MRI and x-ray for low back pain are surprisingly unreliable,1 because things like bulging discs usually aren’t a deal,2 most back pain goes away on its own,3 and trigger points (“muscle knots”) are common and can be alarmingly intense but aren’t dangerous.4 Most patients are much better off when they feel confident about these things. The power of justified, rational confidence is a huge factor in back pain.5 Sadly, many healthcare professionals continue to perpetuate the idea of fragile backs,6 which undermines that valuable confidence.
This stretch gets at the piriformis muscle of the hip flexor. Sit with both legs extended in front of you. Bend the right knee and place the right foot on the floor. Place your right hand behind you and hook your left elbow on the outside of the right knee. As you twist toward the righthand side, keep your spine straight and breathe deeply. Switch sides after about 20 seconds.
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.”
In both younger and older patients, vertebral fractures take weeks to heal with rest and pain relievers. Compression fractures of vertebrae associated with osteoporosis can also be treated with a procedure called vertebroplasty or kyphoplasty, which can help to reduce pain. In this procedure, a balloon is inflated in the compressed vertebra, often returning some of its lost height. Subsequently, a "cement" (methymethacrylate) is injected into the balloon and remains to retain the structure and height of the body of the vertebra. Pain is relieved as the height of the collapsed vertebra is restored.
If you have hip pain, you may benefit from the skilled services of a physical therapist to help determine the cause of your pain. Your PT can work with you to develop a treatment strategy to treat your hip pain or hip discomfort. Understanding why your hip is hurting can help your physical therapist and doctor prescribe the right treatment regimen for your specific condition.
Take a step back and think about where you spend most of your day. If you're a young athlete, you probably spend most of your time at school or maybe work or practice and even a little time at home, if you're lucky. Now think about what position your body is in during those periods. I would bet that you spend most of your day sitting down. You may walk to class or run in practice, but the majority of your day is spent in a seated position.
Bridge: Still lying on your back with your feet flat on floor, lift your hips and torso off the floor into a bridge. Then interlace your hands underneath your hips and press your shoulders and upper arms into the floor, lifting your hips higher. Hold for 10 seconds. Lower yourself slowly back down, rolling down from the top of your spine to your tailbone. Repeat three times.
Sit on floor with knees bent and shins stacked with right leg on top. Use your hand to position right ankle on left knee. Ideally, the right knee will rest on the left thigh, but if your hips are tight, your right knee may point up toward the ceiling (overtime, as your hips become more open, your knee will lower). Keeping your hips squared to the front of the room, hinge at the hips and slowly walk hands slightly forward. If this is enough of a stretch, hold here, or fold your torso over your thighs to go deeper. Hold for at least 30 seconds, then repeat on opposite side.
Hip flexors. These hardworking muscles are crucial in foundational movements such as sitting, standing, walking and running — they act as a bridge connecting your torso to your lower body. Some muscles in this group can be notoriously weak or tight and those of you who have ever had issues with this part of your body will know the uncomfortable pain of either all too well. There’s a lot of debate in the world of sports science over how much you should strengthen and stretch your hip flexors — we’ll explain.
Bone scans are used to detect and monitor infection, fracture, or disorders in the bone. A small amount of radioactive material is injected into the bloodstream and will collect in the bones, particularly in areas with some abnormality. Scanner-generated images can be used to identify specific areas of irregular bone metabolism or abnormal blood flow, as well as to measure levels of joint disease.
The good news is that there are plenty of good hip stretches out there that you can do to relieve discomfort, decrease tightness, and increase mobility in your hips. Since your hips are involved in so many of the movements you make (both inside and outside of the gym) stretching them is a great way to keep them feeling good and ready to work for you. Add some of the 12 hip stretches Atkins demos below to the end of your workout, or spend 10 minutes each day just doing a few of them, to improve mobility in your hips.
The discs are pads that serve as "cushions" between the individual vertebral bodies. They help to minimize the impact of stress forces on the spinal column. Each disc is designed like a jelly donut with a central, softer component (nucleus pulposus) and a surrounding, firm outer ring (annulus fibrosus). The central portion of the disc is capable of rupturing (herniating as in a herniated disc) through the outer ring, causing irritation of adjacent nervous tissue and sciatica as described below. Ligaments are strong fibrous soft tissues that firmly attach bones to bones. Ligaments attach each of the vertebrae to each other and surround each of the discs.
It is not clear whether men or women have higher rates of low back pain. A 2012 review reported a rate of 9.6% among males and 8.7% among females. Another 2012 review found a higher rate in females than males, which the reviewers felt was possibly due to greater rates of pains due to osteoporosis, menstruation, and pregnancy among women, or possibly because women were more willing to report pain than men. An estimated 70% of women experience back pain during pregnancy with the rate being higher the further along in pregnancy. Current smokers – and especially those who are adolescents – are more likely to have low back pain than former smokers, and former smokers are more likely to have low back pain than those who have never smoked.
