Shingles (herpes zoster) is an acute infection of the nerves that supply sensation to the skin, generally at one or several spinal levels and on one side of the body (right or left). Patients with shingles usually have had chickenpox earlier in life. The herpes virus that causes chickenpox is believed to exist in a dormant state within the spinal nerve roots long after the chickenpox resolves. In people with shingles, this virus reactivates to cause infection along the sensory nerve, leading to nerve pain and usually an outbreak of shingles (tiny blisters on the same side of the body and at the same nerve level). The back pain in patients with shingles of the lumbar area can precede the skin rash by days. Successive crops of tiny blisters can appear for several days and clear with crusty inflammation in one to two weeks. Patients occasionally are left with a more chronic nerve pain (postherpetic neuralgia). Treatment can involve symptomatic relief with lotions, such as calamine, or medications, such as acyclovir (Zovirax), for the infection and pregabalin (Lyrica) or lidocaine (Lidoderm) patches for the pain.

Low back pain can be caused by tumors, either benign or malignant, that originate in the bone of the spine or pelvis and spinal cord (primary tumors) and those which originate elsewhere and spread to these areas (metastatic tumors). Symptoms range from localized pain to radiating severe pain and loss of nerve and muscle function (even incontinence of urine and stool) depending on whether or not the tumors affect the nervous tissue. Tumors of these areas are detected using imaging tests, such as plain X-rays, nuclear bone scanning, and CAT and MRI scanning.


The lower back where most back pain occurs includes the five vertebrae (referred to as L1-L5) in the lumbar region, which supports much of the weight of the upper body. The spaces between the vertebrae are maintained by round, rubbery pads called intervertebral discs that act like shock absorbers throughout the spinal column to cushion the bones as the body moves. Bands of tissue known as ligaments hold the vertebrae in place, and tendons attach the muscles to the spinal column. Thirty-one pairs of nerves are rooted to the spinal cord and they control body movements and transmit signals from the body to the brain.
The lower back where most back pain occurs includes the five vertebrae (referred to as L1-L5) in the lumbar region, which supports much of the weight of the upper body. The spaces between the vertebrae are maintained by round, rubbery pads called intervertebral discs that act like shock absorbers throughout the spinal column to cushion the bones as the body moves. Bands of tissue known as ligaments hold the vertebrae in place, and tendons attach the muscles to the spinal column. Thirty-one pairs of nerves are rooted to the spinal cord and they control body movements and transmit signals from the body to the brain.

Example: a friend of mine went to the hospital after a motorcycle accident. He’d flown over a car and landed hard on his head. Bizarrely, he was sent home with very little care, and no imaging of his back, even though he was complaining of severe lower back pain. A doctor reassured him that it was just muscle spasms. (This all happened at a hospital that was notorious for being over-crowded and poorly run.) The next day, still in agony, he went to see a doctor at a walk-in clinic, who immediately took him for an x-ray … which identified a serious lumbar fracture and imminent danger of paralysis. He had been lucky to get through the night without disaster! He was placed on a spine board immediately and sent for surgery. The moral of the story? Sometimes, when you’ve had a major trauma and your back really hurts, it’s because your back is broken. BACK TO TEXT


Deanna is an ACE® certified personal trainer, Balanced Body® Pilates instructor, and NASM® Fitness Nutrition Specialist. She is passionate about inspiring others to lead a healthier lifestyle through fun workouts and healthy food. When she’s not creating new workouts and recipes for her blog The Live Fit Girls she enjoys running with her two dogs and traveling.


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.
I think you should mention that for some people, stretching is not the solution and that it will deteriorate their posture. Some people need stretching, but most people I know need to strengthen their "overstretched" hip flexors. Many people can't do a single hanging leg raise. Check this site if you want to know more about the importance of hip flexors ********** www.smarterpage.wixsite.com/unlock-
This information is not designed to replace a physician's independent judgment about the appropriateness or risks of a procedure for a given patient. Always consult your doctor about your medical conditions or back problem. SpineUniverse does not provide medical advice, diagnosis or treatment. Use of the SpineUniverse.com site is conditional upon your acceptance of our User Agreement

