even after the pain goes away, and is probably an important reason why the pain comes back. Teaching people with chronic low back pain how to use these muscles is recommended as part of a recovery program.
So if you’re doing abs exercises and you feel like your hip flexors are putting in more work, refocus and dial in on the muscles you’re trying to target. It might sound trite to just “think” about a muscle working as you’re doing an exercise (for example, thinking about your abs contracting as you do a sit-up), but it might actually prevent you from mindlessly grinding out reps with poor form.
Physical activity can also help you feel better. “Along with boosting your overall health, exercise can improve your OA symptoms” like pain, stiffness, fatigue, and even depression, says Leigh F. Callahan, PhD, associate director of the University of North Carolina Thurston Arthritis Research Center. One study found that people with knee OA who worked out regularly lowered their pain by 12% compared to those who didn’t.
Lay on your back on your mat and pull your knees to your chest. Place your hands on the inside arches of your feet and open your knees wider than shoulder-width apart. Keeping your back pressed into the mat as much as possible, press your feet into hands while pulling down on feet, creating resistance. Breathe deeply and hold for at least 30 seconds.
In diagnosing the causes of hip pain, it’s important to understand hip anatomy. The hip is basically a ball-and-socket joint similar to the shoulder joint and the arms. The hip joint is impressive in that it serves two factors, it is a support structure and also very flexible. Because it is a strong support structure, it tends to get injured. Because it’s very flexible, it similarly can be susceptible to injuries.
Nerve irritation: The nerves of the lumbar spine can be irritated by mechanical pressure (impingement) by bone or other tissues, or from disease, anywhere along their paths -- from their roots at the spinal cord to the skin surface. These conditions include lumbar disc disease (radiculopathy), bony encroachment, and inflammation of the nerves caused by a viral infection (shingles). See descriptions of these conditions below.
Spinal fusion eliminates motion between vertebral segments. It is an option when motion is the source of pain. For example, your doctor may recommend spinal fusion if you have spinal instability, a curvature (scoliosis), or severe degeneration of one or more of your disks. The theory is that if the painful spine segments do not move, they should not hurt.
Why is back pain still a huge problem? Maybe this: “It is extremely difficult to alter the potentially disabling belief among the lay public that low back pain has a structural mechanical cause. An important reason for this is that this belief continues to be regularly reinforced by the conditions of care of a range of ‘hands-on’ providers, for whom idiosyncratic variations of that view are fundamental to their professional existence.”
5. Feel free as a bird. Open up those hips with yoga’s pigeon pose! Start on all fours with hands below the shoulders and knees below the hips. Bring the right knee forward until it touches the right hand and place the leg flat on the ground across the body (the right foot is now on the left side of the body, parallel to the front of the mat). Drop left leg to the ground, and extend it back with toes turned under. Keep the hips level, inhale, and walk hands forward. Exhale, and fold the torso over, lowering elbows to the floor. Stay in this position for 5-10 breaths before coming back up to switch sides.