"Lower back pain is the most common musculoskeletal ailment in the U.S., and can often be mitigated by strengthening the core musculature," Blake Dircksen, D.P.T., C.S.C.S., a physical therapist at Bespoke Treatments New York, tells SELF. "The 'core' is a cylinder of abdominal and back muscles that wraps around the body like a corset," Dircksen explains. (The glutes are also considered a part of the core, since they connect to the pelvis and ultimately the back and abdominal muscles.) As with any muscles, by strengthening them, you will increase the amount of weight your lower back can comfortably move, which means it will be better equipped to handle the same stress from your workouts and everyday life without getting as achey.
Kneel on your mat with your thighs perpendicular to the floor and tops of your feet facing down. Bring your inner knees together. Slide your feet apart so they are slightly wider than your hips and press the tops of your feet evenly into the mat. Slowly sit down between your feet. Use your hands to turn the top of your thighs inward. Then, lean back onto your forearms and slowly lower torso to floor. Hold for at least 30 seconds.
Intervertebral disc degeneration is one of the most common mechanical causes of low back pain, and it occurs when the usually rubbery discs lose integrity as a normal process of aging. In a healthy back, intervertebral discs provide height and allow bending, flexion, and torsion of the lower back. As the discs deteriorate, they lose their cushioning ability.
An injury to a ligament is called a sprain, and an injury to muscle or tendon is called a strain. Sprains and strains may be caused by repetitive movements or a single stressful incident. Symptoms and signs include pain and swelling. Though treatment depends upon the extent and location of the injury, rest, ice, compression, and elevation are key elements of treatment.
^ Dubinsky, R. M.; Miyasaki, J. (2009). "Assessment: Efficacy of transcutaneous electric nerve stimulation in the treatment of pain in neurologic disorders (an evidence-based review): Report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology". Neurology. 74 (2): 173–6. doi:10.1212/WNL.0b013e3181c918fc. PMID 20042705.
If you’re someone who’s got a good stretching routine down, both before and after a HIIT workout, bike ride or run, odds are the discomfort you feel indicates that there are grounds for more strengthening exercises. It’s important to add that many yogis with extremely flexible hips run into overstretching injuries like hip flexor strains. But, these injuries aren’t just limited to the uber-flexible. Runners, cyclists, and Stairmaster lovers might strain these muscles due to frequent overuse. We’ll share a hip flexor workout below but, first up, some stretches.
Even though low back pain can sometimes be treated without major disruption to a person's life, athletes are often reluctant to seek medical help. Many of them deny or minimize complaints in order to avoid consequences, such as: having to decrease activity in order to recover, losing a position or being removed from a team, missing a competition, or letting the team down. Some athletes simply do not want to bother seeing a doctor for pain; they hope it will recover on its own.
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.
The AANS does not endorse any treatments, procedures, products or physicians referenced in these patient fact sheets. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific neurosurgical advice or assistance should consult his or her neurosurgeon, or locate one in your area through the AANS’ Find a Board-certified Neurosurgeon” online tool.
^ Jump up to: a b c Furlan AD, Yazdi F, Tsertsvadze A, Gross A, Van Tulder M, Santaguida L, Gagnier J, Ammendolia C, Dryden T, Doucette S, Skidmore B, Daniel R, Ostermann T, Tsouros S (2012). "A systematic review and meta-analysis of efficacy, cost-effectiveness, and safety of selected complementary and alternative medicine for neck and low-back pain". Evidence-Based Complementary and Alternative Medicine. 2012: 1–61. doi:10.1155/2012/953139. PMC 3236015. PMID 22203884.
Congenital bone conditions: Congenital causes (existing from birth) of low back pain include scoliosis and spina bifida. Scoliosis is a sideways (lateral) curvature of the spine that can be caused when one lower extremity is shorter than the other (functional scoliosis) or because of an abnormal architecture of the spine (structural scoliosis). Children who are significantly affected by structural scoliosis may require treatment with bracing and/or surgery to the spine. Adults infrequently are treated surgically but often benefit by support bracing. Spina bifida is a birth defect in the bony vertebral arch over the spinal canal, often with absence of the spinous process. This birth defect most commonly affects the lowest lumbar vertebra and the top of the sacrum. Occasionally, there are abnormal tufts of hair on the skin of the involved area. Spina bifida can be a minor bony abnormality without symptoms. However, the condition can also be accompanied by serious nervous abnormalities of the lower extremities.