Traction involves the use of weights and pulleys to apply constant or intermittent force to gradually “pull” the skeletal structure into better alignment. Some people experience pain relief while in traction, but that relief is usually temporary. Once traction is released the back pain tends to return. There is no evidence that traction provides any longterm benefits for people with low back pain.
Nerve block therapies aim to relieve chronic pain by blocking nerve conduction from specific areas of the body. Nerve block approaches range from injections of local anesthetics, botulinum toxin, or steroids into affected soft tissues or joints to more complex nerve root blocks and spinal cord stimulation. When extreme pain is involved, low doses of drugs may be administered by catheter directly into the spinal cord. The success of a nerve block approach depends on the ability of a practitioner to locate and inject precisely the correct nerve. Chronic use of steroid injections may lead to increased functional impairment.
The bones of the hip are supported by specific muscles. The strongest muscle in the body is actually one of the main flexors of the hip, it is called the iliopsoas muscle. It has two attachments to the inner part of the hip as well as the lower part of the back. This muscle is involved in iliopsoas tendinitis, iliopsoas bursitis, and is one of the most common causes of muscle pain that causes hip pain. The tendons attach the muscles to the bones and the ligaments attach bone to bone. Areas that are often susceptible to increased pressure are the tendons or the muscles attached to the bone, so that is another source of pain in iliopsoas tendinitis. The bursa are pockets of fluid that also protect the top part of the bone to prevent pressure on the bone. There are about 160 bursa in the body, and when they get irritated, it can develop into bursitis.

Bleeding in the pelvis is rare without significant trauma and is usually seen in patients who are taking blood-thinning medications, such as warfarin (Coumadin). In these patients, a rapid-onset sciatica pain can be a sign of bleeding in the back of the pelvis and abdomen that is compressing the spinal nerves as they exit to the lower extremities. Infection of the pelvis is infrequent but can be a complication of conditions such as diverticulosis, Crohn's disease, ulcerative colitis, pelvic inflammatory disease with infection of the Fallopian tubes or uterus, and even appendicitis. Pelvic infection is a serious complication of these conditions and is often associated with fever, lowering of blood pressure, and a life-threatening state.
Bony encroachment: Any condition that results in movement or growth of the vertebrae of the lumbar spine can limit the space (encroachment) for the adjacent spinal cord and nerves. Causes of bony encroachment of the spinal nerves include foraminal narrowing (narrowing of the portal through which the spinal nerve passes from the spinal column, out of the spinal canal to the body, commonly as a result of arthritis), spondylolisthesis (slippage of one vertebra relative to another), and spinal stenosis (compression of the nerve roots or spinal cord by bony spurs or other soft tissues in the spinal canal). Spinal-nerve compression in these conditions can lead to sciatica pain that radiates down the lower extremities. Spinal stenosis can cause lower-extremity pains that worsen with walking and are relieved by resting (mimicking the pains of poor circulation). Treatment of these afflictions varies, depending on their severity, and ranges from rest and exercises to epidural cortisone injections and surgical decompression by removing the bone that is compressing the nervous tissue. 

I’m not endorsing or saying these stretches are a miracle cure, but I definitely think they’ve helped. I’ve even started to add a few gentle yoga poses and pilates moves which I could so easily do, back in the day, when I was 63 kilos and participated in the greatest oxymoron ever named … a thing called the Fun Run. If I’m not careful, and I keep stretching away each day, I could end up with a 6 pack and back to my 5′ 7″ instead of 5′ 5″.
Start in a runner’s lunge with right leg forward, right knee over right ankle and back leg straight. Walk right foot over toward left hand, then drop right shin and thigh to the floor, making sure to keep right knee in line with right hip. Allow left leg to rest on the floor with top of left foot facing down. Take a moment to square your hips to the front of the room. Hold here, or hinge at hips and lower torso toward floor, allowing head to rest on forearms. Hold for at least 30 seconds, then repeat on opposite side. You want to feel a moderate stretch in the outside of the right thigh, but if this pose hurts your knees or feels too uncomfortable, stick with Thread the Needle.

The hip flexors play an important role in everyday mobility and exercise. Involved in pulling the knee toward the hip, most movements either directly or indirectly use the hip flexors. That’s why even the slightest injury can cause great discomfort. Learn how you can recover from a hip flexor injury, and what precautions can be taken to avoid them. 
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